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Schedule your doctor’s appointment early in the day 

Written by Diane Archer

In 2011, a paper published in Proceedings of the National Academy of Sciences revealed that judges are more lenient on defendants early in the morning and immediately after lunch. They are less tired and less rushed. Not surprisingly, new research reveals that primary care doctors provide better care early in the day. Schedule your doctor’s appointments in the morning!

Researchers at the Penn Medicine Nudge Unit looked to see when doctors ordered colon and breast cancer screening tests for eligible patients over the course of the day. They wanted to see if there were patterns. Did patients get better preventive care services at particular times of the day?

They found the same pattern with almost all doctors. More patients who saw their doctors early in the day received orders for cancer screening tests than patients who saw their doctors at the end of the day. The data: 64% v. 48% for women eligible for breast cancer screenings and 37% v. 23% for men eligible for colonoscopies. These are preventive care services these patients should be getting.

Similarly, patients who saw their doctors early in the day were more likely to have screening tests than patients who saw their doctors later in the day.

In a separate study, the researchers detected patterns in doctor’s providing flu vaccinations. They found more vaccinations early in the day. Yet another study found that doctors who saw patients later in the day were more likely to prescribe unnecessary antibiotics and opioids.

The researchers believe that “decision fatigue” may be one reason why patients appear to get better medical attention early in the day. People tend to make less good choices after they have had to make a lot of other choices. Doctors and patients both may suffer from decision fatigue at the end of the day. Rushed visits at the end of the day when a doctor’s or patient’s schedule is jammed up can also contribute to poorer medical care.

The researchers suggest a couple of ways to correct this problem. Electronic health records can nudge doctors’ assistants to advise patients to get their screening tests and flu vaccines. A mailed reminder to patients can also be helpful.

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