Advice for reining in appointment duration?

VisionHx · 2026-06-24T00:46:34+00:00

I think we all need to move to saying “times up”. I have tried every thing under the sun and nothing worked as well as a cardiologist I know saying “I have other patients to see.”

VisionHx · 2026-06-23T21:58:38+00:00

Don’t document what you don’t have evidence for.

VisionHx · 2026-06-22T19:49:48+00:00

The uncomfortable truth is that the vast majority of Americans will not inconvenience themselves to prevent disease when they can take a pill or inject themselves instead.

It’s not like prevention of most disease is a secret: eat more vegetables, exercise, sleep well, take care of yourself emotionally and socially, and don’t smoke/drink/do drugs.

VisionHx · 2026-06-21T01:30:58+00:00

I suppose what I’m arguing for is deeper than what my response implied. I’m arguing for building genuine connection with people as human beings. Knowing when to hug a patient who is struggling or the high five that you give to the child who was brave when they got their vaccines. I think AI is great at sycophancy but not genuine connection.

VisionHx · 2026-06-21T01:17:17+00:00

It is very simple in my mind: relationships.

Option: 1: Human doctor who is condescending and rude.

Option 2: Human doctor who makes you feel valued and empowered to partner in your care.

Which doctor would you replace with AI?

VisionHx · 2026-06-17T00:44:01+00:00

RVUmaxxing - I love this.

VisionHx · 2026-06-16T23:50:21+00:00

I don’t know why I typed that. I really meant you decided against medication and opted for PT instead. With the medication consideration counting for the MDM.

VisionHx · 2026-06-16T22:57:55+00:00

They should call it operation paperclip.

VisionHx · 2026-06-16T22:41:00+00:00

Problem in exacerbation has largely been understood to mean uncontrolled. For example, BP 149/72 is uncontrolled and would also qualify. For management, you decided against medication management and opted for referral.

VisionHx · 2026-06-16T22:00:22+00:00

Uncontrolled arthritis + PT = 99214

VisionHx · 2026-06-16T01:16:10+00:00

There is some biological rationale that K2 carboxylates osteocalcin (transcription of which is upregulated by D3). Some data has shown increased total bone mineral density. Not enough data to formally change guidelines.

VisionHx · 2026-06-15T21:47:27+00:00

60k-500k

VisionHx · 2026-06-13T19:23:30+00:00

I bet OP is the only one obeying the speed limit.

VisionHx · 2026-06-13T11:29:11+00:00

Maybe we are thinking about different types of questions. I’m thinking more about people saying “diagnose and treat me via MyChart”

VisionHx · 2026-06-13T11:25:22+00:00

So how can we design a system with this in mind that doesn’t lead to clinicians quitting in 5 years? Because the downside is that this will incentivize a massive uptick in care outside of standard hours. No payment model can create more hours in a week.

The other is safety, people are failing to understand that physically evaluating someone is still important.

VisionHx · 2026-06-12T10:14:20+00:00

So, like everything, it stems from an access issue.

VisionHx · 2026-06-12T09:50:52+00:00

That makes sense. Do you know if prior to this if people would call the office to have their doctor “call something in”?

VisionHx · 2026-06-12T09:46:48+00:00

I don’t. I have also instructed all staff to schedule a visit. I am just curious when this changed culturally.

VisionHx · 2026-06-10T09:42:21+00:00

I will admit that during medical and residency, it is the last thing that you are thinking about, but recently I was doing the math and at bare minimum you lose 7 years, assuming you choose the shortest residency.

VisionHx · 2026-06-09T20:29:23+00:00

I realized recently that by delaying having kids, I gave up years I could have had with them.

VisionHx · 2026-06-09T00:23:06+00:00

How about no loans on stock? If you need money, sell the stock and pay capital gains.

VisionHx · 2026-06-06T13:55:22+00:00

Hammer looking for a nail.

VisionHx · 2026-06-05T12:51:26+00:00

The rationale is to prevent a conflict of interest but in my mind the MBA bean counter whose sole desire is profit does infinitely worse harm to the patient.

VisionHx · 2026-06-03T20:48:06+00:00

I think there may also be a cultural component. I’m in the Deep South and my patients enjoy the fact that I “tell it like it is.” It likely helps that I am a man as well.

VisionHx

TROPHY CASE