The Immeasurable Value Of Direct Care — Time To Listen


– Stephen Cocksedge, Listening as Work in Primary Care

That’s worth repeating: 85% of diagnoses can be made just by listening to the patient.

It’s clear cut: When doctors do not have enough time to listen the result is that they do not listen.

A study from 1984 of primary care physicians observed throughout patient visits revealed the following:

  • Doctor interrupted the patient within 18 seconds on average.
  • In only 17 (23%) of the 74 visits was the patient provided the opportunity to complete his or her opening statement of concerns.
  • In 51 (69%) of the visits, the physician interrupted the patient’s statement and directed questions toward a specific concern.
  • In only 1 of these 51 visits was the patient afforded the opportunity to complete the opening statement.

“This lack of listening is the core care problem in American healthcare today,” says Stephen Schimpff.

And it’s not getting better. It is the inadequate income per patient (effects of crippling red tape) that is driving the lack of listening. Today the average PCP sees too many patients for too little time. They pay into the red tape, they pay into the insurance companies, they pay into the drug companies, and they get burnt out doing so. They tell students to stay out of the practice.

But with Direct Care, we cut out the middleman, and make it affordable for doctors and patients to interact, comfortably, at their convenience. We eliminate the stress, the concern abut deductibles, the “what will this cost?” That’s gone. And, because we’ve eliminated insurance, we don’t spend two hours every day transcribing notes, just to get paid. We can use that time to negotiate discounts for extraneous labs and tests, to fill your prescriptions for pennies per pill, and to read up on current trends in healthcare (GPs have to cover an array of disciplines).

And speaking of good books, Simon Cocksedge has explored the value of primary care physicians who DO listen.

We encourage Direct Care docs, current and considering, to read the excerpt and additional sections from Listening as Work in Primary Care by Simon Cocksedge.

And, if you can, pick up a copy on They’re going for just a couple bucks, and offer excellent perspective.