Study: Physicians spend less face-to-face time with patients when clinic is running behind

Physicians at three Johns Hopkins Medicine outpatient clinics in Baltimore spent more face-to-face time with patients when the clinic was on schedule and less when it was running late, according to a study published in BMJ Open.

Here are five things to know.

1. For the study, researchers gathered data on patient appointment time, patient arrival time, patient interactions and physician-patient interaction for 23,635 visits.

2. Three different facilities were used in the study: a low-volume pain management clinic, a medium-volume academic pain management clinic and a high-volume radiation oncology service in the clinic.

3. Researchers sorted patients into three groups. The first group represented individuals who arrived at the clinic and were in the examination room before their scheduled appointment time. The second group comprised individuals who arrived before their appointment time but were not in the examination room until after their appointment time, which indicates the clinic was busy and running behind. The third group included people who arrived at the clinic after their appointment time, reports News Medical Lifesciences.

4. At the low-volume clinic, the average processing times for the first, second and third groups were 38.31, 26.23 and 29.50 minutes, respectively. At the medium-volume clinic, processing times were 65.59, 53.53 and 50.91 minutes, respectively. The high-volume clinic saw processing times of 47.51, 17.59 and 47.90 minutes, respectively.

5. Researchers found that adapting behavior to catch up with the clinic's schedule harms efficiency by creating unpredictable time variability in the system.

"The take-home message is that one way to ease the trade-off between wait time and face time is to reduce uncertainty in the overall system," says Chester Chambers, PhD, assistant professor of operations management at Johns Hopkins University Carey Business School and an associate faculty member at the Johns Hopkins Armstrong Institute for Patient Safety and Quality. "If a doctor is more consistent in the amount of time spent with each patient, wait times tend to go down, and it puts less pressure on the doctor to make up the time by rushing."

 

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