The Article in Brief

Physician Activities During Time Out of the Examination Room

Valerie Gilchrist, MD , and colleagues

Background The limited time available for medical visits can be a source of frustration for patients and doctors. Doctors must divide their office time between direct patient care and other administrative and communication responsibilities. This study set out to learn more about how practicing primary care doctors spend their office time.

What This Study Found On average, doctors in this study spend 8 hours and 8 minutes in the office per day and have 20 patient visits. Visits last an average of 17.5 minutes. Doctors spend 23 percent of the office day on medical activities other than patient visits, including completing patient charts, dictating medical notes, reviewing reports, consulting medical resources, consulting colleagues, and communicating with patients. This does not include time spent delivering medical care in other settings, such as hospitals, nursing homes, or emergency rooms.

Implications

• If out-of- examination room medical care activities were considered part of the patient visit, visit time would increase by about 7 minutes, or 40%. This does not include the many other responsibilities doctors perform outside the office.
• Medical care activities outside the examination room reflect the complexity of managing primary care patients; however, patients and payers often do not recognize this care.
• To help ensure high-quality care and satisfaction, medical policy and reimbursement should reflect the actual work performed by clinicians.