After internist Jan Gurley breaks down the numbers, it’s easy to see why. Primary care doctors, on average, have patient panels averaging 2,500 patients or so. Assuming full-time working doctor who only takes the 10 federal holidays off per year, “[patients] ‘own’ only (50 weeks X 40 hours, minus 10 X 8 hours, minus 50 weeks X 8 hours; divided by 2500) 36 minutes a year of [their] doctor’s time.”
KevinMD notes the Osbyte study* in which they found it would take the average PCP with the average daily patient visit volume 18 hours to do all the care they could/should be doing for their patients with chronic conditions. He forgot to mention that there were an additional 7 hours needed to care for the urgent patients who called in that day or the day before.
The root cause is the under-financing of primary care. When adequately financed we have the capacity to match the true needs of the patient populations. We can get off the hamster wheel. We can spend time listening to people and help tailor plans beyond the 'one size fits all' care plans we see coming out of some shops.
The difference between adequately financed shops and not is huge. Patients are happier and get better care, the outcomes are better, and in spite of the extra spending (in fact BECAUSE of the extra spending) on primary care, the total costs of health care are lower. By a lot.
- "I can see you today"
- "I can see you on time"
- "We can take all the time you want and need"
This is all possible. I did it for years in my old practice and will do it all again in my new one.
*Ostbye, T., Yarnall, K. S., Krause, K. M., Pollak, K. I., Gradison, M., & Michener, J. L. (2005). Is there time for management of patients with chronic diseases in primary care? Annals of Family Medicine, 3, 209– 214.