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My doctor splits my physical into two appointments. Why? Add to ...

The question: When I went to book my annual physical, I was asked whether I wanted to book my “upper” or “lower” first. Upon asking the secretary to repeat herself (just to make sure I was hearing her correctly), she indicated I would have to make two separate appointments. This means booking time off work (twice) to wait an hour (twice) to be seen by the doctor for two five-minute appointments. I asked my doctor why she books appointments in this manner and she said: “Things come up that may take longer to address in one appointment.” Is this a common practice? Is this ethical?

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The answer: I’ve never heard of a human being divided for a physical and I can’t imagine how it would be done, so I consulted Philip Berger, chief of the department of family and community medicine at St. Michael’s Hospital in Toronto. He seemed equally baffled.

“To divide a body in half is artificial and totally illogical division and makes no sense at all,” said Dr. Berger, who is also medical director of St. Michael’s inner city health program. “It’s bizarre. All parts of the body are connected to each other, and where would the midpoint be, anyway?”

Dr. Berger has been practising medicine for almost 35 years and said he’s never heard anything like it. He knows of no doctor who books five-minute appointments, other than those cases of writing sick notes or prescription renewals. It’s “impossible,” he said, for a physician to provide minimally adequate care for preventive purposes in that time period.

This brings us back to your issue. You need what many refer to as a physical – which are really periodic preventive care exams – done in one appointment. Those typically take 15 to 30 minutes.

I think this division of your body is really about a division of labour for your physician. For scheduling or billing reasons, she'd rather have two short appointments than one longer one. Either way, it’s an inconvenience to you.

“I would never teach any students to practice in this fashion,” Dr. Berger said. “I think it’s unethical because the doctor’s interests are being put ahead of the patient’s interests. The patient’s interests are to have her routine preventive care check done within one appointment.”

If you had a choice – and there wasn’t a doctor shortage – I would suggest ditching this doctor and finding someone better. That may not be realistic, so why not have a little fun and ask if you can book these two appointments back to back, instead of top to bottom. By that I mean, booking two consecutive appointments so you only have to make one trip.

Also ask yourself how good a clinician your physician is. I’ll put up with a bit of aggravation if I think the physician is particularly adept but I won’t with someone who’s middling. These five-minute appointments really make me wonder what quality of care you are receiving.

The Patient Navigator is a column that answers reader questions on how to navigate our health-care system. Send your questions to patient@globeandmail.com

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