Overheard "You're there to make money, not to talk," in clinical

JustaNrsgStudent · Apr 7, 2011

This was actually said by a medical student resident and an attending physician.

CBsMommy · Apr 7, 2011

I had clinical Saturday on Mother/Baby postpartum and I was in the nursery for most of the day. I overheard a resident talking to her attending about how she was more comfortable in the hospital setting, but in the clinic she couldn't get patients to stop talking and asking questions. Word for word this is what I heard her attending say to her, "You'll learn how to make them be quiet, you're there to make money not talk." :angthts:
Seriously?! I about flipped when I heard this because I for one have really crappy health insurance and I'm about to get my yearly check-up and I've been making a short list of things to ask my doctor while I'm there. As crappy as this economy I fully understand that patients are going to be asking more questions while at their appointment to get their money's worth. It just really upset and offended me to hear an attending say that. I was curious what other people's take on doctors were as nurses or nursing students.

I do think this is the way MDs are trained which is unfortunate. The good news is, you can interview doctors and make a choice as to who you go to. The bad news, it may take a while to figure out which MD is right for you. The other bad news, we are limited by our insurance.

I would still take your questions in to your doctor's appointment and try to ask. That may make or break that particular doctor for you (if they are willing to listen to you or not).

BTW, I will say that just like nurses, not all MD's are cut from the same fabric. You may have heard one attending state that but it doesn't mean they all think alike.

ImThatGuy, BSN, RN · Apr 7, 2011

What's wrong? It's more or less realistic. Healthcare or not, most people that work for the public end up not liking anything about working with people after a certain period of time. When you're outside of the academic setting you're exposed to reality. Frankly, I think the attending was being realistic. I know of a local group practice where the administrator refers to patients as "units," lol. That practice (read: business) is also so powerful that it's not going anywhere though and the doctors in it are slowly taking over every element of healthcare in town with the exception of surgical sub-specialites. A kid in my clinical group overheard a nurse refer to one of her assigned patients as a five letter word that rhymes with itch. Her little eyes got big, and she said, "OMG, can you believe she just called that patient that?!" Nurses are not taught to be anymore professional than anyone else. Everyone is a person with human characteristics. I really don't understand the shock, but then again I am a burned out, cynical, distrusting *****rd.

newRNstudent02 · Apr 7, 2011

My comment was deleted. Oh well...I was just pointing out the fact that it's not always about the money.

Moogie · Apr 7, 2011

I've talked to lots of doctors who feel frustrated that they don't get to spend time with their patients. Administration pushes quantity rather than quality. Unfortunately, if a physician or other health care provider can't take time to talk to a patient, important details might get missed. But the bean counters would rather people make appointments for every single complaint to save time rather than have providers spend "too much time" with one visit.

ETA: I don't think it's the doctors who are pushing the idea of making money over taking care of patients. Some do but not all. Rather, it's the mentality of health care today. Many docs are told they can spend only 15 minutes or less with each patient and they're encouraged by their health systems to see more patients in less time.

classicdame, MSN, EdD · Apr 7, 2011

Having worked in MD offices for many years I will say some patients really will suck up the MD's time. They like the attention. In order to get the most done the MD has to learn to get out of a talker's room. Same with nursing. If your patients are old enough to talk, or have parents around, you will find your time is restricted by long conversations. Wish we had the time to spend on patient's more.

~Mi Vida Loca~RN, ASN, RN · Apr 8, 2011

I have had to pay for office visits out of pocket many times. My bill is usually around 200 dollars just for the Docs visit, not including any testing and stuff. The doc usually is in the room for 15 mins. Hmmmmm 200 bucks, 15 mins, yea I will talk his ear off if I please

MsJasmine · Apr 8, 2011

LOL! I'd be talking his ear off too! :)

dudette10, MSN, RN · Apr 8, 2011

IMO, it's the healthcare system at fault. I'm familiar with one payment system that is often used, so I'll explain that one.

Under the capitated payments system (usually via an HMO), a primary healthcare provider is paid a certain amount for each enrollee based on age, gender, etc., hence "capitated." All healthcare for each enrollee is then taken out of the sum of capitated payments. The system was intended to encourage health promotion, i.e. healthier people need less medical care; however, it also means that each time a healthplan member comes into the office, the total amount of money paid to the PCP by the insurance company is used. Whatever amount of capitated payments is left at the end of a certain time period goes straight into the practice's pocket. In effect, the physician has an incentive to not spend much time with you!

I started looking into capitated payment plans because of something that happened to my family. When I was going over the bills with the insurance person at our doctor's office, she made the statement, "Your family is taking all our money." Frankly, I didn't care, but it helped me understand that payment system. My family's care was nearly a half million dollars, all taken out of the capitation payments made by the insurance company to my primary care provider.

A little off-topic, but: A doctor was talking to me about the Medicare system the other day. If anyone ever gets a chance to talk to a friendly doctor about the ways in which Medicare stupidly reduces reimbursements--and the ways that doctors get around the reductions--do it. It is quite enlightening about how messed up our system is.

JustaNrsgStudent · Apr 8, 2011

Maybe I'm young and naive, and I know I have no experience in healthcare (other than clinical), but I just think that's incredibly sad that all these people (nurses and doctors) who supposedly care about people and want to help let CEOs and insurance companies run the way they work. Ultimately you're there to help people get better and I understand that some patients talk your ear off just to do so, but even from a "business perspective" if you provide good thorough "customer service" the patients will come back and that will result in "more money"...right? I'm not trying to criticize anyone whose been in the field I'm learning what healthcare is truly all about, and it's unfortunate.

morte, LPN, LVN · Apr 8, 2011

I had clinical Saturday on Mother/Baby postpartum and I was in the nursery for most of the day. I overheard a resident talking to her attending about how she was more comfortable in the hospital setting, but in the clinic she couldn't get patients to stop talking and asking questions. Word for word this is what I heard her attending say to her, "You'll learn how to make them be quiet, you're there to make money not talk." :angthts:
Seriously?! I about flipped when I heard this because I for one have really crappy health insurance and I'm about to get my yearly check-up and I've been making a short list of things to ask my doctor while I'm there. As crappy as this economy I fully understand that patients are going to be asking more questions while at their appointment to get their money's worth. It just really upset and offended me to hear an attending say that. I was curious what other people's take on doctors were as nurses or nursing students.

actually, this is the best way to get your money's worth...be organized and prioritize. Be assertive but not demanding. Not wandering about (verbally) will save your time and the doc's.