TY - JOUR
AU - L. S. Rotenstein
AU - M. Frits
AU - C. Iannaccone
AU - M. L'Heureux
AU - J. Fangman
AU - M. Rancier
AU - R. Gitomer
AU - D. W. Bates
AU - B. Landon
A1 - 
AB - BACKGROUND: Given a marked expansion in the work of primary care in recent decades, it is critical to have an accurate understanding of the time involved in managing a primary care panel and the determinants of this time. OBJECTIVE: To estimate the yearly work effort involved for primary care physicians (PCPs) in caring for a patient panel, explore how work effort varies by clinical full-time equivalent (cFTE) status, and identify patient panel factors associated with differential time expenditure. DESIGN: Cross-sectional, observational study using electronic health record and administrative data scaled by a literature-based estimate of activities inadequately captured by these data sources. SETTING: 33 clinics in the Mass General Brigham health system. PARTICIPANTS: 406 attending PCPs who delivered care for at least 9 months in 2021. MEASUREMENTS: Total yearly time expenditure per patient and full-time PCP. RESULTS: The median work effort for a full-time PCP was 2844.3 yearly hours (IQR, 2324.9 to 3478.9 yearly hours), or 61.8 weekly hours (IQR, 50.5 to 75.6 weekly hours), for a 1.0-cFTE physician assuming a 46-week work year. This translates to a median of 1.7 hours (IQR, 1.4 to 2.2 hours) per patient per year. Part-time PCPs spent more time per patient on average than full-time PCPs. Patient medical advice request volume and certain panel characteristics, including greater average age, medical complexity, and percentage of patients with Medicaid, were associated with greater yearly PCP time expenditure per patient. LIMITATION: Derivation of data from a single integrated health system and lack of information about practice structures and staff supports for PCPs. CONCLUSION: Primary care physicians spend a median of 62 weekly hours caring for a patient panel. Panel characteristics and patient message volume are associated with time expenditure. These findings provide valuable insights for designing sustainable primary care roles and adjusting panel size expectations. PRIMARY FUNDING SOURCE: The Physicians Foundation.
AD - Division of Clinical Informatics and Digital Transformation and Division of General Internal Medicine, University of California at San Francisco, San Francisco, California, and Division of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts (L.S.R.).; Division of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts (M.F., C.I.).; Division of General Internal Medicine, Massachusetts General Hospital, and Department of Medicine, Harvard Medical School, Boston, Massachusetts (M.L.).; Mass General Brigham Community Physicians, Boston, Massachusetts (J.F., M.R.).; Division of General Internal Medicine, University of California at San Francisco, San Francisco, California (R.G.).; Division of General Internal Medicine, Brigham and Women's Hospital; Department of Medicine, Harvard Medical School; and Harvard School of Public Health, Boston, Massachusetts (D.W.B.).; Department of Medicine, Harvard Medical School; Beth Israel Deaconess Medical Center; and Department of Healthcare Policy, Harvard Medical School, Boston, Massachusetts (B.L.).
AN - 41115280
BT - Ann Intern Med
C5 - Education & Workforce
CP - 12
DA - Dec
DO - 10.7326/annals-25-01412
DP - NLM
ET - 20251021
IS - 12
JF - Ann Intern Med
LA - eng
N2 - BACKGROUND: Given a marked expansion in the work of primary care in recent decades, it is critical to have an accurate understanding of the time involved in managing a primary care panel and the determinants of this time. OBJECTIVE: To estimate the yearly work effort involved for primary care physicians (PCPs) in caring for a patient panel, explore how work effort varies by clinical full-time equivalent (cFTE) status, and identify patient panel factors associated with differential time expenditure. DESIGN: Cross-sectional, observational study using electronic health record and administrative data scaled by a literature-based estimate of activities inadequately captured by these data sources. SETTING: 33 clinics in the Mass General Brigham health system. PARTICIPANTS: 406 attending PCPs who delivered care for at least 9 months in 2021. MEASUREMENTS: Total yearly time expenditure per patient and full-time PCP. RESULTS: The median work effort for a full-time PCP was 2844.3 yearly hours (IQR, 2324.9 to 3478.9 yearly hours), or 61.8 weekly hours (IQR, 50.5 to 75.6 weekly hours), for a 1.0-cFTE physician assuming a 46-week work year. This translates to a median of 1.7 hours (IQR, 1.4 to 2.2 hours) per patient per year. Part-time PCPs spent more time per patient on average than full-time PCPs. Patient medical advice request volume and certain panel characteristics, including greater average age, medical complexity, and percentage of patients with Medicaid, were associated with greater yearly PCP time expenditure per patient. LIMITATION: Derivation of data from a single integrated health system and lack of information about practice structures and staff supports for PCPs. CONCLUSION: Primary care physicians spend a median of 62 weekly hours caring for a patient panel. Panel characteristics and patient message volume are associated with time expenditure. These findings provide valuable insights for designing sustainable primary care roles and adjusting panel size expectations. PRIMARY FUNDING SOURCE: The Physicians Foundation.
PY - 2025
SN - 0003-4819
SP - 1688
EP - 1697+
ST - Primary Care Physician Time Spent in Patient Care: An Observational Study Using Electronic Health Record Logs
T1 - Primary Care Physician Time Spent in Patient Care: An Observational Study Using Electronic Health Record Logs
T2 - Ann Intern Med
TI - Primary Care Physician Time Spent in Patient Care: An Observational Study Using Electronic Health Record Logs
U1 - Education & Workforce
U3 - 10.7326/annals-25-01412
VL - 178
VO - 0003-4819
Y1 - 2025
ER -