Article Figures & Data
Tables
Time Use Categories and Activities Hours Mean (SD) Percent of Total Workday *Activities included in the paperwork time category. Total workday 8.6 (1.82) 100.0 Face-to-face patient care 4.72 (1.19) 54.9 Visit-specific work outside the examination room 1.25 (0.92) 14.5 Chart (reviewing, writing, or dictating notes) 0.52 (0.62) 6.0 Completing encounter form, billing sheet* 0.14 (0.23) 1.6 Other (eg, talking with patient in hallway, waiting for patient to undress or dress) 0.13 (0.10) 1.5 Arranging for tests or consultations* 0.11 (0.09) 1.3 Writing prescription 0.10 (0.15) 1.2 Getting materials (equipment, preparing for procedure, patient education) 0.07 (0.06) 0.8 Consultation with other physician or staff 0.06 (0.10) 0.7 Interpreting laboratory work or radiographs 0.04 (0.06) 0.5 Looking up medical information 0.03 (0.07) 0.3 Performing laboratory work 0.02 (0.03) 0.2 Completing forms (disability, school physical, etc)* 0.01 (0.01) 0.1 Finding missing or pending laboratory information, radiographs, charts 0.01 (0.03) 0.1 Looking up allowed referrals or formulary options* <0.01 (0.01) 0.05 Talking with insurance company regarding patient; completing forms* <0.01 (0.01) 0.04 Work outside the examination room related to care of patients not currently being seen 1.97 (1.08) 22.9 Chart (reviewing, writing, or dictating notes) 0.69 (0.64) 8.0 Telephone calls from/to patients, family members 0.41 (0.73) 4.8 Reviewing laboratory results, radiographs, patient letters 0.24 (0.36) 2.8 Fielding questions from staff about patient calls, laboratory results, etc 0.16 (0.17) 1.9 Checking schedule 0.16 (0.25) 1.9 Other (eg, pharmacy calls, scheduling patient, instructing nurse to provide educational materials to patient) 0.11 (0.23) 1.3 Consulting with other physicians about patients 0.09 (0.11) 1.0 Completing forms (disability, insurance, school physical, etc)* 0.03 (0.06) 0.3 Writing prescriptions 0.02 (0.05) 0.2 Talking with insurance company regarding patient; completing forms* 0.01 (0.04) 0.1 Finding missing or pending laboratory information, radiographs, charts <0.01 (0.02) 0.07 Responding to patients’ questions when they come in for laboratory or nurse visit <0.01 (0.01) 0.07 Arranging for tests or consultations* <0.01 (0.02) 0.06 Looking up medical information <0.01 (0.01) 0.06 Looking up allowed referrals or formulary options* <0.01 (0.01) 0.03 Other work outside the examination room Administration 0.33 (0.35) 3.8 Office management and personal issues 0.12 (0.18) 1.4 Other 0.07 (0.16) 0.8 Hospital committees and meetings 0.06 (0.26) 0.7 Reading mail or e-mail 0.04 (0.05) 0.5 Visits from sales representatives 0.03 (0.08) 0.3 Scheduling office hours and call coverage 0.01 (0.02) 0.1 Practice meetings 0.00 (0.00) 0.00 Academic activities 0.21 (0.58) 2.4 Teaching (lecture, seminar, etc, outside of patient care) 0.09 (0.41) 1.0 Precepting (teaching during patient care) 0.05 (0.05) 0.7 Other 0.04 (0.08) 0.5 Continuing medical education, conferences 0.02 (0.11) 0.2 Research <0.01 (0.02) 0.03 Patient care in other settings 0.09 (0.30) 1.0 Hospital rounds 0.07 (0.24) 0.8 Travel time 0.02 (0.06) 0.2 Home visits 0.00 (0.00) 0.00 Nursing home rounds 0.00 (0.00) 0.00 Other 0.00 (0.00) 0.00 Other activities 0.03 (0.08) 0.3
Additional Files
The Article in Brief
Time Spent in Face-to-Face Patient Care and Work Outside the Examination Room
Andrew Gottschalk, BS , and colleagues
Background It is widely thought that doctor visits are becoming shorter. According to national estimates by doctors, however, the length of primary care office visits increased during a 10-year period (1988-1998). One possible explanation is that when doctors estimate the length of patient visits, they combine face-to-face patient care time with patient-related work outside the examination room. This study examines that possibility by directly observing doctors� work time in and out of the examination room.
What This Study Found In this study, doctors work an average of 8.6 hours per day in the office. Face-to-face patient care accounts for 55% of the day; 14% of the day is spent on work outside the examination room related to current patients. One fifth (23%) of the day involves work related to patients not currently in the office. This includes writing or dictating notes, making phone calls about patient care, and interpreting laboratory results.
Implications
- When estimating the length of patient visits, doctors might include patient care responsibilities outside the examination room. It is therefore possible that face-to-face visit time has decre
- Office systems, such as electronic prescribing and electronic health records, could help streamline the doctor�s role and increase the efficiency of information management in the doctor�s office.
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