By Julia Ranniko Jun 30, 2008, 3:07 GMT
Berlin - For many patients, consultations with a doctor are often frustrating. The doctor speaks incomprehensible medical jargon, does not really listen, stares constantly at a computer screen, and has just a few minutes to spare, they complain.
'Doctors' offices are usually jam-packed,' noted the Berlin-based National Association of Statutory Health Insurance Physicians. 'Doctors often have no choice but to see their patients relatively quickly.'
Good doctor-patient relations are important, however, because they can improve the chances of successful treatment. 'It is strongly believed that therapy is much more effective when the doctor communicates optimally with the patient,' remarked Professor Martin Schnell, director of the Institute for Ethics and Communication in Health Care at Witten/Herdecke University.
Schnell said that patients who understood their doctor were more likely to follow the doctor's advice and not, for example, toss prescribed medicines into the trash because the side effects listed in the package insert seemed so frightening.
According to the General Patient Association (APV) in Marburg, the payment system for doctors in Germany is the main reason that patients continue to complain of 'three-minute medicine.'
'It's still in doctors' interests to see as many patients as possible, have brief consultations, and do unnecessary procedures in order to increase revenues,' criticised APV President Christian Zimmermann. He said the most lucrative patients at present were the chronically ill who showed up every three months.
Wolfgang Grebe, an internist and sports physician from the German town of Frankenberg, argues that doctors should be paid for the amount of time they spend with patients, including patients covered by public health insurance.
'You'll only have time to spend with the person if you're paid better,' he said. 'That would get to the root of the problem.'
It is difficult to put a number on how long a medical consultation should be, though. Grebe believes that at least half an hour is necessary for the initial visit, during which the doctor takes down the patient's medical history. For checkups, 10 to 15 minutes are sufficient, he said.
'But there are calculations by doctors' associations that come to four to seven minutes,' and in some doctors' offices, between 120 and 150 patients are 'marched through' every day, Grebe said.
How can a patient get a doctor to speak with him or her at length? By preparing well for the visit, experts agree. 'You should inform yourself beforehand and make a list of questions,' advised Ingolf Duerr of the German Green Cross in Marburg. 'Otherwise, at some point you'll only be listening and won't have the nerve to ask.'
Sources of information include the internet, medical dictionaries, public health insurance companies, and the public health department, Duerr said. And if a doctor uses a medical term that is unclear, the patient should simply say so.
'Normally it can't be explained with another word, but with two or three sentences,' Duerr said.
Schnell has another piece of advice, one that can be hard to follow: Patients should criticise a doctor if need be.
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