Primary care providers need more than 26 hours a day to follow national care guidelines, study estimates

Primary care providers don't have nearly enough time to provide guideline-recommended preventive, chronic disease and acute care, according to a new study. 

The study was led by researchers at the University of Chicago, Baltimore-based Johns Hopkins University and Imperial College London. Their findings, published July 1 in the Journal of General Internal Medicine, showed providing recommended care would take a primary care physician 26.7 hours per day to see an average number of patients. Researchers estimated it would take 14.1 hours per day to provide recommended preventive care, 7.2 hours per day for chronic disease care, 2.2 hours a day for acute care, and 3.2 hours per day for administrative work. 

"There is this sort of disconnect between the care we've been trained to give and the constraints of a clinic workday," Justin Porter, MD, lead study author and assistant professor of medicine at the University of Chicago, said in an Aug. 3 news release. "We have an ever-increasing set of guidelines, but clinic slots have not increased proportionately."

The researchers conducted a simulation study on hypothetical panels of 2,500 patients using data from the U.S. 2017-18 National Health and Nutrition Examination survey. They calculated the time required to provide 2020 guideline-recommended preventive, chronic disease and acute care to the hypothetical patient panels. 

Researchers also found a team-based model — which involves nurses, physician assistants, counselors and others in the delivery of recommended care — reduced the time a physician needs to deliver care to 9.3 hours per day. Under this model, estimates suggest primary care physicians would need two hours per day for preventive care, 3.6 hours per day for chronic disease care, 1.1 hours per day for acute care, and 2.6 hours a day for documentation and inbox medicine. 

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