May 7, 2003
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ASHINGTON, D.C.—While physicians spent about two additional hours a week on patient care in 2001 than in 1997, more doctors say they dont have enough time with patients, according to a national tracking study released today by HSC.
The proportion of time physicians spent in direct patient care activities increased from 81 percent in 1997 to 86 percent in 2001. Nonetheless, the proportion of physicians reporting inadequate time with patients grew from 28 percent in 1997 to 34 percent in 2001.
Possible explanations for the growing number of physicians who feel pressed for time with patients include increased diagnostic and treatment options, managed care plans easing of tight restrictions on care, people living longer with chronic illnesses that may require more complex coordination among caregivers and a growing list of recommended preventive services, the study noted.
"As the practice of medicine grows more complex, physicians may be frustrated because they have too much to discuss with their patients in too little time," said Paul B. Ginsburg, Ph.D., president of HSC, a nonpartisan policy research organization funded exclusively by The Robert Wood Johnson Foundation.
The studys findings are detailed in a new HSC Tracking Report—So Much to Do, So Little Time: Physician Capacity Constraints, 1997-2001—available by clicking here. The study is based on results from HSCs Community Tracking Study nationally representative Physician and Household Surveys, which involve about 12,000 physicians and 60,000 consumers, respectively.
Other signs of strained physician capacity include patients waiting longer for appointments and fewer physicians willing to accept all new patients. Yet, the supply of physicians grew modestly, more medical practices employed nurse practitioners and other nonphysician caregivers, and the average number of doctor visits per person annually remained constant between 1997 and 2001.
Signs of strained physician capacity have emerged as the health care marketplace shifted away from tightly managed care practices that restricted patients access to physicians and gave them more freedom to seek care without substantial out-of-pocket cost increases, the study noted. Current physician capacity constraints may ease if higher out-of-pocket costs prompt patients to seek less care.
"The real question is whether the current imbalance between physician capacity and patients seeking care is a blip on the radar screen or a longer-term problem," said HSC Senior Health Researcher Sally Trude, Ph.D., the studys author.
"In 2001, we still had a tight labor market, and many employers were reluctant to pass higher health care costs to workers, making only small increases in workers deductibles and copayments," Trude said. "As health insurance premiums continue to skyrocket, employers are more aggressively shifting higher costs to workers, and that may prompt people to seek less care and ease current physician capacity constraints."
Other key findings include:
The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely insights on the nations changing health system to help inform policy makers and contribute to better health care policy. HSC, based in Washington, D.C., is funded exclusively by The Robert Wood Johnson Foundation and is affiliated with Mathematica Policy Research, Inc.