But hospital administrators say their institutions must adapt to survive. The hospital wants to get more for its money. But the doctors feel like they're sinking and they're doing the best they can do. But as long as patients continue to receive top-notch care, said Dr. David Fairchild, director of primary care at Brigham and Women's, the productivity push is having positive results, particularly for patients. In the old system, it worked for the physicians, so there wasn't much focus on whether the patients were happy,' said Dr. David R. Fulton, chief of cardiology outpatient services at Children's Hospital, who put changes in place last year.
Doctors choose the path.
Fulton was brought in two years ago from New England Medical Center to increase productivity and efficiency in the outpatient cardiology clinic, where children and their parents were spending four to five hours a visit. A child could wait two hours between having his vital signs read and receiving an echocardiogram. And doctors wandered in and out, disappearing to return phone calls, teach medical residents, conduct research, or check on patients who'd stayed overnight. That had to stop, Fulton said. So he asked all the doctors how many patients they could see each day and how long they needed for each visit.