Confounding conventional wisdom, researchers writing in the New England Journal of Medicine have found that the spread of managed care during the past decade has not reduced the amount of time spent with patients. In fact, physicians in 1998 spent one to two more minutes with patients than in 1989, when managed care’s rapid expansion was just beginning.
The authors used a pair of sources to determine duration of office visits. In 1989, the National Ambulatory Medical Care Survey timed the average visit at 16.3 minutes; the AMA’s Socioeconomic Monitoring System pegged it at 20.4 minutes. By both instruments, time with each patient increased one to two minutes. Further, time spent in 1998 with patients with indemnity coverage was merely 0.6 minute more than with those in managed care plans, partially closing what had been a one-minute gap in 1989.
In their discussion, the authors theorized that physician dissatisfaction with managed care in general has been projected to create a perception — however incorrect — that time with patients has been sacrificed. Some of that feeling may stem from the fact that primary care physicians in particular offer a broader range of services than in years past, but in actuality that demands a longer office visit. They add that increased competition encourages physicians to keep patients happy — and thus spend more time with them.
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