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Time Spent with Physician

How much time do patients spend with their physicians during office visits?

Patients spent about 19 to 20 minutes with their physician on average during office visits in 2003 and 2004, as compared with about 16 to 17 minutes in 1989 and 1990.

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Why is this important?

The amount of time physicians spend with their patients is one measure of the responsiveness of the health care system to patient needs. A common perception is that recent cost-containment pressures and paperwork burdens are squeezing out time for patient care.

Findings

The average time that patients spend with physicians during physician office visits increased by about two to three minutes from 1989–1990 (16.3–16.7 minutes) to 2003–2004 (18.7–19.7 minutes), based on data reported by physicians to a national government survey (Mechanic et al. 2001; NCHS 2001–2006).

Implications

In other national surveys, one of five patients said that they did not spend enough time with their physician (KFF 2005), and two of five physicians said that they did not spend enough time with patients to deliver quality care (Blendon et al. 2001).

A perception that less time is being spent with patients may arise from the need to do more during a patient visit, including provide preventive care and more fully explain a larger number of treatment options as patients ask more questions.

Measure:

The denominator population includes outpatient visits by civilian, noninstitutionalized persons to "the offices of nonfederally employed physicians (excluding those in the specialties of anesthesiology, radiology, and pathology) who were classified by the American Medical Association (AMA) and the American Osteopathic Association (AOA) as 'office-based, patient care.' Visits to private, nonhospital-based clinics and health maintenance organizations (HMOs) were within the scope of the survey, but those that occurred in federally operated facilities and hospital-based outpatient departments were not. Telephone contacts and visits made outside the physician’s office were also excluded. . . . Sample physicians were asked to complete Patient Record forms for a systematic random sample of approximately 30 office visits occurring during a randomly assigned one-week reporting period" (NCHS 2006).

Limitations:

These data were not adjusted for changes in the case-mix of physician visits or the intensity of services provided during visits. However, an analysis of 1989 to 1998 data found that the upward trend observed during that time period could not be explained by increases in physician supply, the aging of the population, or the complexity of care for sicker patients. Moreover, the trend toward longer physician office visits occurred for both new and established patients as well as both routine and complex cases (Mechanic et al. 2001).

Source:

Patient encounter data were collected by nationally representative samples of physician offices participating in the National Ambulatory Medical Care Survey. Results for 1989–1998 were compiled by researchers at Rutgers University (Mechanic et al. 2001). Results for 1999–2004 were compiled by the National Center for Health Statistics (NCHS 2001, 2002, 2003, 2004, 2005, 2006).

References:

* Indicates source of data used in the chart(s).

Blendon, R. J., C. Schoen, K. Donelan et al. 2001. Physicians' Views on Quality of Care: A Five-Country Comparison. Health Affairs 20 (3): 233–43.

KFF (Kaiser Family Foundation). 2005. USA Today/Kaiser Family Foundation/Harvard School of Public Health, Health Care Costs Survey. Menlo Park, Calif.: Kaiser Family Foundation,.

* Mechanic, D., D. D. McAlpine, and M. Rosenthal. 2001. Are Patients' Office Visits with Physicians Getting Shorter? New England Journal of Medicine 344 (3): 198–204.

* NCHS (National Center for Health Statistics). 2001. National Ambulatory Medical Care Survey: 1999 Summary. Advance Data 322: 1–36.

* NCHS (National Center for Health Statistics). 2002. National Ambulatory Medical Care Survey: 2000 Summary. Advance Data 328: 1–32.

* NCHS (National Center for Health Statistics). 2003. National Ambulatory Medical Care Survey: 2001 Summary. Advance Data 337: 1–44.

* NCHS (National Center for Health Statistics). 2004. National Ambulatory Medical Care Survey: 2002 Summary. Advance Data 346: 1–44.

* NCHS (National Center for Health Statistics). 2005. National Ambulatory Medical Care Survey: 2003 Summary. Advance Data 365: 1–48.

* NCHS (National Center for Health Statistics). 2006. National Ambulatory Medical Care Survey: 2004 Summary. Advance Data 374: 1–33.