Thank you for your excellent questions and comments. So far, our discussion has unpacked the problem of “not enough time” to recognize that it is both the duration of the appointment and also the quality of the time that affects our ability to connect with patients. We’ve identified factors that influence quality of time, including quality measures, billing, and the attention which we bring to encounters. Several commentators have affirmed the importance of having time to attend to not only our patients’ biologic diseases but also the psychosocial dimensions of their illnesses. A few of you have offered valuable suggestions for interventions that can help us to better maximize whatever time we have (e.g., meditation practice, increased numbers of support staff, filling in templates before and after the encounter). Yesterday, Dr. Koven pushed us to think more boldly: to move away from efforts to work around requirements and instead to challenge them. Are you aware of, or participating in, any clinician-led movements that challenge the systemic barriers to human connection in medicine? If not, what prevents clinicians from organizing themselves to change the status quo?
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