A Tale of Two Countries: How I Saw More Patients With More Joy in Internal Medicine Practice
Authors: Dawn E. DeWitt
Journal: Annals of Internal Medicine (2017)

Ideas and Opinions2 May 2017A Tale of Two Countries: How I Saw More Patients With More Joy in Internal Medicine PracticeDawn E. DeWitt, MD, MScDawn E. DeWitt, MD, MScFrom Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-0244 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail After 14 years in Australia and Canada, I dreaded my return to practice in the United States. In 2003, after 10 years of academic practice in Seattle, I moved to Australia to develop rural and regional clinical training for the University of Melbourne. Practicing and teaching internal medicine in Australia was much easier and more rewarding than in the United States. My experience reinforces that complexity, fragmentation, and unnecessary documentation are driving physician burnout, patient dissatisfaction, high costs, and suboptimal outcomes in this country. Simplifying our system could save money, preserve patient choice, and improve outcomes.The data are clear—countries ...References1. Macinko J, Starfield B, Shi L. The contribution of primary care systems to health outcomes within Organization for Economic Cooperation and Development (OECD) countries, 1970-1998. Health Serv Res. 2003;38:831-65. [PMID: 12822915] CrossrefMedlineGoogle Scholar2. Goss E, Fletcher J, Lechuga C, Meissner P, Blank A, Lounsbury D, et al. Teamwork and working at “top of license” among physicians, nursing, and non-professional staff at teaching and non-teaching ambulatory practices. J Gen Int Med. 2011;26 Suppl 1 211. Google Scholar3. Shanafelt TD, Boone S, Tan L, Dyrbye LN, Sotile W, Satele D, et al. Burnout and satisfaction with work–life balance among US physicians relative to the general US population. Arch Intern Med. 2012;172:1377-85. [PMID: 22911330] CrossrefMedlineGoogle Scholar4. Sinsky C, Colligan L, Li L, Prgomet M, Reynolds S, Goeders L, et al. Allocation of physician time in ambulatory practice: a time and motion study in 4 specialties. Ann Intern Med. 2016;165:753-60. [PMID: 27595430]. doi:10.7326/M16-0961 LinkGoogle Scholar5. Wenger N, Méan M, Castioni J, Marques-Vidal P, Waeber G, Garnier A. Allocation of internal medicine resident time in a Swiss hospital: a time and motion study of day and evening shifts. Ann Intern Med. 2017. [Epub ahead of print]. [PMID: 28135724] doi:10.7326/M16-2238 LinkGoogle Scholar6. Erickson SM, Rockwern B, Koltov M; Medical Practice and Quality Committee of the American College of Physicians. Putting patients first by reducing administrative tasks in health care: a position paper of the American College of Physicians. Ann Intern Med. 2017;166:659-61. doi:10.7326/M16-2697 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-0244.Corresponding Author: Dawn E. DeWitt, MD, MSc, Spokane Academic Center, PO Box 1495, Spokane, WA 99210-1495; e-mail, dawn.[email protected]edu.Author Contributions: Conception and design: D.E. DeWitt.Analysis and interpretation of the data: D.E. DeWitt.Drafting of the article: D.E. DeWitt.Critical revision of the article for important intellectual content: D.E. DeWitt.Final approval of the article: D.E. DeWitt.Collection and assembly of data: D.E. DeWitt.This article was published at Annals.org on 28 March 2017. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPutting Patients First by Reducing Administrative Tasks in Health Care: A Position Paper of the American College of Physicians Shari M. Erickson , Brooke Rockwern , Michelle Koltov , Robert M. McLean , and A Tale of Two Countries Dawn E. DeWitt A Tale of Two Countries Vaibhav Kumar Metrics Cited byOath to Self-Care and Well-BeingPhysician Burnout in the Electronic Health Record EraN. Lance Downing, MD, David W. Bates, MD, MSc, and Christopher A. Longhurst, MD, MSThe Potential Impact of Scribes on Medical School Applicants and Medical Students with the New Clinical Documentation GuidelinesONE-YEAR TIME ANALYSIS IN AN ACADEMIC DIABETES CLINIC: QUANTIFYING OUR BURDENA Tale of Two CountriesVaibhav Kumar, MD 2 May 2017Volume 166, Issue 9Page: 669-670KeywordsComputersDisclosureElectronic medical recordsHealth carePatientsPrimary care physiciansResidencySub-specialty careSurgeryUrticaria ePublished: 28 March 2017 Issue Published: 2 May 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...