Poor Patient Outcomes Associated with Visiting Doctor in Afternoon

A new study suggests that doctors are more likely to skip screenings and otherwise make mistakes with patients later in the day. According to a JAMA Network Open study, doctors ordered fewer breast and colon cancer screenings for patients with an afternoon appointment – despite the fact that all patients were due for a screening. According to the study, the doctor was most likely to order a medical screening for his patient with an 8 AM appointment. By 4 PM, the likelihood that the doctor would order screens for their patient had dropped by 10 to 15 percent.

Other studies have confirmed that poorer outcomes for patients are more likely in the afternoon. A 2014 study, cited by The New York Times, found that doctors were more likely to dole out unnecessary antibiotic prescriptions in the afternoon. In fact, the likelihood of an unnecessary antibiotic is 26 times higher for a 4 PM appointment compared to an 8 AM appointment.  Other studies located by the New York Times found that patients were less likely to receive the flu vaccine and more likely to receive prescription opioids for back pain. Even the amount of hand washing by doctors fell during the afternoon hours.

Doctors say the reason for their decline in performance during the afternoon hours is three-fold. First, doctors – like everyone else – suffer from decision fatigue. In simplest terms, this refers to the phenomena where people tend to make the easier choice – instead of the best choice or correct choice– after a long day of decision-making. Patients are not immune to “decision fatigue,” either. According to the New York Times article, patients with an afternoon appointment were less likely to make necessary “after-visit cancer screening arrangements.”

Second, doctors spend a substantial and, according to them, an unnecessary amount of time on electronic health records. According to a doctor in the New York Times article, this administrative task consumes one to two hours per day. Finally, there simply are not enough hours in each day for the doctor to adequately address each patient. According to the same doctor, this would result in “11 to 18 hours a day providing preventative and chronic care, never mind addressing new problems.” As the afternoon wears out, the doctor must spend less time with each patient and skip more routine procedures and tests just to keep up.

Our attorneys protect the rights of medical malpractice victims.  Please contact us to discuss your potential case.

Contact Information