Medicine needs more time

Thank you for the excellent article on falls (“Age and the Rising Risk of Falling,” January 2025). However, I have a concern—perhaps it's a soapbox I've been on for a while. The article includes at least four references to the time limitations of primary care visits. Although I retired from clinical medicine a little more than a decade ago, and completely retired a few years thereafter, I certainly agree that we physicians continue to suffer from utterly unreasonable time constraints in our daily work. We should not, in my opinion, assume that “it has to be this way.”

I attended a meeting for hospital C-suite executives a few years ago when I was a chief medical officer. In a session on improving the patient experience, the presenter, a social worker, started with an introduction that has become ubiquitous: “Thank you for taking time out of your busy schedule to attend this meeting.” During the question-and-answer session (there were no other questions), I asked, “When will we stop starting every health care-related presentation with that phrase?”

I pointed out that by accepting unrealistic time limitations we send a message to our patients, our colleagues, and ourselves that includes variations of the following:

• We're too busy to listen.
• We're overwhelmed.
• We don't have time to carefully consider how we can do our best.

I recall that a few years ago, the American Academy of Family Practice estimated that a standard primary care practice would require 27 hours every day just to properly care for our patients. I believe the Society of General Internal Medicine published a similar statement a few years later. Medicine has become far more complex just over the last two years. I think it's time we said, “Stop.” I hope all physicians will join me in advocating for adequate time to do our best.

Richard S. Frankenstein, MD, MACP
Tustin, Calif.