According to medical guidelines, your doctor requires a 27-hour work day

Some doctors say that, no matter how reasonable the guidelines may seem, their cumulative burden is causing “constant frustration” to medical practice.

< p class="css -at9mc1 evys1bk0">The intention is admirable: give doctors guidelines so they can be sure to cover what needs to be discussed with patients and help select options. Let's talk about your diet and sleep issues. Are you exercising enough? Otherwise, here are some tips. You need to be screened for colon cancer. Do you prefer a colonoscopy or a fecal test? Here are the pros and cons of each.

But there is a problem. There simply aren't enough hours in a workday to discuss and act on all the guidelines.

Suppose an American doctor wants a star gold when he sees patients and follows all guidelines for preventive, chronic and acute care issued by renowned medical groups. It could take nearly 27 hours a day, a team of doctors wrote in a study last year for the Journal of General Internal Medicine.

No one could actually do this, then Imagine a doctor ignoring chronic and acute care, as well as administrative work, and just following the preventive care checklist recommended by the U.S. Preventive Services Task Force, an independent group of experts in health. That would be 8.6 doctor hours each day, according to a study published in the American Journal of Public Health.

Like anyone who has had an annual exam minutes wellness visit knows, doctors can not be so demanding. The fact that the guidelines are so comprehensive and yet so often overlooked raises questions about their usefulness. At the same time, doctors' salaries are often dependent on checking the guidelines boxes.

"Is that a problem? Absolutely," Dr. Michael said. Pignone, former member of the Preventive Services Task Force and chair of the University of Texas Department of Internal Medicine at Dell Medical School in Austin. Suffice it to say, what has been promoted is not always what provides the most health or benefits,” Dr. Pignone said.

guidelines have become "a constant frustration," said Dr Minna Johansson, a general practitioner in Uddevalla, Sweden, who also runs the Global Center for Sustainable Healthcare at the University of Gothenburg. other countries on an analysis of the issue which was published last month in BMJ. "Many guidelines can don't seem reasonable when considered in isolation," Dr. Johansson said. "But the cumulative burden of all the recommendations in the combined guidelines is absurd."

Dr. Johansson was inspired to research the issue while working in a small town on the west coast of Sweden.

"I have an annual visit with my patients," said she declared. Spending that precious time discussing a lifestyle prescription that, no matter how well-intentioned, is unlikely to change a patient's habits, is of dubious value, she said. And, she added, it "crowds out more important discussions".

"Maybe the patient smokes or has suicidal thoughts," a- she said.

And, she added, many guidelines, like those for in-depth discussions on the improvement in exercise habits or diet, lead to significant health benefits.

Dr. Johansson worked with Dr. Gordon Guyatt of McMaster University in Hamilton, Ontario, and Dr. Victor Montori of the Mayo Clinic in Rochester, Minnesota. They argue that this problem affects medical systems in North America and Western Europe.

In Norway, for example, guidelines for the assessment and treatment of high blood pressure apply to nearly three-quarters of adults whose blood pressure exceeds the 120/80 target. If guidelines were strictly adhered to, patients would need so many regular follow-up visits