PCPs average over 60 hours a week caring for patients, partly due to patient messages
Medically complex patients and patient message volume were associated with longer work hours, offering insight into designing sustainable primary care roles and adjusting panel size expectations, said the authors of a recent study.
Patients' messages about medical advice were associated with long workweeks for primary care physicians (PCPs) and partly accounted for the fact that they work 61.8 hours a week on average, according to a recent study.
Researchers studied data from 406 PCPs at 33 clinics in the Mass General Brigham health system who delivered care for at least nine months in 2021. The researchers estimated the annual average work effort per patient for each physician by combining total appointment time and time spent on the EHR outside scheduled patient visit hours. The results of the study, which was funded by The Physicians Foundation, were published Oct. 21 by Annals of Internal Medicine.
The doctors had a median of 944 patients (interquartile ratio [IQR], 567 to 1,358 patients) in their panels, or 1,668 patients (IQR, 1,432 to 1,883 patients) per 1.0 clinical full-time equivalent (FTE). The median work effort for a full-time physician was 2,844.3 yearly hours (IQR, 2,324.9 to 3,478.9 yearly hours), or 61.8 weekly hours (IQR, 50.5 to 75.6 weekly hours), for one clinical FTE physician, assuming a 46-week work year. Hours worked weekly ranged up to 89 for those at the 90th percentile. The 61.8 hours translates to a median of 1.7 hours (IQR, 1.4 to 2.2 hours) per patient per year, the researchers calculated.
Part-time physicians spent more time per patient on average, according to the study. Patient characteristics associated with more work hours included higher average age, more medical complexity, more medical advice request messages, and Medicaid coverage.
“These findings provide valuable insights for designing sustainable primary care roles and adjusting panel size expectations,” said the study authors, who noted that physicians in the studied system carry smaller patient panels than the typical 2,500 patients.
“Of note, our estimates are substantially lower than the estimated 26.7 hours per day that PCPs could theoretically spend if they were to provide all guideline-recommended preventive, chronic disease, and acute care to a hypothetical panel of patients,” the study authors wrote. “This discrepancy likely reflects the reality that many primary care needs are going unmet, given the current reimbursement and organization of primary care in the United States.”