Balancing Clinician Workload Through Strategic Patient Panel Designs

Abstract

Background and Objectives: Clinician workload is a key contributor to burnout and well-being as well as overtime and staff shortages, particularly in the primary care setting. Appointment volume is primarily driven by the size of patient panels assigned to clinicians. Thus, finding the most appropriate panel size for each clinician is essential to optimization of patient care. Methods: One year of appointment and panel data from the Department of Family Medicine were used to model the optimal panel size. The data consisted of 82 881 patients and 105 clinicians. This optimization-based modeling approach determines the panel size that maximizes clinician capacity while distributing heterogeneous appointment types among clinician groups with respect to their panel management time (PMT), which is the percent of clinic work. Results: The differences between consecutive PMT physician groups in total annual appointment volumes per clinician for the current practice range from 176 to 348. The optimization-based approach for the same PMT physician group results in having a range from 211 to 232 appointments, a relative reduction in variability of 88%. Similar workload balance gains are also observed for advanced practice clinicians and resident groups. These results show that the proposed approach significantly improves both patient and appointment workloads distributed among clinician groups. Conclusion: Appropriate panel size has valuable implications for clinician well-being, patients' timely access to care, clinic and health system productivity, and the quality of care delivered. Results demonstrate substantial improvements with respect to balancing appointment workload across clinician types through strategic use of an optimization-based approach.

Predicting Provider Workload Using Predicted Patient Risk Score and Social Determinants of Health in Primary Care Setting

“…Research indicates that patients with higher levels of medical complexity are more likely to require additional non-visit care interactions. 6,7 Therefore, to appropriately assign a new patient to a primary care physician (PCP) panel, a patient's health conditions and complexity are important factors to understand. However, for patients who are established with primary care services for the first time, health and risk factor information may not be available when the appointment request is made.…”