Effect of Nonvisit Care on Resident Workload in a Family Medicine Residency

Primary care physicians can spend 24% of their ambulatory care work day on patient care duties outside the office visit (ie, nonvisit care [NVC]). Resident work hours must be performed within duty hour restrictions defined by the Accreditation Council for Graduate Medical Education, making it crucial for program directors to understand how much time residents spend on NVC tasks. Little information is available on resident work hours dedicated to NVC generated in the continuity clinic. We designed this study to look at an objective measure of the time family medicine residents spend on NVC.

We collected and categorized from the electronic health record the NVC events completed by 22 family medicine residents in a rural residency training clinic over a 9-month period. With the use of an institutional time study performed in 2014, we identified the average amount of time required to complete a single event in each category of NVC.

Residents spent a mean of 13.6 hours per month completing NVC, which was equivalent to 127.3 minutes of NVC per 100 empaneled patients per month for each resident.

This study quantified the amount of time residents spend on NVC, allowing program directors to plan curriculum so that residents can keep their work time within duty hour requirements.