Adults visited with their primary care physician (PCP) a mean of 16 minutes per visit in 1991 and 1992. However, the length of individual visits was influenced by both patient and practice characteristics, as well as procedures performed during the visit, according to a study supported by the Agency for Health Care Policy and Research (HS07892). For instance, older patients, patients new to the physician's practice, those referred by another physician, and patients with psychosocial problems had significantly longer visits. Patients insured by health maintenance organizations (HMOs) or Medicaid had visits that were shorter by 2 percent and 5 percent, respectively. Patients who had eye or dental problems or were pregnant also had shorter visits (16 percent and 6 percent shorter, respectively).
Taking into account patient-related factors when allotting time for an individual patient's visit could improve patient scheduling, physician productivity, and patient satisfaction, concludes David Blumenthal, M.D., M.P.P., of Harvard Medical School. Dr. Blumenthal and his colleagues analyzed the results of physician interviews and data from the 1991-1992 National Ambulatory Medical Care Survey on 19,192 visits by adults to 686 PCPs.
The exact nature of the visit also influenced its length. For instance, the performance of four or more diagnostic tests (compared with none) increased visit length more than any other variable (71 percent or 11 minutes). Pap smears increased visit length by 34 percent, ambulatory surgical procedures by 34 percent, patient admission to the hospital by 32 percent, and performing three or more preventive screening tests increased visit length by 25 percent. In cases where no followup was planned, visit length was decreased by 8 percent.
Several physician practice factors also decreased visit length. PCPs who practiced in four or more locations had 43 percent shorter visits with patients than those who practiced in a single location. Also, those in practices with 6 to 25 full-time employees (compared with none) had 13 percent shorter visits. PCPs in the West visited with their patients 11 percent longer than PCPs in the Northeast.
See "The duration of ambulatory visits to physicians," by Dr. Blumenthal, Nancyanne Causino, Ed.D., YuChiao Chang, Ph.D., and others, in the April 1999 Journal of Family Practice 48(4), pp. 264-271.