![]() There is no definite association between visit length and outcomes of chronic diseases. 8 both found a greater likelihood of patients feeling they had inadequate time with their physician in visits scheduled to last 5 minutes compared with visits scheduled to last 10 and 15 minutes, respectively. Other studies of patient satisfaction and visit length have come from Great Britain. 6 They found that patients who stated they wished they had spent more time with the physician were less satisfied. ![]() Like and Zyzanski studied determinants of patient satisfaction in a university-based family practice in Cleveland. did not, however, report actual visit lengths. In addition, physicians with a practice volume under 70 visits per week tended to have a favorable decision-making style. ![]() They found that physicians with a more participatory decision-making style were 30% less likely to have patients leave their care. 5 They had previously found that patients of physicians with a “participatory decision-making style” had better health outcomes and were more satisfied. studied general internists and family physicians as part of the Medical Outcomes Study (data from 1986). 4 Their analysis did not explicitly include factors related to visit length. found that patients ranked the importance of providing health-related information second only to clinical skill. 3 In a study of community-based general internists, Laine et al. studied patient satisfaction in an academic family medicine practice and found that time the physician spent in health education and the effects of treatment had an important bearing on patient satisfaction. Finally, we offer recommendations for teaching medical students and residents skills that will help establish and maintain their patient-doctor relationships in the face of time pressure.Īlthough patient satisfaction with outpatient care is associated with activities that are time-intensive, the association with visit length is less clear. We review the effects that are attributable to managed care. In this article we examine the effects of limiting time on the patient-doctor relationship. These factors have moved time management for physicians, in their practices and in their lives, to the forefront as a critical issue. 2 Because of social and demographic changes in the physician workforce, many physicians have family responsibilities that reduce their time available for work. The 1995 Commonwealth Fund survey found that 41% of physicians noted a decline in the amount of time spent with patients and 43% noted a decline in the amount of time spent with colleagues between 19. Increasing administrative requirements for health care delivery (e.g., service and authorization requests, utilization review processes) encroach on time spent with patients. In the current practice environment, physicians face mounting demands on their time. Importantly, time is always finite: no matter what demands a physician faces, there are only 24 hours in a day. Physicians spend time in face-to-face contact with patients gathering information, and developing a relationship, doing administrative work related to visits, and maintaining their knowledge base. Furthermore, with an increasing emphasis on value and efficiency in health care delivery, quality time between physician and patient is an increasingly valuable resource. ![]() 1 Yet both as a contribution to health care costs and as a key element in patient-doctor relationships, there is reason to believe that it deserves more attention. There has been relatively little study of physician time as a resource. At the same time, physicians may be called on to limit utilization of health care resources to services that are judged to be “medically necessary.” Modern information transfer technology has made physicians' ability to access information about these advances easier and contributed to patients being more aware of changes in many aspects of health care. Major advances are frequent in the arenas of diagnostic testing, therapeutics, and pharmaceuticals. ![]() The technical resources that go into the delivery of health care have been studied extensively. Achieving such a goal requires availability, a broad spectrum of medical knowledge, effective use of the local health care system, and attention to both the “big picture” and the details of a patient's life and health. This is especially true for primary care physicians who set as their goal the delivery and coordination of comprehensive care for patients. Being a physician always has been a busy job. ![]()
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