Study: PCPs Need 26.7 Hours Per Day to Provide Recommended Care
According to a UChicago Medicine article from earlier this month by Devon McPhee, if primary care physicians followed national recommendation guidelines for preventative care, chronic disease care, and acute care, it would take them 26.7 hours per day to see an average number of patients, according to a new study. The study is entitled “Revisiting the Time Needed to Provide Adult Primary Care,” and is published in the Journal of General Internal Medicine.
The article says that “The research, conducted by the University of Chicago, Johns Hopkins University, and Imperial College London, used a simulation study to compute time per patient based on data from the National Health and Nutrition Examination Survey.”
The breakdown of the 26.7 hours, according to the article, is 14.1 hours/day for preventive care, 7.2 hours/day for chronic disease care, 2.2 hours/day for acute care, and 3.2 hours/day for documentation and inbox management.
Justin Porter, M.D., assistant professor of medicine at the University of Chicago and lead author of the paper was quoted in the article saying that “There is this sort of disconnect between the care we’ve been trained to give and the constraints of a clinic workday. We have an ever-increasing set of guidelines, but clinic slots have not increased proportionately.”
Further, “The study also looked at physician time as part of a team, where nurses, physician assistants, counselors and others help to deliver recommended care.
“It found that team-based care reduced the time a physician needed to deliver care to 9.3 hours/day, broken into 2.0 hours/day for preventive care, 3.6 hours/day for chronic disease care, 1.1 hours/day for acute care, and 2.6 hours/day for documentation and inbox management.”
The article adds that a 2003 study from Duke University estimated it would take a primary care physician 7.4 hours a day to provide preventative care for an average-sized patient population. In a 2005 study from Mount Sinai, the estimated time per day was 8.6 hours.
“The new study went one step further by including all types of care a primary care physician provides—preventive, acute, and chronic—as well as administrative tasks, and accounted for changes to the guidelines that have occurred since the earlier studies were published,” the article adds. “It also used a different methodology, employing real patient data from an annual national survey to calculate its results. The earlier studies used hypothetical patient populations based on the U.S. population.”
Moreover, “The researchers used the Comprehensive Primary Care Plus (CPC+) model to develop the estimates for team-based care. The model allows physicians to focus on advanced care and brings in specialized medical professionals to take over other areas. Dietitians, for instance, would handle nutritional counseling for patients with diabetes or obesity, a time-intensive task. Overall, the researchers determined that 65% of primary care services could be handled by other team members.”
The article concludes by explaining that time constraints are a major factor in physician burnout and a main reason that medical students are leaving the field.
