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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
"Patient-time", "doctor-time", and "institution-time": perceptions and definitions of time among doctors who become
1Center for Bioethics, College of Physicians & Surgeons and Mailman School of Public Health, Columbia University, 1051 Riverside Drive, Unit 29, New York, NY 10032, USA. rlk2@columbia.edu
Objective:
To examine views and experiences of conflicts concerning time in healthcare, from the perspective of physicians who have become patients.
Methods:
We conducted two in-depth semi-structured 2-h interviews concerning experiences of being health care workers, and becoming a patient, with each of 50 doctors who had serious illnesses.
Results:
These doctor-patients often came to realize as they had not before how patients experience time differently, and how "patient-time", "doctor-time", and "institution-time" exist and can conflict. Differences arose in both the long and short term, regarding historical time (prior eras/decades in medicine), prognosis (months/years), scheduling delays (days/weeks), daily medical events and tasks (hours), and periods in waiting rooms (minutes/hours). Definitions of periods of time (e.g., "fast", "slow", "plenty", and "soon") also varied widely, and could clash. Professional socialization had heretofore impeded awareness of these differences. Physicians tried to address these conflicts in several ways (e.g., trying to provide test results more promptly), though full resolution remained difficult.
Conclusions:
Doctors who became patients often now realized how physicians and patients differ in subjective experiences of time. Medical education and research have not adequately considered these issues, which can affect patient satisfaction, doctor-patient relationships and communication, and care.
Practice Implications:
Physicians need to be more sensitive to how their definitions, perceptions, and experiences concerning time can differ from those of patients.
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