Productivity, Quality, and Patient Satisfaction. Comparison of Part-time and Full-time Primary Care Physicians

Abstract

CONTEXT: Although few data are available, many believe that part-time primary care physicians (PCPs) are less productive and provide lower quality care than full-time PCPs. Some insurers exclude part-time PCPs from their provider networks.OBJECTIVE: To compare productivity, quality of preventive care, patient satisfaction, and risk-adjusted resource utilization of part-time and full-time PCPs.DESIGN: Retrospective cohort study. SETTING: Boston.PARTICIPANTS: PCPs affiliated with 2 academic outpatient primary care networks.MEASUREMENTS: PCP productivity, patient satisfaction, resource utilization, and compliance with screening guidelines.RESULTS: Part-time PCP productivity was greater than that of full-time PCPs (2.1 work relative value units (RVUs)/bookable clinical hour versus 1.3 work RVUs/bookable clinical hour, P < .01). A similar proportion of part-time PCPs (80%) and fulltime PCPs (75%) met targets for mammography, Pap smears, and cholesterol screening (P = .67). After adjusting for clinical case mix, practice location, gender, board certification status, and years in practice, resource utilization of part-time PCPs ($138 [95% confidence interval (CI), $108 to $167]) was similar to that of full-time PCPs ($139 [95% CI, $108 to $170], P = .92). Patient satisfaction was similar for part-time and full-time PCPs.CONCLUSIONS: In these academic primary care practices, rates of patient satisfaction, compliance with screening guidelines, and resource utilization were similar for part-time PCPs compared to full-time PCPs. Productivity per clinical hour was markedly higher for part-time PCPs. Despite study limitations, these data suggest that academic part-time PCPs are at least as efficient as full-time PCPs and that the quality of their work is similar. KEY WORDS: productivity; quality of care; patient satisfaction; part-time physicians; women in medicine. J GEN INTERN MED 2001;16:663±667.

Part-Time Physicians…Prevalent, Connected, and Satisfied

“…Interestingly, part-time physicians spent proportionately more of their work week in teaching and research. Similar to other studies, 8 we found no differences in patient ratings of trust or satisfaction based on physician work status. Some investigators report associations between working fewer hours and increased productivity 8 and higher-quality performance, 20 an area warranting further research.…”

“…Similar to other studies, 8 we found no differences in patient ratings of trust or satisfaction based on physician work status. Some investigators report associations between working fewer hours and increased productivity 8 and higher-quality performance, 20 an area warranting further research. Our data support and extend prior work, demonstrating that patient satisfaction is unaffected by physician part-time status.…”

“…6 In the search of increased flexibility, many physicians, especially women, are choosing to work part-time. 7 Existing literature suggests that physicians and patients are satisfied with part-time work 8 ; however, contributors to this satisfaction are unclear.…”

Factors influencing female doctors’ career decisions at Tshwane District Hospital, Pretoria

“…Female doctors with family responsibilities were most likely to report burnout symptoms. 5,13 Female doctors found it challenging to have to balance their professional and personal lives, and this increased the likelihood of developing burnout. Female doctors were more likely than male doctors to suffer from sleep deprivation, and to report being preoccupied with domestic chores.…”

Part-Time Careers in Academic Internal Medicine: A Report From the Association of Specialty Professors Part-Time Careers Task Force on Behalf of the Alliance for Academic Internal Medicine

“…15,16 Part-time physicians often have increased productivity, as they may choose to extend their work into nonpaid time. 16 Therefore, part-time clinical faculty can readily be incorporated into the department. A 0.75 FTE clinical faculty member would attend 75% of clinic sessions compared with a full-time physician, take 75% of call, and assume 75% of productivity targets.…”