BACKGROUND: The time spent and complexity of work done by primary internal medicine physicians between office visits has not been well studied. OBJECTIVE: To measure the time and complexity of this care. DESIGN: Cross-sectional study. SETTING: General internists practicing on primary care teams with electronic medical records at a tertiary Veterans Health Administration Medical Center. PARTICIPANTS: Ten physicians. MAIN MEASURES: The project was designed to measure physician work between office visits. The electronic record was used to record the number and complexity of work events by physicians for 1 month. Complexity of work was measured on five levels ranging from Level I with no change in management, Level II with change in management of one disease, Level III of two diseases, Level IV of three diseases, and Level V of four or more diseases. Time sampling was done over 5 days to determine the time spent by level of complexity. Total time per physician was calculated by multiplying the number of events each physician captured by the average time for that physician for that level of complexity. KEY RESULTS: Physicians worked a median of 7.9 h per week between office visits. Work was apportioned among Level I (18.3%), Level II (38.3%), Level III (36.5%), Level IV (4.6%), and Level V (2.3%). LIMITATIONS: Single VA population and self-reported data. Findings may not be generalizable to other practice settings. CONCLUSION: Primary internists spent a median of 7.9 h per week in work between office visits with 82% of the time involved in changes in management.
BACKGROUND: The time spent and complexity of work done by primary internal medicine physicians between office visits has not been well studied. OBJECTIVE: To measure the time and complexity of this care. DESIGN: Cross-sectional study. SETTING: General internists practicing on primary care teams with electronic medical records at a tertiary Veterans Health Administration Medical Center. PARTICIPANTS: Ten physicians. MAIN MEASURES: The project was designed to measure physician work between office visits. The electronic record was used to record the number and complexity of work events by physicians for 1 month. Complexity of work was measured on five levels ranging from Level I with no change in management, Level II with change in management of one disease, Level III of two diseases, Level IV of three diseases, and Level V of four or more diseases. Time sampling was done over 5 days to determine the time spent by level of complexity. Total time per physician was calculated by multiplying the number of events each physician captured by the average time for that physician for that level of complexity. KEY RESULTS: Physicians worked a median of 7.9 h per week between office visits. Work was apportioned among Level I (18.3%), Level II (38.3%), Level III (36.5%), Level IV (4.6%), and Level V (2.3%). LIMITATIONS: Single VA population and self-reported data. Findings may not be generalizable to other practice settings. CONCLUSION: Primary internists spent a median of 7.9 h per week in work between office visits with 82% of the time involved in changes in management.
Authors: Karen E Hauer; Steven J Durning; Walter N Kernan; Mark J Fagan; Matthew Mintz; Patricia S O'Sullivan; Michael Battistone; Thomas DeFer; Michael Elnicki; Heather Harrell; Shalini Reddy; Christy K Boscardin; Mark D Schwartz Journal: JAMA Date: 2008-09-10 Impact factor: 56.272
Authors: Mark Linzer; Linda Baier Manwell; Eric S Williams; James A Bobula; Roger L Brown; Anita B Varkey; Bernice Man; Julia E McMurray; Ann Maguire; Barbara Horner-Ibler; Mark D Schwartz Journal: Ann Intern Med Date: 2009-07-07 Impact factor: 25.391
Authors: G Talley Holman; John W Beasley; Ben-Tzion Karsh; Jamie A Stone; Paul D Smith; Tosha B Wetterneck Journal: J Am Med Inform Assoc Date: 2015-09-02 Impact factor: 4.497
Authors: Urmimala Sarkar; Doug Bonacum; William Strull; Christiane Spitzmueller; Nancy Jin; Andrea López; Traber Davis Giardina; Ashley N D Meyer; Hardeep Singh Journal: BMJ Qual Saf Date: 2012-05-23 Impact factor: 7.035
Authors: Philip Zazove; Melissa A Plegue; Michael M McKee; Melissa DeJonckheere; Paul R Kileny; Lauren S Schleicher; Lee A Green; Ananda Sen; Mary E Rapai; Elie Mulhem Journal: Ann Fam Med Date: 2020-11 Impact factor: 5.166
Authors: Andrew S Hwang; Steven J Atlas; Johan Hong; Jeffrey M Ashburner; Adrian H Zai; Richard W Grant; Clemens S Hong Journal: J Gen Intern Med Date: 2016-10-21 Impact factor: 5.128
Authors: Ming Tai-Seale; Cliff W Olson; Jinnan Li; Albert S Chan; Criss Morikawa; Meg Durbin; Wei Wang; Harold S Luft Journal: Health Aff (Millwood) Date: 2017-04-01 Impact factor: 6.301
Authors: Shin-Ping Tu; Sherry Feng; Richard Storch; Mei-Po Yip; HeeYon Sohng; Mingang Fu; Alan Chun Journal: J Health Care Poor Underserved Date: 2012-11