10 Minutes to Think

by on May 18, 2023 · 7 comments

in Health, Ocean Beach

The bean counters of medical establishments have figured out how to keep our doctors busy

By Joni Halpern

Take a good look at your doctors the next time you go to see them.  They don’t have time to do more than glance at you, so you can give them a good going over while they engage in cyber-course with computerized algorithms that now dictate every moment of their working life.

You’ll notice a growing number of your doctors look tired; they have bags under their eyes, regardless of their age.  They look as if they could trade places with you on the examining table and sleep for a week.

Often their skin is sagging.  Many of them are putting on a few pounds – the ones they advise us to take off.  You may find yourself wondering how your doctors could put on weight while running from one examining room to the next.

Of course, the medical establishment that employs them urges them to use their lunch break to get some exercise.  But if they step out for a walk, they get behind in their emails, patient notes, and reports.  As a result, they receive warnings and queries from the medical software program about why they did not meet their required number of revenue-producing interactions with patients.

Watch as your doctors race through irrelevant questions the computer software forces them to ask.  You come in for migraines.  The computer requires questions about colonoscopies, vaccinations, and past ailments you may have already attempted to erase or correct in your computerized chart.  Although your doctors may acknowledge these items are irrelevant to the present complaint, they have no choice but to ask them, eating up precious minutes they could have used to ask you about the problem at hand.

Your doctors may hand you surveys the government forces them to provide.  While you busy yourself answering a barrage of questions that have nothing to do with your present concerns, your doctors race to see patients waiting in the next examining room who are sitting on the table, looking at the wall charts, wondering whether they should get dressed.

On your doctors’ faces, you may see frozen images of strain, fatigue, and even despair.  You may try to crack the ice by telling them how much you appreciate what they do for all the patients who come to them.  You may tell them you know how hard they work, how they have given up so much to become well-trained.  But be careful.  They are not used to being appreciated.  It sometimes makes them fight back tears.

If you’re lucky, your doctors may have time to examine you, maybe even converse with you.  But not for long.  They only get about 10 minutes, sometimes less, to complete all tasks for a regular visit, including answering all the computer questions and inputting all new information.  If they ever get 15 minutes, they feel like a racehorse out for a stroll.  Sometimes they have people who write things in the computer for them.  But that doesn’t mean the doctor gets more time with you.

Doctors who have practiced for many years think of their profession as an art that improves with experience and advances in technology.  But a great portion of the art – and the satisfaction that comes from practicing the art – only arises in a relationship in which trust allows the doctor to unearth sensitive, relevant information from patients who would otherwise be reticent to share or perhaps would not think certain essential facts were important.  It takes time to build trust in any relationship, and nowhere is it more valuable than when it is needed to assist in the diagnosis and treatment of a person’s illness.

Having time to think is also important, for it helps doctors pull together their own knowledge and experience, their patient’s information and experience, and the results of technology, all of which become the foundation of better medical outcomes.  Having time to think also allows doctors to feel they are engaged in the interesting and challenging job of identifying cause, effect, and treatment.

But time spent ruminating is not a billable event, so today’s doctors can’t do that on the clock.  Instead, they are tethered to the schedule like Gulliver , with dozens of protocols that maximize billing, filling doctors’ time only with actions that can be monetized.

Take a good look at your doctors.  What you see in large part are intelligent, well-trained human beings who once wanted to serve others, be respected, improve their expertise through experience and exposure to new ideas and technology, and make a decent living.  This may be what they wanted.  It is not what they have.

Today, your doctors are factory workers.  Many of them toil in the health care equivalent of the old Ford factories, where workers were pushed to the limit of production line output.  Were it not for the preeminence of revenue as a goal in every portion of our society, we should not find it necessary to remind ourselves that the medical profession should be different, because human beings are not like Model-Ts.  We are healed in part by the trust we place in our doctors, and in fact, they are nourished by it as well.

It is a theft of the public treasure to rob doctors of the time they need to develop a relationship with patients, think about a case, consult with colleagues, research, teach, or otherwise engage in the full breadth and depth of a profession that has been at the forefront of our advancement as a society.  And that theft is costing us in the growing number of well-trained, experienced physicians who are leaving the field before a normal age of retirement.  It is also costing us in the loss of well-qualified young people who are avoiding the profession in search of more gratifying and appreciated ways of making a living.

