HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Supplemental data: Appendixes In Brief TRACK Comments: Submit a response Alert me when this article is cited Alert me when TRACK Comments are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gilchrist, V. Articles by Zaharna, M. Search for Related Content PubMed PubMed Citation Articles by Gilchrist, V. Articles by Zaharna, M.

Physician Activities During Time Out of the Examination Room

¹ Northeastern Ohio Universities College of Medicine (NEOUCOM), Rootstown, Ohio
² Akron General Medical Center, Akron, Ohio
³ Barberton Citizens Hospital, Barberton, Ohio
⁴ Aultman Hospital, Canton, Ohio
⁵ St Elizabeth’s Hospital, Youngstown, Ohio
⁶ Allegheny General Hospital, Pittsburgh, Pa
⁷ Cleveland Clinic Foundation, Cleveland, Ohio
⁸ Rush Presbyterian St Luke’s Medical Center, Chicago, Ill
⁹ Ohio State University Children’s Hospital, Columbus, Ohio
¹⁰ Boston University School of Public Health, Boston, Mass

CORRESPONDING AUTHOR: Valerie Gilchrist, MD, Department of Family Medicine, Brody School of Medicine, at East Carolina University, 600 Moye Blvd - Brody 4N84, Greenville, NC 27834, gilchristv{at}mail.ecu.edu

PURPOSE Comprehensive medical care requires direct physician-patient contact, other office-based medical activities, and medical care outside of the office. This study was a systematic investigation of family physician office-based activities outside of the examination room.

METHODS In the summer of 2000, 6 medical students directly observed and recorded the office-based activities of 27 northeastern Ohio community-based family physicians during 1 practice day. A checklist was used to record physician activity every 20 seconds outside of the examination room. Observation excluded medical care provided at other sites. Physicians were also asked to estimate how they spent their time on average and on the observed day.

RESULTS The average office day was 8 hours 8 minutes. On average, 20.1 patients were seen and physicians spent 17.5 minutes per patient in direct contact time. Office-based time outside of the examination room averaged 3 hours 8 minutes or 39% of the office practice day; 61% of that time was spent in activities related to medical care. Charting (32.9 minutes per day) and dictating (23.4 minutes per day) were the most common medical activities. Physicians overestimated the time they spent in direct patient care and medical activities. None of the participating practices had electronic medical records.

CONCLUSIONS If office-based, medically related activities were averaged over the number of patients seen in the office that day, the average office visit time per patient would increase by 7 minutes (40%). Care delivery extends beyond direct patient contact. Models of health care delivery need to recognize this component of care.

Key Words: Physician time • direct observation • health care delivery • reimbursement

This article has been cited by other articles:

				N. Pimlott Who has time for family medicine? Can Fam Physician, January 1, 2008; 54(1): 14 - 16. [Full Text] [PDF]

				K. C. Stange In This Issue: Trade-Offs, Time Use, Depression Care Ann. Fam. Med, November 1, 2005; 3(6): 482 - 483. [Full Text] [PDF]