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Research ArticleOriginal ResearchA

Estimating a Reasonable Patient Panel Size for Primary Care Physicians With Team-Based Task Delegation

Justin Altschuler, David Margolius, Thomas Bodenheimer and Kevin Grumbach
The Annals of Family Medicine September 2012, 10 (5) 396-400; DOI: https://doi.org/10.1370/afm.1400
Justin Altschuler
Center for Excellence in Primary Care, Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California
MD
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David Margolius
Center for Excellence in Primary Care, Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California
MD
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Thomas Bodenheimer
Center for Excellence in Primary Care, Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California
MD
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  • For correspondence: TBodenheimer@fcm.ucsf.edu
Kevin Grumbach
Center for Excellence in Primary Care, Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California
MD
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Abstract

PURPOSE Primary care faces the dilemma of excessive patient panel sizes in an environment of a primary care physician shortage. We aimed to estimate primary care panel sizes under different models of task delegation to nonphysician members of the primary care team.

METHODS We used published estimates of the time it takes for a primary care physician to provide preventive, chronic, and acute care for a panel of 2,500 patients, and modeled how panel sizes would change if portions of preventive and chronic care services were delegated to nonphysician team members.

RESULTS Using 3 assumptions about the degree of task delegation that could be achieved (77%, 60%, and 50% of preventive care, and 47%, 30%, and 25% of chronic care), we estimated that a primary care team could reasonably care for a panel of 1,947, 1,523, or 1,387 patients.

CONCLUSIONS If portions of preventive and chronic care services are delegated to nonphysician team members, primary care practices can provide recommended preventive and chronic care with panel sizes that are achievable with the available primary care workforce.

  • primary care
  • delegation
  • panels
  • health care team
  • allied health personnel
  • physician’s practice patterns
  • models
  • organizational
  • practice-based research
  • Received for publication October 25, 2011.
  • Revision received January 11, 2012.
  • Accepted for publication January 25, 2012.
  • © 2012 Annals of Family Medicine, Inc.
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The Annals of Family Medicine: 10 (5)
The Annals of Family Medicine: 10 (5)
Vol. 10, Issue 5
September/October 2012
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Estimating a Reasonable Patient Panel Size for Primary Care Physicians With Team-Based Task Delegation
Justin Altschuler, David Margolius, Thomas Bodenheimer, Kevin Grumbach
The Annals of Family Medicine Sep 2012, 10 (5) 396-400; DOI: 10.1370/afm.1400

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Estimating a Reasonable Patient Panel Size for Primary Care Physicians With Team-Based Task Delegation
Justin Altschuler, David Margolius, Thomas Bodenheimer, Kevin Grumbach
The Annals of Family Medicine Sep 2012, 10 (5) 396-400; DOI: 10.1370/afm.1400
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