Take a good look at your doctor the next time you go in.  Think about what it means to give up your youth in order to excel in college, medical school, residency, fellowship, and all the other types of advanced training required in order for doctors to care for us.  Think what would make a person devote their life to medicine when it means that every day, they will encounter their fellow human beings when we are at our worst – smelly, soiled, bloody, hurting, out of our minds – waiting for them to relieve our discomfort in bodily spaces others would never have the courage to touch.

The bean counters of medical establishments have figured out how to keep our doctors busy enough that lunchtime is a luxury and time spent at home catching up on computer input is commonplace.  Sure, it costs a lot of money to run health care institutions, regardless of whether they are nonprofit or for-profit.

But if we allow our doctors to be forced into practice regimens that rob them of satisfaction and deprive them of emotional nourishment, we will lose them to other “factories” where the student debt is not as large and the professional responsibilities are not as demanding.

Maybe when we see our doctors, we should sit still and not say a word.  That would give them at least 10 minutes to think.

{ 7 comments… read them below or add one }

Frank Gormlie May 18, 2023 at 4:06 pm

This trend that Joni highlights, has been going on for a while now. I’ve seen individuals in certain professions — like doctors and lawyers even — squeezed into being little more than factory workers, working under a false time pressure, trying to crank out “products” (their valuable services). It is called capitalism, I’m afraid, where the bottom line is the all-mighty god.


Bodysurfer Bob May 18, 2023 at 5:11 pm

Beautifully written. Why aren’t we seeing more of your writings?


Joni Halpern May 18, 2023 at 10:19 pm

You haven’t seen more of my writings, Bodysurfer Bob, because in this time we live in, I am often overwhelmed by the breadth and depth of my feelings about so many things that are broken in this country that I can’t find the starting point to express myself. Any suggestions? And thank you for taking the time to read what I wrote.


sealintheSelkirks May 19, 2023 at 8:57 pm

I completely agree with you, Joni. It’s called being ‘dehumanized,’ and I seriously doubt that it is an accident. There is only one small elite group that always benefits from such a society.

Remember that every single (major) empire that has arisen in the last 9,000 years was a slave-owing one. I assume that the current owners are tired of playing games with ‘their’ disposable workers. Been getting rid of those pesky unions, too, which both parties seem to not care much for. Except of course those so-called cop ‘unions’ which always goes against every principle I know of about unions…

To really look around the world and start counting up how many Fascist, Authoritarian, Totalitarian, military Dictatorships, Monarchies, etc etc types of governments are currently on this planet gives one pause as to what our future is, doesn’t it?

But that takes a very strong stomach. Better to just ignore it all, eh? Pretend everything is fine? Firmly place head in sand…

And then we have to remember that every ‘major’ Empire (I read that anthropologists consider the US to be #22) have all done the same thing; rotted from within while using up their available natural resources and then died and/or morphed into chaos or one version or another of the above types.

Then there is this:
US Sold Weapons to Roughly 60% of World’s Authoritarian Nations in 2022: Analysis


No surprise there, is it?

Big sigh, Joni. As I said, I’m right there with you…



Joni Halpern May 22, 2023 at 12:21 pm

Thank you for your thoughts, sealinktheSelkirks. I can see you are thinking several layers down into the quagmire in which we find ourselves these days. I am hoping that all those who care about where we are going will make their voices heard on even the smallest level in which they find us not doing our best. Way beyond the rote rituals of saluting a flag should be our individual commitment to be the best we can be, to do the best we can do, as a testimony to what this country purportedly allows its citizens to accomplish.


Joni Halpern May 22, 2023 at 12:17 pm

I received a private response to this article from a person I respect highly. Here is his comment:

“Unfortunately what you say is true.

I had a chance to speak with a previous doctor that was under some stress from management. I felt so bad that I gave him a couple of hundred in cash and told him to go have a nice dinner.”


nostalgic May 22, 2023 at 2:37 pm

Does anyone know the etiquette for tipping MDs? Many medical groups are owned out of LA now. Same for dentists. Insurance sets the parameters. Kaiser is a different model. A good idea; I don’t know how to present it.


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