Do Doctors Give Better Care in the Morning?

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FRIDAY, May 10, 2019 (HealthDay News) — Many people do their best work in the morning, and new research suggests the same may hold true for doctors.

The study, of nearly 53,000 primary care patients, found that doctors were more likely to order cancer screenings for patients seen early in the day, versus late afternoon.

During 8 a.m. appointments, doctors ordered breast cancer screenings for 64% of women who were eligible for them. That figure declined over the next few hours, rebounded around lunchtime, then fell again as the afternoon wore on: During 5 p.m. appointments, doctors ordered screening for just under 48% of eligible patients.

A similar pattern was seen with colon cancer screening. About 36% of patients with 8 a.m. appointments received a screening order, versus only 23% of those with 5 p.m. appointments.

What’s going on? Senior researcher Dr. Mitesh Patel speculated on one explanation: As the day goes on, doctors often fall behind schedule, and may run out of time for cancer screening discussions.

There’s “a lot to get done” during a standard appointment, Patel noted — from routine health checks, to flu shots, to whatever concerns the patient is bringing up.

“So the doctor might think, ‘I have limited time. I’ll talk about this [screening test] the next time,'” said Patel, an assistant professor of medicine at the University of Pennsylvania.

It’s also possible “decision fatigue” is a factor, he said.

If a doctor has spent much of the day talking to patients about cancer screening — and often hearing “no” — he or she might let it slide by day’s end.

“This is a reminder that doctors are human, too,” said Dr. Jeffrey Linder, a professor of medicine at Northwestern University Feinberg School of Medicine in Chicago. “They’re laboring under the same psychological and fatigue constraints as everyone else.”

Linder wrote an editorial accompanying the study, published May 10 in the journal JAMA Network Open.

“Not everyone can get an 8 a.m. appointment,” Linder pointed out. But, he said, it’s good for doctors and patients to be aware that time of day might affect their care.



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