Biomaterial Database

Primary care physician productivity: the physician factor. 1995

D M Smith, and D K Martin, and C D Langefeld, and M E Miller, and J A Freedman

Division of General Medicine, Richard L. Roudebush VAMC, Indianapolis, IN 46202, USA.

OBJECTIVE To model physician productivity as a function of clinic (support system) characteristics and physician characteristics and to model the time a physician spends with the patient as a function of patient characteristics. METHODS Observational study. METHODS A general medicine clinic of a university-affiliated Veterans Affairs medical center. METHODS A cohort of 2,520 patients having 2,721 consecutive outpatient visits to 56 physicians. METHODS Physician productivity defined as patients seen/physician/hour and time (minutes) spent with the patient. RESULTS Physicians saw a mean (+/- SD) of 1.62 +/- 0.68 patients/hour. Clinic characteristics explained 8.2% of the variability of session-specific physician productivity. Controlling for clinic characteristics, a factor representing the physician explained an additional 55.4%. A model for overall physician productivity, using physician characteristics, explained 84.9% of the variance, and time spent with the patient was an important predictor. Modeling physician time with patients, patient characteristics accounted for only 7% of the variability. Controlling for patient characteristics, the individual physician again provided the greatest explanatory power, an additional 22.8% of the variability. CONCLUSIONS Physicians' practice patterns, rather than clinic or patient characteristics, may account for most of the variation in physician productivity. Given the magnitude of the influence of individual practice patterns, interventions to increase productivity need to consider methods to affect physician behavior.

UI	MeSH Term	Description	Entries
D007196	Indiana	State bounded on the north by Lake Michigan and Michigan, on the east by Ohio, on the south by Kentucky, and on the west by Illinois.
D009819	Office Visits	Visits made by patients to health service providers' offices for diagnosis, treatment, and follow-up.	Office Visit,Visit, Office,Visits, Office
D010045	Outpatients	Persons who receive ambulatory care at an outpatient department or clinic without room and board being provided.	Out-patients,Out patients,Out-patient,Outpatient
D010821	Physicians, Family	Those physicians who have completed the education requirements specified by the American Academy of Family Physicians.	Family Physician,Family Physicians,Physician, Family
D011216	Practice Management, Medical	The organization and operation of the business aspects of a physician's practice.	Medical Practice Management Services,Management, Medical Practice,Medical Practice Management,Practice Management Services, Medical,Managements, Medical Practice,Medical Practice Managements,Practice Managements, Medical
D004526	Efficiency	Ratio of output to effort and or resources, or the ratio of effort and or resources produced to energy expended.	Productivity
D001071	Appointments and Schedules	The different methods of scheduling patient visits, appointment systems, individual or group appointments, waiting times, waiting lists for hospitals, walk-in clinics, etc.	Patient Appointments,Patient Schedules,Schedules, Patient,Appointments,Schedules,Appointment,Appointment, Patient,Appointments, Patient,Patient Appointment,Patient Schedule,Schedule,Schedule, Patient,Schedules and Appointments
D013996	Time and Motion Studies	The observation and analysis of movements in a task with an emphasis on the amount of time required to perform the task.	Time Studies,Studies, Time,Study, Time,Time Study
D014481	United States	A country in NORTH AMERICA between CANADA and MEXICO.
D015233	Models, Statistical	Statistical formulations or analyses which, when applied to data and found to fit the data, are then used to verify the assumptions and parameters used in the analysis. Examples of statistical models are the linear model, binomial model, polynomial model, two-parameter model, etc.	Probabilistic Models,Statistical Models,Two-Parameter Models,Model, Statistical,Models, Binomial,Models, Polynomial,Statistical Model,Binomial Model,Binomial Models,Model, Binomial,Model, Polynomial,Model, Probabilistic,Model, Two-Parameter,Models, Probabilistic,Models, Two-Parameter,Polynomial Model,Polynomial Models,Probabilistic Model,Two Parameter Models,Two-Parameter Model