As a pediatrician working for NYC Health + Hospitals (H+H), one of the largest public health care systems in the country, I have experienced firsthand the challenges of providing quality care to patients from diverse backgrounds. Whether they are native-born or recently arrived children, my colleagues and I are committed to ensuring they receive the medical attention they need. However, recent administrative changes at H+H have raised concerns about our ability to deliver comprehensive care, particularly for the most vulnerable patients. I am concerned that other healthcare systems may follow suit, compromising the quality of care provided to pediatric patients.
H+H recently announced a significant reduction in appointment times for new patients in both adult primary care and pediatrics, cutting them from 40 minutes to just 20 minutes. This decision deviates from the industry standard, which typically allows 30 to 40 minutes for outpatient visits and 40 minutes for specialists based on the complexity and age of the patient. This reduction in appointment times is not merely an inconvenience; it poses a serious threat to the quality of care provided to pediatric patients.
One critical aspect of pediatric care is ensuring that children receive up-to-date vaccinations, a prerequisite for school attendance. During new-patient pediatric visits, it is essential to ascertain the child’s vaccination history, which can be particularly challenging for children from other countries. Parents may share vaccine records via messaging platforms like WhatsApp, but verifying these records can be time-consuming, as the vaccines administered may differ from those required in the U.S. Ensuring the accuracy and completeness of vaccination records is crucial to prevent potential outbreaks of infectious diseases in schools. While I am able to bridge some communication gaps as a Spanish speaker, many of my colleagues require translators, adding to the time needed to understand the child’s vaccination status.
Attempting to complete this process within a 20-minute appointment is virtually impossible. The first visit with a new patient is crucial for building trust, gathering medical history, and formulating a treatment plan. This process is already challenging with English-speaking patients and becomes even more complex with patients who speak different languages or come from diverse healthcare systems. Rushing through these visits not only compromises the accuracy of diagnoses but also undermines the patient’s experience, potentially discouraging them from seeking future care.
The new policy implemented by H+H forces healthcare providers to rush through patient appointments, which is unfair to patients and places everyone at risk – patients, doctors, and the broader community. Inadequate vaccine coverage can lead to increased risks of infectious diseases such as tuberculosis, measles, and other preventable illnesses. Most healthcare professionals enter this field because they are passionate about helping people and value patient care. Rushing through appointments increases the likelihood of errors, including misdiagnoses, missed tests, and incomplete assessments, ultimately jeopardizing patient outcomes and eroding trust in the healthcare system.
Effective healthcare is not solely about issuing prescriptions or ordering tests; it is about building relationships, making informed recommendations, and collaborating with patients to make decisions about their care. These critical components of care cannot be adequately addressed within a 20-minute window. Physicians and healthcare workers are trained to think critically, communicate effectively, and approach each case with care – rushing through appointments undermines these foundational principles of ethical care.
H+H administrators have justified the reduction in appointment times by citing the overwhelming demand for services and the insufficient number of healthcare providers to meet this demand. While this may be a valid concern, cutting appointment times is not a sustainable solution. Rather than addressing the root issue by hiring more staff, H+H’s policy compromises patient safety and the well-being of medical professionals. Decisions about patient care should be made collaboratively between healthcare providers and patients, not dictated by administrative constraints or financial considerations.
From a financial standpoint, the new policy may appear beneficial for the hospital system, as reimbursement rates for new patients are typically higher than those for follow-up visits. However, this short-term gain comes at a significant cost to the morale of healthcare staff and the safety of patients. The rush to increase revenue through higher patient turnover undermines the quality of care provided and jeopardizes patient outcomes.
The solution to addressing overcrowded clinics is not to rush through patient visits but to invest in the necessary staff and resources to deliver high-quality care to every patient. It is essential to reevaluate this policy before it spreads to other healthcare institutions, potentially setting a dangerous precedent nationwide. Collaborative decision-making between healthcare providers and administrators is essential to ensure that patient care remains the top priority in healthcare systems.
In conclusion, the recent reduction in appointment times for new pediatric patients at H+H poses a significant threat to the quality of care provided to vulnerable populations. Healthcare providers are committed to delivering comprehensive care that prioritizes patient safety and outcomes. Rushing through patient appointments compromises the accuracy of diagnoses, erodes trust in the healthcare system, and undermines the values that guide the medical profession. It is imperative to reconsider this policy and prioritize patient care over financial gains to ensure the well-being of both patients and healthcare professionals.
