What is the Best Time of Day for Medical Care?
What is the Best Time of Day for Medical Care?
When scheduling a medical appointment or procedure, most of us try to book a time that we feel is most convenient. Some people prefer early mornings while others want to see their doctors after work. Although convenience is important, it turns out the level of care can worsen as the workday progresses. Issues, like fatigue and time constraints, can make it hard for medical providers to perform their best and make good decisions.
Read on to learn tips when considering the best time of day for medical care.
What factors can lessen the quality of care?
Many factors can lead to a potential worsening of care as the day progresses.
Mental and physical fatigue.
Medical work can be mentally and physically exhausting, particularly when doctors work long hours or overnight shifts. Unfortunately, mental and physical fatigue can make it hard for doctors to provide top-notch care. Fatigue can cause:
- Slowed reflexes and responses.
- Impaired decision-making and judgment.
- Impaired hand-to-eye coordination.
- Blurry vision.
- Short-term memory problems.
- Poor concentration.
Similarly, patients can also start to feel physically and mentally exhausted as the day progresses which can make it harder to understand and remember medical information and to make decisions. Additionally, fatigue can cause patients and their caregivers to rush through appointments.
As the day progresses, doctors and patients can develop decision fatigue. This is the tendency to make poor medical choices after many hours of prolonged decision-making. Why does this happen? Constant decision-making taxes the executive functioning of the brain, therefore making it harder to make good decisions. This can be a concern for all involved including doctors, patients, and caregivers.
As the day progresses, doctors can fall behind schedule which can lead to rushed appointments and less time for patient-doctor conversations which are an important part of every visit.
Additionally, experts consider time constraints or rushed appointments as a major cause of missed or wrong diagnoses. Why? While under time constraints, doctors may make quick assumptions which can not only increase the chance of missing warning signs for diseases but can lead to poor decision-making as well.
How could this impact the care you or the person you care for receive?
Unfortunately, receiving care later in the day can contribute to a range of issues from getting unneeded prescriptions to an increased risk of death. Read below for a few examples.
Appointment time can impact the likelihood of cancer screening.
Researchers analyzed records from more than 50,000 patient visits from 33 primary care practices over a two year period. They found as the day progressed, doctors became less likely to order cancer screenings for patients who were eligible for routine tests. Furthermore, patients seen later in the day were less likely to complete their recommended screening within one year of their appointment.
Why are doctors less likely to recommend cancer screenings as the day progresses?
- As doctors fall behind schedule, they may not have time to discuss cancer screenings.
- Doctors may be less likely to discuss cancer screenings with patients simply because they’ve already done it repeatedly throughout the day.
- If/when patients seen earlier in the day decline a screening, doctors may feel reluctant to bring up the topic later in the day.
- Some patients with later appointments may be anxious to finish the appointment and may, therefore, decline a conversation about cancer screening.
Nighttime surgeries have higher death rates.
An evaluation of mortality rates associated with more than 41,700 elective and emergency surgeries found a significant increase of death when patients had procedures at night.
After adjusting for patients' age and risk scores, patients operated on between 11:30 p.m. and 7:29 a.m. were over two times more likely to die than those who had surgeries during regular daytime hours. Additionally, patients who were operated on later in the workday or in the evening were nearly one-and-half times more likely to die than those who had daytime surgeries.
The researchers theorize this increase in mortality has many potential causes including operating room staff fatigue, overnight hospital staffing issues, delays in treatment, and the patient being too sick to wait for a postponed treatment.
Here are a few more examples of how time of day can impact care.
- Medication errors increase when health care providers feel rushed or fatigued, among other factors.
- Patients who see primary care doctors later in the day are more likely to receive unnecessary antibiotics.
- Patients who see doctors later in the day for lower back pain were significantly more likely to receive an opioid prescription.
- Health care providers wash their hands less often toward the end of their shifts, increasing the risk of transferring germs to patients.
What can you do?
Even if it may be inconvenient, schedule medical appointments and procedures as early in the day as possible. No matter what time of day your loved one sees their doctor, it is important that you engage in the process.
- Prepare a list of questions and discussion topics before each appointment.
- Learn which screenings are recommended for your loved one’s age and gender, and talk to your doctor about what is right for you.
- Take notes and record appointments so you can correctly remember important medical information discussed.
- Make needed appointments right away if your doctor orders additional screenings or tests.
- Be sure to follow up about the results after each test. Don’t assume no news is good news.
In summary, try to schedule surgeries between 7:30 a.m. and 3:30 p.m. However, scheduling a procedure during that time does not guarantee that it will occur as planned as surgeries are routinely postponed. If your doctor wants to change a daytime surgery to a nighttime slot, you can ask to reschedule the procedure for another daytime slot.
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This post is adapted for Caregiving.com from “What is the Best Time of Day for Medical Care?” that originally appeared on Zaggo’s website.
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