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Multicenter Study
. 2001 Oct;16(10):663-7.
doi: 10.1111/j.1525-1497.2001.01111.x.

Productivity, quality, and patient satisfaction: comparison of part-time and full-time primary care physicians

D G Fairchild  1 , K S McLoughlin, S Gharib, J Horsky, M Portnow, J Richter, N Gagliano, D W Bates
Affiliations
Multicenter Study

Productivity, quality, and patient satisfaction: comparison of part-time and full-time primary care physicians

D G Fairchild et al. J Gen Intern Med. 2001 Oct.

Abstract

Context: Although few data are available, many believe that part-time primary care physicians (PCPs) are less productive and provide lower quality care than full-time PCPs. Some insurers exclude part-time PCPs from their provider networks.

Objective: To compare productivity, quality of preventive care, patient satisfaction, and risk-adjusted resource utilization of part-time and full-time PCPs.

Design: Retrospective cohort study.

Setting: Boston.

Participants: PCPs affiliated with 2 academic outpatient primary care networks.

Measurements: PCP productivity, patient satisfaction, resource utilization, and compliance with screening guidelines.

Results: Part-time PCP productivity was greater than that of full-time PCPs (2.1 work relative value units (RVUs)/bookable clinical hour versus 1.3 work RVUs/bookable clinical hour, P< .01). A similar proportion of part-time PCPs (80%) and full-time PCPs (75%) met targets for mammography, Pap smears, and cholesterol screening (P = .67). After adjusting for clinical case mix, practice location, gender, board certification status, and years in practice, resource utilization of part-time PCPs (138 dollars [95% confidence interval (CI), 108 dollars to 167 dollars]) was similar to that of full-time PCPs (139 dollars [95% CI, 108 dollars to 170 dollars], P = .92). Patient satisfaction was similar for part-time and full-time PCPs.

Conclusions: In these academic primary care practices, rates of patient satisfaction, compliance with screening guidelines, and resource utilization were similar for part-time PCPs compared to full-time PCPs. Productivity per clinical hour was markedly higher for part-time PCPs. Despite study limitations, these data suggest that academic part-time PCPs are at least as efficient as full-time PCPs and that the quality of their work is similar.

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Figures

FIGURE 1
FIGURE 1
Adjusted mean expenses per member per month ($PMPM) adjusted for Ambulatory Care Group (ACG) weight, practice location, physician board status, gender and years in practice. Part-time versus full-time primary care physicians (PCPs) from Brigham and Women's Hospital and Massachusetts General Hospital practicing during 1996 and 1997.
See this image and copyright information in PMC

Comment in

  • Time is of the essence.
    Warde C. Warde C. J Gen Intern Med. 2001 Oct;16(10):712-3. doi: 10.1111/j.1525-1497.2001.08020.x. J Gen Intern Med. 2001. PMID: 11679040 Free PMC article. No abstract available.

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