The Curse of the 15-minute Appointment

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This is a big problem in modern medicine. It refers to the fact that most family doctors and some specialists do not want any appointment to go longer than 10 minutes and certainly no longer than 15. This is largely due the fact that they get paid the same amount for 15 minutes as for 10. It also relates to some shortages in doctors. Insurers demand efficiency and they often incentivize fast turn-overs in the doctor’s office.

This causes the system to try to rush the doctors and their patients. However, it is more complicated than that. Patients want to feel something was done with them, and they may expect or demand an answer or the initiation of a next step or a medication before the 15 minutes is over. As of 2021 in Canada and likely elsewhere, it is extremely unusual to find a patient that has had an detailed assessment of their fibromyalgia risks, precipitating factors, aggravating factors or relieving factors, or any in-depth effort to get at the roots of the problem.

The doctors cannot afford to disappoint them so often the give a prescription. Doctors must try to reduce their liability for making an error and so tests are ordered. This make patients feel that something was done.

The system was not designed for complex poorly explained illness or any of the many types of central sensitization syndromes including fibromyalgia, IBS and migraine. These are exceedingly common conditions. Severe cases are sometimes helped by medications, but rarely cured. The system needs to be adjusted to allow for a more in depth patient approach that focuses on underlying issues such as stress and poor sleep.