The physician-patient relationship is the key to successful diagnosis and treatment. However, it has two sides, and in this article, we examine the physician's perspective. What is their perception of patients? Are they satisfied with their patient-physician relationships? We asked physicians about their needs and struggles when working with patients on a daily basis.
At a glance:
Understanding challenges that physicians face
Asking general questions is the way to start. That way, we learn what’s on physicians' minds. It is also the gateway to insider information about the field. That is why the Infermedica team invited physicians to an Individual In-depth Interview (IDI). The goal was to understand physicians’ perspectives and their needs, and ask additional questions to get the full picture of the challenges they face in communicating with patients.
Our researchers also ran interviews with patients. Check out their results →
Why is running IDIs so important? At Infermedica, we create solutions that support healthcare. Our goal is to answer the needs of the real end-users, and IDIs help us see problems through their eyes. Understanding the actual user is invariably important to us.
Scope of the physician IDI
Within our research, we spoke with general practitioners with a minimum of 2 years’ experience working in public and private health organizations. Among other questions, we asked them about:
- Their experience working at a physician's office
- Their routine tasks and rituals in the consulting room
- The flow of medical consultations
- Their needs during and after visits
- Challenges they face while working with patients
- The ideal setup for consultations
Insights for researchers and healthcare managers
Analyses of users' needs and behaviors are important for researchers, as they help us develop new and improve existing solutions. They are also crucial to healthcare organizations, providers, and insurers, as they bring essential insights on how businesses can improve.
IDIs bring additional perspectives on the needs of working physicians and help them express concerns from a safe distance. As the study was conducted by external researchers, it helped physicians open up more and to consider possible solutions without worrying about employment repercussions or interpersonal conflicts.
For physicians taking part in the research, it was also a moment to take a deep breath and reflect on their work, patients, and how they interact. It was a way to highlight the daily routines, stress, and rushing that often lead to physician burnout, turnover, and in the longer perspective—physician shortage.
The biggest challenges physicians face working with patients
1. Patients surprised with visit length
There seems to be a mismatch between what patients expect and what physicians can provide when it comes to visit length. Physicians interviewed commented that patients will often state that visits are too short or too long. The reality is that physicians only have a predefined time to consult with patients. This situation often causes tensions on both sides.
2. Too many topics at once
Patients may often try to address several problems at one visit with limited time scheduled. This can lead to missing the main reason for the visit, miscommunication, and unnecessary stress for both patient and physician. Keeping in mind that visit times are limited, patients should be instructed on how to prioritize their concerns and should be informed that often a physician will only have time for one or two issues.
“Patients are poorly prepared for the visit,” comments Marcin, a physician participating in the IDIs. “It would be great if the patient registration would remind them how to prepare before the appointment.”
3. Patients unsure what symptoms to report
Patients often come to the visit unprepared; they are unsure about the symptoms they are experiencing and have trouble reporting symptom duration and intensity. They often lack the language to describe their symptoms. Instead of efficient information transfer, physicians need to interview patients, often at length, and learn their symptoms from their stories.
4. Patients don’t understand medical processes
Physicians note that patients often don't know their own medical history or family's medical history and don't remember what medications they take. Patients can easily get overwhelmed when presented with medical terms. They also often seem stressed during the visit, and when they hear a repeated question, they get frustrated.
5. Inability to consult in a short time
In some cases, physicians aren’t sure about their patient’s symptoms. They may use digital sources to research conditions or consult their colleagues. This must often be done during the patient interview, which can further limit face-to-face time between patient and physician, resulting in more anxious and unhappy patients.
6. Adding data to EHRs/EMRs
Interviewed physicians declared that administrative duties like adding data to digital EMR or EHR systems is a struggle. Many make notes on paper and transfer them to the system after the visit, as EHRs may not have user-friendly UIs or because physicians do not want to appear to be staring at a screen while the patient is talking. This duplication of work creates more time pressure on the physician, limits the number of patients they can see, and introduces room for error. Over time, these routine tasks can lead to physician burnout.
“I usually enter the documentation at the end of the visit ... at the beginning of the meeting, I focus on talking to the patient. Typing data into the computer is received by the patient as if I did not focus on them.” comments Agata, interviewed physician.
7. Patients not completing treatment
Physicians report that patients often do not follow the prescribed treatment regimen, either immediately after the consultation (by not filling the prescription or not attending the referral), or after a few days by stopping the treatment early. The reason for this varies. Patients may not understand the instructions given or may not agree with the physician’s assessment. They may not be able to afford the prescribed therapy or they may not be able to attend (or may be unaware of the dates for) a referral. Because of this, treatments are often not completed as they were intended to be, resulting in poorer outcomes and a prolonged recovery process.
“Patients often do not follow what was recommended to them. They only follow the simplest part of the treatment, often adjusting it to their convenience,” comments Piotr, a physician taking part in the research.
8. High levels of mutual stress
Small misunderstandings, limited consultation time, patient uncertainty, and the high number of tasks required by physicians all lead to high levels of stress for all parties. They also make diagnosis and treatment more challenging.
These results are not surprising. They confirm what we’ve been hearing about physicians and patients for years. Yet these challenges still have not been successfully solved.
How can we improve medical consultations?
Physician-patient meetings are important and often intimate, where conversation and observation are the foundation to achieving a correct diagnosis. If there is not enough time or space for physicians to do their best, they often experience low levels of satisfaction, stress, and decreased quality of medical advice. Physicians work under high pressure, there is no doubt about it.
According to Medscape's research, over 42% of physicians experienced burnout in 2021. This number grew to 47% in 2022.
A solution to this problem isn’t easy. On one hand, we should look for system improvements; on the other, we should ensure better preparation and education for patients. Researchers working here at Infermedica teamed up with engineers and doctors to seek technological support for these challenges. What we have developed is a solution that runs a preliminary medical interview before the visit—collecting patient intake data and medical histories.
First, the Intake solution prepares patients for their visit and organizes their medical information for the doctor, giving patients more time to consider their needs before the visit. Then, it asks them dynamic questions about related symptoms, and thus gathers a complete symptom profile for the physician. Finally, physicians, equipped with patient data, have more time to verify symptoms, ask about details, and establish the most likely diagnosis. The collected information can be easily transferred to internal data systems, taking a load off physicians’ shoulders.
“Individual In-depth Interviews (IDIs) are a great resource for designers working on new solutions,” comments Alicja Jędrzejas, UX designer at Infermedica. “While building the Intake, we've repeatedly revisited the interviews with physicians. Throughout solution development, from ideation to MVPs, we've listened to physicians and their actual needs. They helped us to understand and later solve their challenges.”