Increased time with patients improves the quality of primary care visits.
A study conducted at the University of Michigan, Ann Arbor found that primary care and family practice physicians are spending more time with patients and simultaneously improving the quality of the office visits. The study findings are reassuring to those who have thought that an older, sicker patient population combined with lagging payments for primary care would cause these physicians to spend less time with patients.
The research team examined 46,000 primary care visits and found that the overall number of visits had increased about 10% from 1997-2005 and the average length of visit increased from 18 minutes to 20 minutes. Quality of care also improved, which was measured by nine medical, counseling, and screening indicators.
The researchers noted that fewer physicians are choosing family medicine and primary care as a career, largely because of work demands and lower income when compared to other practice areas. Improved reimbursement for primary care and family practice and wider use of electronic medical records may be ways to increase the number of physicians practicing in these areas.
Another thought would be to increase the utilization of nurses to fill in the gaps and complement the care provided by primary care and family practice physicians. The problem with this approach, of course, is that nursing care is still not directly reimbursed by Medicare and other third party payers. Legislation has been introduced to mandate payment for nursing care; however, it is now buried somewhere beneath the healthcare reform legislation that was recently introduced.
Chen LM, Farwell WR, Jha AK. Primary care visit duration and quality: does good care take longer? Arch Intern Med 2009;169:1866-1872.