The battle between primary care and time: Doctors are losing - MedCity News

The classic battle between time and the patient’s best interest is real in primary care.

The average primary care physician has between 1200 to 1900 patients, with Kaiser Permanente reporting an average physical panel size of 1,751. This is most likely not accurate these days, with some reports saying 2,500 to 4,000 is the new norm, as brilliantly pointed out in a LinkedIn comment by Dr. Sharon Ng

I asked my followers to share their thoughts on how they can make the healthcare system better, and they posted great comments about it Linkedin topic – 70 comments and counting.

What does this mean?

Basically, primary care doctors don’t have much time to do anything but the basics and very little time for preventative measures.

With basic math you can see that the numbers don’t add up, 24 hours a day, proper care takes 26.7 hours. And unfortunately, we’re not robots that can work non-stop or manipulate time with the Infinity Gauntlet or have special powers like Dr. Strange to make up the difference.

PCPs are estimated to be needed 26.7 hours/dayinclusive

  • 14.1 h/day for prevention
  • 7.2 hours/day for treatment of chronic diseases
  • 2.2 hours/day for emergency care
  • 3.2 hours/day for documentation and inbox management

“There’s this kind of disconnect between the care we’re trained to provide and the constraints of the clinic workday,” said Dr. Justin Porter, assistant professor of medicine at the University of Chicago and lead author of the paper. “We have an ever-growing pool of guidelines, but clinic slots have not increased commensurately.”

Since most doctors spend less than 15 to 20 minutes with their patients per visit, there is not much time for fact-finding, let alone training the doctor to learn what preventive screening resources are available to their patients. even if that care is reimbursable by Medicare/Medicaid, such as lung cancer screening.

For many chronic disease management reviews

Chronic diseases are a leading cause of morbidity and mortality worldwide, and preventive examinations are the most effective way to reduce the risk of developing a chronic disease. However, many people do not take advantage of preventive screening services for chronic diseases, especially in rural areas.

Another study from Duke in 2005 estimated that physicians would need an additional 10.6 hours per workday to manage the top 10 chronic conditions among their patients.

And it has real implications for health care delivery; the researchers said time pressures help explain why improvements in outcomes have not kept pace with progress in the field, the study said.

If you survey patients about what frustrates them about their medical care, you’ll often hear, “My doctor doesn’t spend time with me” or “My doctor doesn’t follow up,” Porter said in the UChicago article. “I think a lot of times that is interpreted as a lack of empathy or a lack of desire to care for a patient. But the reality – for most doctors – is simply a lack of time.

Why is that?

The key is physician education, time and patient access. All things can be fixed if resources and expertise are properly allocated.

with 59% With all Americans (194 million) suffering from at least one chronic disease, and nearly one in three adults with three or more chronic diseases, doctors are tasked with doing the impossible. human lives and costs of care for risk carriers.

Source: Rand Corporation

The authors suggest “team-based care,” in which nurses, physician assistants, counselors, and others help deliver recommended care, as one solution to the problem of overwhelmed, burned-out primary care records.

Using team-based care, they estimated that the primary care physician’s time could be reduced by up to 9.3 hours per day.

Photo: malerapaso, Getty Images

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