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Allocation of Physician Time in Ambulatory Practice: A Time and Motion Study in 4 Specialties.

Abstract：

Background:Little is known about how physician time is allocated in ambulatory care. Objective:To describe how physician time is spent in ambulatory practice. Design:Quantitative direct observational time and motion study (during office hours) and self-reported diary (after hours). Setting:U.S. ambulatory care in 4 specialties in 4 states (Illinois, New Hampshire, Virginia, and Washington). Participants:57 U.S. physicians in family medicine, internal medicine, cardiology, and orthopedics who were observed for 430 hours, 21 of whom also completed after-hours diaries. Measurements:Proportions of time spent on 4 activities (direct clinical face time, electronic health record [EHR] and desk work, administrative tasks, and other tasks) and self-reported after-hours work. Results:During the office day, physicians spent 27.0% of their total time on direct clinical face time with patients and 49.2% of their time on EHR and desk work. While in the examination room with patients, physicians spent 52.9% of the time on direct clinical face time and 37.0% on EHR and desk work. The 21 physicians who completed after-hours diaries reported 1 to 2 hours of after-hours work each night, devoted mostly to EHR tasks. Limitations:Data were gathered in self-selected, high-performing practices and may not be generalizable to other settings. The descriptive study design did not support formal statistical comparisons by physician and practice characteristics. Conclusion:For every hour physicians provide direct clinical face time to patients, nearly 2 additional hours is spent on EHR and desk work within the clinic day. Outside office hours, physicians spend another 1 to 2 hours of personal time each night doing additional computer and other clerical work. Primary Funding Source:American Medical Association.

journal_name

Ann Intern Med

journal_title

Annals of internal medicine

authors

Sinsky C,Colligan L,Li L,Prgomet M,Reynolds S,Goeders L,Westbrook J,Tutty M,Blike G

doi

10.7326/M16-0961

subject

Has Abstract

pub_date

2016-12-06 00:00:00

pages

753-760

issue

eissn

0003-4819

issn

1539-3704

pii

2546704

journal_volume

165

pub_type

杂志文章

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Allocation of Physician Time in Ambulatory Practice: A Time and Motion Study in 4 Specialties.