What a fake homeless man, a Seminary student and being in a rush can teach us about Healthcare in America and the role of DPC

n 1973 two social psychologists, John M. Darley and C. Daniel Batson, struck out to understand what influences people’s behavior more. They formed an experiment at the Princeton University Theological Seminary in New Jersey wherein they studied 47 Seminary students.(1) Each of these students were given personality tests prior to the experiment and split into two groups at random.

One group was asked to prepare a talk on the parable of the Good Samaritan (a parable from the Bible wherein a Samaritan, a member of a marginalized community, comes upon the man that had been beaten while traveling to Jerusalem and takes care of him when others passed him by.) The other group was assigned an unrelated topic for their talk. Before the talk, participants were directed to move between two buildings under varying levels of urgency: high hurry, intermediate hurry, or low hurry.

While traveling between buildings, participants encountered a staged situation involving an man slumped in a doorway, appearing to need help. The person coughed and groaned but did not actively seek help.

Through their study, these two social psychologists learned that it was not the personality of the student, the focus of their studies or which topic was on their mind at the time they came across this person in need on their campus. Rather, Darley and Batson found that only 10% of seminary students in the hurried condition stopped to help the man. In comparison, 63% of the participants in the unhurried condition stopped!!!!

It doesn’t matter that these students have actively dedicated their lives to serving others, or attended a school that, according to its mission statement, “prepares women and men to serve Jesus Christ in ministries marked by faith, integrity, scholarship, competence, compassion, and joy…”, or that they spent the last few hours expressly studying helping those in need when it was a burden! Instead, all that mattered was how much time they felt they had! 

The comparison is an obvious one. With the average face-to-face time of a private practice physician with their patients being only 9.7 minutes(2) clinicians will find themselves figuratively walking past the person in need some 90% of the time. The extra time we have afforded us and our patients in Direct Primary Care models allows good people to do good things. 

I saw this same thing in my practice. I’ve been in DPC for 6 years now. Prior to that I was working in the industrialized model of healthcare for 3 years during which time I saw a patient we will call Donna. After 3 years of caring for her, she followed me to my brand new DPC office and during her first visit I came across a thyroid nodule that I had never felt before. Admittedly, due to the time restraints imposed by the factory model of medicine, my physical exams were cursory at times. When I mentioned it to her she stated she knew it was there, but she never mentioned it because, “That was on my B List, and I never had time to make it all the way through my A List.” She had the same physician in both settings, but it was only in the environment that afforded time, and therefore a thorough consideration of her needs that she found the help she needed. This discovery ultimately saved her life!

Altruism, kindness and the ability to stop and think have all but evaporated from our Healthcare system. In the words of the authors of this study, “Conflict, rather than callousness, can explain their failure to stop.”. Direct Primary Care puts the care back in healthcare.

1. Darley, J. M., & Batson, C. D. (1973). “From Jerusalem to Jericho”: A study of situational and dispositional variables in helping behavior. Journal of Personality and Social Psychology, 27(1), 100–108. https://doi.org/10.1037/h0034449

2. Tai-Seale, M., McGuire, T. G., & Zhang, W. (2007). Time allocation in primary care office visits. Health Services Research, 42(5), 1871–1894. https://doi.org/10.1111/j.1475-6773.2006.00689.x