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Related Experiment Videos

Trade-offs in high-volume primary care practice

S J Zyzanski1, K C Stange, D Langa

  • 1Department of Family Medicine, Case Western Reserve University, Cleveland, OH, USA. sjz@po.cwru.edu

The Journal of Family Practice
|May 23, 1998
PubMed
Summary

High-volume primary care physicians see patients faster but may compromise preventive care and patient satisfaction. This efficiency may impact the doctor-patient relationship, highlighting trade-offs in healthcare productivity.

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Area of Science:

  • Primary Care Medicine
  • Health Services Research
  • Clinical Efficiency

Background:

  • Primary care physicians face pressure to increase patient volume for cost reduction and efficiency.
  • Understanding factors influencing physician volume is crucial in modern healthcare settings.

Purpose of the Study:

  • Identify factors associated with variations in physician patient volume.
  • Evaluate differences in clinical outcomes and time utilization during patient visits based on physician volume.

Main Methods:

  • Direct observation of 3893 outpatient visits across 108 family physicians.
  • Data collection via direct observation, patient/physician questionnaires, and medical record review.
  • Comparison of high-, medium-, and low-volume practices regarding preventive services, patient satisfaction, and time use.

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Main Results:

  • High-volume physicians had shorter visits and saw fewer patients for well care.
  • Practice ownership and male gender were more common in high-volume physicians.
  • Despite similar time use, high-volume practice patients received fewer preventive services and reported lower satisfaction and poorer doctor-patient relationships.

Conclusions:

  • High-volume practices appear more efficient, delivering services in less time.
  • This efficiency may be linked to reduced preventive care delivery and lower patient satisfaction.
  • Healthcare plans and physicians should weigh the benefits against potential drawbacks of high-volume models.