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Related Experiment Videos

Addressing multiple problems in the family practice office visit.

S A Flocke1, S H Frank, D A Wenger

  • 1Department of Family Medicine, Case Western Reserve University, Cleveland, Ohio, USA.

The Journal of Family Practice
|March 17, 2001
PubMed
Summary
This summary is machine-generated.

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Family practice visits often address multiple patient and physician-raised problems, increasing visit length. Current billing records may underrepresent the true number of problems managed during primary care encounters.

Area of Science:

  • Primary Care Research
  • Family Medicine
  • Health Services Research

Background:

  • Outpatient family practice encounters frequently involve addressing multiple health issues.
  • Understanding the scope of problems managed is crucial for evaluating physician productivity and healthcare delivery.

Purpose of the Study:

  • To quantify the number and nature of problems addressed in family practice outpatient visits.
  • To examine the impact of additional problems on visit duration.
  • To assess the accuracy of billing records in reflecting the problems managed.

Main Methods:

  • A cross-sectional study analyzed 266 randomly selected adult patient encounters with 37 physicians.
  • Problems were defined as issues requiring physician action (decision, diagnosis, treatment, monitoring).

Related Experiment Videos

  • Visit duration and the number of billing diagnoses were recorded and compared to observed problems.

    • Main Results:

    • An average of 2.7 problems and 8 physician actions occurred per encounter.
    • Multiple problems were addressed in 73% of visits, with patients raising 58% of additional issues.
    • Each additional problem extended visit duration by an average of 2.5 minutes, and billing records tended to underreport managed problems.

    Conclusions:

    • Family physicians commonly manage multiple problems per visit, initiated by both patients and physicians.
    • Existing metrics for physician productivity and billing may not accurately capture the complexity of primary care.
    • Further research is needed to develop more comprehensive models for assessing primary care workload and value.