Research Activities, May 2011: Primary Care: Primary care physicians spend a fifth of their time in patient care activities outside of office visits

Primary Care
Primary care physicians spend a fifth of their time in patient care activities outside of office visits

Internists who serve as primary care physicians spend an average of 1.6 hours (20 percent) of their work day on patient care activities outside of office visits (AOVs), according to a new study. These AOVs may save a median of five office visits per physician day, suggest the researchers. Their findings, based on direct observation of 33 physicians during a work day, are close to those previously found in studies of family physicians (23 percent) and geriatricians at academic institutions (22 percent). This time is generally not reimbursed by payers, but may be useful in coordinating patient care or may substitute for office visits that might otherwise occur.

The internists' work day averaged 7.7 hours, including an average 4.9 hours for patient visits (a median of 18 patient visits with median duration of 15 minutes each). Most of the AOV time (62 percent) was not related to a patient appointment occurring the same day. The internists perceived that a median of 37 percent of non-visit-specific AOV time substituted for office visits (a median potential savings of five visits per physician day). Excluding the time to enter information into patients' charts, the internists identified activities that could be performed by support staff as representing a median of 15 percent of total AOV time. Fourteen (42 percent) of the surveyed internists were able to identify at least one visit on the study day that could have been replaced by AOV activity—an average of 1.2 visits per physician overall. The study was funded in part by the Agency for Healthcare Research and Quality (T32 HS00066).

More details are in "Patient care outside of office visits: A primary care physician time study," by Melinda A. Chen, M.D., M.S., James P. Hollenberg, M.D., Walid Michelen, M.D., and others in the January 2011 Journal of General Internal Medicine 26(1), pp. 58-63.


Research Activities, May 2011: Primary Care: Primary care physicians spend a fifth of their time in patient care activities outside of office visits