Only One Third of Family Physicians Can Estimate Their Patient Panel Size

Peterson, Lars E.; Cochrane, Anneli; Bazemore, Andrew; Baxley, Elizabeth G.; Phillips, Robert L.

doi:10.3122/jabfm.2015.02.140276

Cited by 14 publications

(17 citation statements)

References 3 publications

(4 reference statements)

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“…Nonetheless, only a third of FPs can estimate their patient panel size. 16 Although patient panel size varied with the time spent in direct patient care, only one-third of FPs' estimates were reasonable, indicating physicians may be overpaneled and/or underresourced. [16][17][18] While a broader scope of practice of primary care physicians is associated with lower health care costs, 19 the scope of practice of FPs has been declining over the last decade.…”

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confidence: 96%

“…16 Although patient panel size varied with the time spent in direct patient care, only one-third of FPs' estimates were reasonable, indicating physicians may be overpaneled and/or underresourced. [16][17][18] While a broader scope of practice of primary care physicians is associated with lower health care costs, 19 the scope of practice of FPs has been declining over the last decade. [20][21][22] Working with an NP or PA who can partially supplement or substitute the responsibilities of a physician 23,24 may enable the physician to provide more services or to simply take care of more patients.…”

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confidence: 96%

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Scope of Practice and Patient Panel Size of Family Physicians Who Work With Nurse Practitioners or Physician Assistants

Dai

Ingham

Peterson

2019

Fam Med

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BACKGROUND AND OBJECTIVES:Little is known about how the presence of nurse practitioners (NPs) and physician assistants (PAs) in a practice impacts family physicians' (FPs') scope of practice. This study sought to examine variations in FPs' practice associated with NPs and PAs. METHODS:We obtained data from American Board of Family Medicine practice demographic questionnaires completed by FPs who registered for the Family Medicine Certification Examination during 2013-2016. Scope of practice score was calculated for each FP, ranging from 0-30 with higher numbers equating to broader scope of practice. FPs self-reported patient panel size. Primary care teams were classified into NP only, PA only, both NP and PA, or no NP or PA. We estimated variation in scope and panel size with different team configurations in regression models. RESULTS:Of 27,836 FPs, nearly 70% had NPs or PAs in their practice but less than half (42.5%) estimated a panel size. Accounting for physician and practice characteristics, the presence of NPs and/or PAs was associated with significant increases in panel sizes (by 410 with PA only, 259 with NP only and 245 with both; all P<0.05) and in scope score (by 0.53 with PA only, 0.10 with NP only and 0.51 with both; all P<0.05). CONCLUSIONS:We found evidence that team-based care involving NPs and PAs was associated with higher practice capacity of FPs. Working with PAs seemed to allow FPs to see a greater number of patients and provide more services than working with NPs. Delineation of primary care team roles, responsibilities and boundaries may explain these findings.

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confidence: 96%

mentioning

confidence: 96%

Scope of Practice and Patient Panel Size of Family Physicians Who Work With Nurse Practitioners or Physician Assistants

Dai

Ingham

Peterson

2019

Fam Med

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“…Only one-third of family physicians can even estimate the size of their patient panel. 1 The percentage who can define the "community" they serve is likely lower, which ultimately leaves clinicians feeling unprepared. 2 To address this gap, practices can implement community-oriented primary care (COPC), by executing 4 iterative steps: defining the community, identifying health problems, developing and implementing interventions, and conducting ongoing evaluation.…”

Section: Introductionmentioning

confidence: 99%

Clinicians’ Overestimation of Their Geographic Service Area

et al. 2019

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In this study, we evaluated family physicians' ability to estimate the service area of their patient panel-a critical first step in contextual population-based primary care. We surveyed 14 clinicians and administrators from 6 practices. Participants circled their estimated service area on county maps that were compared with the actual service area containing 70% of the practice's patients. Accuracy was ascertained from overlap and the amount of estimated census tracts that were not part of the actual service area. Average overlap was 75%, but participants overestimated their service area by an average of 166 square miles. Service area overestimation impedes implementation of targeted community interventions by practices.

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“…23 Many physicians in the public sector, especially those in the safety net setting, find it particularly challenging to determine their panel size because patients access ambulatory care sporadically, making accurate tracking difficult. 24 It is easier for physicians in the private sector to determine their panel size because of insurance payments and network selection.…”

Section: Is a Primary Care Panel Size Of 2500 Patients Reasonable?mentioning

confidence: 99%

A Primary Care Panel Size of 2500 Is neither Accurate nor Reasonable

Raffoul

Moore

Kamerow

et al. 2016

The Journal of the American Board of Family Medicine

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Only One Third of Family Physicians Can Estimate Their Patient Panel Size

Abstract: In addition to payments for services rendered to individual patients, primary care physicians will increasingly be paid for their ability to achieve goals across the body of patients most closely associated with them: their "panel.

Cited by 14 publications

References 3 publications

Scope of Practice and Patient Panel Size of Family Physicians Who Work With Nurse Practitioners or Physician Assistants

Scope of Practice and Patient Panel Size of Family Physicians Who Work With Nurse Practitioners or Physician Assistants

Clinicians’ Overestimation of Their Geographic Service Area

A Primary Care Panel Size of 2500 Is neither Accurate nor Reasonable

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