One of the many reasons I left outpatient medicine, except for a volunteer clinic where I get to spend as much time with each patient as he or she needs:
Patient comes to the ER of Big Teaching Hospital because he’s getting worse and nobody can figure out why, in spite of his going to a string of doctors. One put him on propranolol for his tremor, another told him his psychomotor slowing was due to depression and gave him something for that, another handed him a script because he had balance problems that affected his walking, and a fourth gave him arthritis meds for his stiffness. NONE of these docs ever listened to more than one complaint at a time, probably because they were locked into a 15-minutes (or less) appointment schedule. Only when somebody sat down and listened to the whole story could his Parkinson’s be diagnosed. But because it’s easier to write a script than to listen, this gent went undiagnosed for months.
In my humble opinion the Nobel Prize in medicine should go to anybody who can figure out a way to motivate doctors to do a good job instead of seeing as many patients as possible every day.