Time Allocation in Primary Care Office Visits

Abstract

Many topics compete for visit time, resulting in small amount of time being spent on each topic. A highly regimented schedule might interfere with having sufficient time for patients with complex or multiple problems. Efforts to improve the quality of care need to recognize the time pressure on both patients and physicians, the effects of financial incentives, and the time costs of improving patient-physician interactions.

How much time does it take to prescribe a new medication?

“…Approximately 5% of the 16 minute office visit length in this study was spent introducing and explaining newly prescribed medications. The average visit time is similar to those reported in previous studies (1,19,27,28). More than half of this time was dedicated to discussing the core issues contained in the MCI of how many, when, why and for how long to take the medication, and medication side effects.…”

“…But the contents of a visit do not substantially change the total visit length; physicians perform tradeoffs in their discussions to maintain similar overall visit times (27). Indeed, although physicians in this study required more time to more thoroughly cover the basics of new medication information, this was not reflected in the total office visit length.…”

Physicians Asking Patients About Guns: Promoting Patient Safety, Respecting Patient Rights

“…The average visit in a primary care provider's office lasts somewhere between 10 and 18 min. 29 During that time, the physician must address the patient's primary concern and evaluate other health risks. For health/safety risks without symptoms or previous record, relevant patient information should be collected.…”

Patient Satisfaction Reporting and Its Implications for Patient Care

“…The Choosing Wisely initiative, for example, describes a number of commonly used procedures and services that could be considered low-value, such as early imaging for back pain or antibiotics for upper respiratory infections [12]. Given regulations and declining reimbursements, physicians have limited time to spend on each patient visit [13], and it may be time consuming to explain to patients who expect low-value treatments why they should be withheld. If a physician is faced with penalties for low patient experience scores, it may be the path of least resistance to agree to such requests; even the anticipation of patient dissatisfaction may drive unnecessary or different care in individual cases.…”