Is 23 seconds enough? Why doctors don't listen

You walk into your primary care doctor's office, tired, sick, perhaps too muddled to talk about what you're feeling, but definitely needing medical attention for that migraine or flu...you know, the one that has you knocked out and desperate for relief. A nurse takes you into a waiting room and you sit, perhaps on a torn piece of paper on an exam table, uneasily waiting for your doctor to make his or her ritual appearance.

He appears, and bam! It's showtime. Guess what...you've got 23 seconds to make the case for what you need.  No, that isn't a typo. Not 23 minutes...23 seconds. That's how long it the average primary care doctor actually pays attention to what you're saying, according to a recent study by a professional research organization.

Why is this? It's easy to trot out stereotypes that sound right. But they're not. Here's some myths worth busting:

• You're just a number to them:  OK, some doctors may click into robot mode, but many, many care enormously about what they do and give as much of themselves as they can. The problem is that they're forced to see as many patients as they can if they want to make a living, because your health insurer probably isn't paying them nearly enough. (And *that's* a tale of its own.)
  
• They're too arrogant to pay attention to you:  Again, given a group of many thousands of human beings, there's going to be some MDs who have the famous "God complex." But many others just dig in and do their best to make suffering people feel better. They're just overwhelmed.
• They're too rich to understand ordinary people's problems: OK, I'll admit that in the case of some high-flying specialists, there might be some truth to this one.  (Radiologist salaries? $700,000 a year plus. Ack!) But in the case of your basic family medicine doctor, the one you see most often, think again.  The average primary care doctor makes, say, about $150,000 a year, a nice salary to be sure but not so great if a) you have *gigantic* student loans to pay off and b) you work 70 hours a week.  In the big cities, they're just upper middle class folks.

So how do we understand what's going on in this brief half-minute flash of interaction?  Honestly, they work this way because they're smart, they're busy, and it's usually enough to get the job done.  Let's face it -- most of us don't show up with exotic diseases. We get colds and migraines and asthma, stuff that's pretty much grade school for someone who's been to college and residency for a ten year stretch. Basically, we're no-brainers to them.

That being said, I do feel a bit uncomfortable at times that my smart, friendly primary care physician and I can't bond a little bit -- hell, talk about Anna Nicole Smith or what he thinks about the doctoring that takes place on dramas like House. It is a bit awkward, even for an extrovert like me, to discuss female troubles with a very detached, hurried guy who's ten years younger than me and pretty set in his opinions. But for him, I guess, getting straight to the point IS breaking the ice.

I guess what it comes down to is that even if he doesn't hear me for more than a little bit of time, if he's sharp enough to gather  the facts into that super-processor brain of his, it'll have to do. If I want bonding, I'll have to get a pet.  But if I want an amoxicillin prescription for my bronchitis, I'm glad that my half-a-minute with Dr. Paster fits the bill.