Are patients' office visits with physicians getting shorter?

Area of Science:

• Health Services Research
• Medical Economics
• Ambulatory Care

Background:

• Managed care is widely believed to pressure physicians into shorter patient visits.
• This study investigates the impact of managed care on physician office visit duration.

Purpose of the Study:

• To examine trends in physician office visit length from 1989 to 1998.
• To determine if managed care significantly altered visit duration.

Main Methods:

• Analysis of nationally representative data from the National Ambulatory Medical Care Survey (NAMCS) and the American Medical Association's Socioeconomic Monitoring System (SMS).
• Assessment of visit duration trends for managed care (prepaid) versus non-prepaid visits.
• Examination of trends across primary and specialty care, new and established patients, and common/serious diagnoses.

Main Results:

• Physician office visits increased in volume but not per capita rate.
• Average visit duration slightly increased by 1-2 minutes between 1989 and 1998.
• Visit length increased for both prepaid and non-prepaid plans, with non-prepaid visits remaining consistently longer.

Conclusions:

• Contrary to expectations, managed care growth did not correlate with reduced physician visit times.
• Observed trends in visit length were not explained by physician availability, gender shifts, or case mix complexity.