• Justin Porter, Cynthia Boyd, M Reza Skandari, and Neda Laiteerapong.
• Department of Medicine, University of Chicago, Chicago, IL, USA. jporter1@medicine.bsd.uchicago.edu.
• J Gen Intern Med. 2023 Jan 1; 38 (1): 147155147-155.

BackgroundMany patients do not receive guideline-recommended preventive, chronic disease, and acute care. One potential explanation is insufficient time for primary care providers (PCPs) to provide care.ObjectiveTo quantify the time needed to provide 2020 preventive care, chronic disease care, and acute care for a nationally representative adult patient panel by a PCP alone, and by a PCP as part of a team-based care model.DesignSimulation study applying preventive and chronic disease care guidelines to hypothetical patient panels.ParticipantsHypothetical panels of 2500 patients, representative of the adult US population based on the 2017-2018 National Health and Nutrition Examination Survey.Main MeasuresThe mean time required for a PCP to provide guideline-recommended preventive, chronic disease and acute care to the hypothetical patient panels. Estimates were also calculated for visit documentation time and electronic inbox management time. Times were re-estimated in the setting of team-based care.Key ResultsPCPs were estimated to require 26.7 h/day, comprising of 14.1 h/day for preventive care, 7.2 h/day for chronic disease care, 2.2 h/day for acute care, and 3.2 h/day for documentation and inbox management. With team-based care, PCPs were estimated to require 9.3 h per day (2.0 h/day for preventive care and 3.6 h/day for chronic disease care, 1.1 h/day for acute care, and 2.6 h/day for documentation and inbox management).ConclusionsPCPs do not have enough time to provide the guideline-recommended primary care. With team-based care the time requirements would decrease by over half, but still be excessive.© 2022. The Author(s), under exclusive licence to Society of General Internal Medicine.

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