The Time Of Day Visiting Your Doctor Matters

It makes a big difference as to whether you visit your doctor in the morning or later in the day a recent study has revealed.

A study done by researchers at he University of Pennsylvania and published by the Journal of the American Medical Association (JAMA) showed that patients who were eligible and being examined by their primary care physicians early in the morning received 64% more orders to be screened for breast cancer but by later in the afternoon the same doctors only ordered 48% of eligible patients to be screened for cancer.

And the results were the same for patients who were eligible to be screened for colon cancers. More tests were ordered earlier in the day than later in the day with 

37 % of tests being ordered for 8 am patients but only 23% for patients at 5pm.

The study suggests that ‘decision fatigue,’ described as the mental burn out which makes it harder for people to make decisions the farther into their day it gets could be the reason for the drop-off in ordering of tests by the doctors in the later part of the day. The study also acknowledged though the possibility of doctors running out of time because they were getting behind on their appointments.

Researchers also suggested that as the day progresses, physicians may spend less time discussing screenings with their patients because they have already done so a number of times as well as the possibility that later in the day, patients are in a hurry to get done with their appointment and don’t want to take the extra time to discuss a cancer screening.

This study presents a sobering observation of decision fatigue which does not only include the medical profession but also in other areas such as video streaming tendencies, water polo players and even parole decisions in law enforcement when decisions are made later in the day.

To remedy this situation for afternoon decision fatigue in the medical community, ‘nudges’ or reminders are made to doctors electronically on computers to discuss with their patients who are eligible for cancer or colorectal screenings to have one done.

Dr. Mitesh Patel, who is the director of the Penn Medicine Nudge Unit and who is an assistant professor of Medicine at the University of Pennsylvania, says “Our new study adds to the growing evidence that time of day and decision fatigue impacts patient care. In past work, we’ve found that nudges in the electronic health record can be used to address these types of gaps in care, which we suspect will be the case here.”