Why does your doctor seem so rushed and dismissive? That bedside manner may be the result of the health care system
In the fast-paced environment of healthcare, many patients have experienced the frustration of rushed medical visits, often feeling unheard and dismissed by their doctors. This sentiment is echoed in a recent national poll revealing that over half of U.S. adults believe their health concerns have been overlooked by medical professionals. While it’s easy to place blame on individual doctors for these hurried interactions, the reality is that systemic issues within healthcare organizations significantly contribute to this phenomenon. Factors such as productivity pressures, administrative burdens, and flawed payment models often dictate how care is delivered, leaving physicians with little time for meaningful patient engagement.
As healthcare systems increasingly prioritize efficiency over quality, doctors find themselves overwhelmed by heavy workloads and administrative tasks. Many have transitioned from private practices to employment within larger healthcare organizations, often under the ownership of private equity firms. This shift has resulted in diminished control over their schedules, forcing them to see more patients in less time. The consequences are profound: rushed visits can lead to misdiagnoses, prescription errors, and prolonged hospital stays, which can adversely affect patient health outcomes. Research indicates a direct correlation between healthcare professionals’ workloads and the quality of care provided, with studies showing that higher nurse workloads are linked to increased mortality rates among hospitalized patients.
However, the article emphasizes that these administrative harms are not insurmountable. Both patients and healthcare providers can advocate for change. Patients are encouraged to assert their needs during appointments and provide feedback to healthcare administrators about their experiences. Doctors and care teams should not accept unsustainable working conditions as the norm; instead, they need to communicate the impact of their workloads on patient care. By fostering a collaborative approach, where patients and doctors join forces to push for better staffing, adequate appointment times, and supportive policies, meaningful improvements in healthcare delivery can be achieved. With the right systemic changes, healthcare interactions can become more patient-centered, ultimately leading to improved outcomes and a more satisfying experience for both patients and providers.
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Behind hurried moments are care teams that are working within a health care system that is often stretched too thin.
Morsa Images/DigitalVision via Getty Images
We’ve all been there: You wait 45 minutes in the exam room when the doctor finally walks in.
They seem rushed. A few questions, a quick exam, a glance at the clock and then a rapid-fire plan with little time for discussion – and you leave
feeling unheard, hurried and frustrated
.
And what if you’re hospitalized? You may face a similar experience.
More than half of U.S. adults say their doctors have ignored or dismissed their concerns, or not taken their symptoms seriously, according to a
December 2022 national poll
.
It’s easy to blame the doctor. But the reality is, most doctors would like to sit down and
have an in-depth conversation
with patients and their families. Instead, your unpleasant visit may be the result of
productivity pressures and administrative burdens
, often shaped by health care systems,
payment models and policy decisions
that influence how care is delivered.
Patients are increasingly experiencing what’s known as
administrative harm
– those unintended but very real consequences arising from administrative decisions, made far upstream, that directly influence how doctors practice. Ultimately, these types of interactions
affect the care patients receive
and
their outcomes
.
As a doctor and researcher
who specializes in business and health care delivery, I’ve studied how organizational decisions have ripple effects, shaping patients’ relationships with their doctor and the quality of care they receive. Patients may be unaware of these upstream administrative decisions, but they affect everything from time allotted for an appointment to the number of patients the doctor has to see and whether a visit is covered by insurance.
Quality interactions of doctors and patients, like this one, are at risk of becoming too few and far between.
ljubaphoto/E+ via Getty Images
A look behind the scenes
Increasingly, health care organizations and physician groups
face intense financial pressures
. Many doctors can no longer sustain their private practice due to declining reimbursements, rising costs and
increasing administrative burdens
; instead, they’ve become employees of larger health care systems. In some cases, their practices have been
acquired by private equity groups
.
With this shift, doctors have less control over their workloads and the time
they get with their patients
. More and more,
payment models fail to cover
the true cost of care. The default solution is often for doctors to see more patients with less time for each, and to
squeeze in additional work after hours
.
But that approach comes with costs, among them the time needed to
build meaningful connections with patients
. That negative, impolite tone you may have experienced might be because the doctor has many patients waiting and a full evening ahead just to
catch up on writing visit notes
, reviewing medical records and completing other required documentation. During the work day, they’re often fielding over
100 messages and alerts daily
, including referrals and coordinating care, all while trying to focus on the patient in front of them.
But the consequences go beyond their bedside manner. Research makes clear that doctors’ performance and the quality of care patients receive are
affected by their workload
. A similar pattern is true with nurses: Their higher workloads are
associated with higher death rates
among hospitalized patients.
Suppose you’re hospitalized for pneumonia, but because your doctor is caring for too many patients, your hospital stay is longer, which increases your
risks of infection, muscle loss and other adverse outcomes
. In the doctor’s office, a rushed visit can mean
delayed or missed diagnoses
and even
prescription errors
.
About half of U.S. doctors
report feelings of burnout
, and about one-third are considering
leaving their current job
, with 60% of those likely
to leave clinical practice entirely
.
Long work hours also brings higher risks of
heart disease, stroke and other health problems
for health care professionals. In the U.S., 40% of doctors
work 55 hours per week or more
, compared with less than 10% of workers in other fields.
A doctor’s rushed demeanor can sometimes stem from a heavy administrative load of reviewing notes and medical records.
andresr/E+ via Getty Images
A better way
The administrative harms stemming from upstream decisions are not inevitable. In large part, they are preventable. Overhauling the health care system may seem daunting, but patients and doctors are not powerless.
Patients and their families
must advocate for themselves
. Ask questions and be direct. This phrase: “I am still really worried about … ” will quickly get your doctor’s attention. If your visit seems rushed, share it with
patient representatives
or through patient surveys. These insights help administrative leaders recognize when systems are falling short.
Doctors and care teams should not normalize unsustainable work conditions. Health systems need structured, transparent mechanisms that make it easy and safe for doctors and care team members to report when workloads, staffing or administrative decisions
may be harming patients
.
Even more powerful is when patients and their doctors speak up together. Collective voices can drive meaningful change – such as lobbying for adequate time, staffing or policies
to support high-quality, patient-centered care
. It is also important for administrative leaders and policymakers to take responsibility for how decisions affect both patients and the care team.
More research is needed to define what safe, realistic work standards look like and how care teams should be structured. For example, when does it make sense for a doctor to provide care, or a
physician assistant or nurse practitioner
? At the same time, health systems have the opportunity to
think creatively about new care models
that address clinician shortages.
But research shows that the medical profession can’t afford to wait for perfect data to act on what’s already clear. Overworked and understaffed teams
hurt both patients and their doctors
.
Yet when doctors do have enough time, the interactions feel different – warmer, more patient and more attentive. And as research shows,
patient outcomes improve as well
.
Dr. Marisha Burden reports funding from the Agency for Healthcare Research and Quality, the National Institute for Occupational Health and Safety, University of Colorado Innovations digiSPARK award, Med-IQ and the American Medical Association not related to this work. Dr. Burden contributed to the development of GrittyWork, a digital workforce application, and a registered trademark of the University of Colorado not related to this work. The author utilized the ChatGPT language model developed by OpenAI and Microsoft Co-pilot for editing of original author content to improve readability.
