Physicians spent more time on patient care in 2001 than they did four years earlier, but an increasing number of doctors say they do not have enough time with those in their care, a new study suggests.
The research, issued Wednesday by the Center for Studying Health System Change, shows that, on average, physicians spent 46.6 hours on direct patient care per week in 2001, up from the 44.7 hours noted in previous surveys in 1997 and 1999.
Overall, physicians devoted 54.4 hours per week to medically related activities in 2001--including administrative tasks and professional activities, in addition to patient care. That is less than the 55.5 hours from the 1997 study.
Still, 34% of the 12,000 physicians surveyed say the time with patients is inadequate, vs. just 28% four years earlier.
"They still feel pressed," says Alwyn Cassil, spokesperson for the Center for Studying Health System Change, a not-for-profit, Washington-based project of the Robert Wood Johnson Foundation.
"We're getting conflicting signals from changes in the healthcare system," Cassil says. "I don't think we can draw any conclusions here."
The study's author, HSC senior health researcher Sally Trude, does offer the hypothesis that physician capacity may be tightening, a situation that could ease if employers and health plans continue to shift healthcare costs onto their employees and enrollees.
In the study, HSC says that 78% of all Americans saw a physician at least once during 2001, up only slightly from the 77% in 1997, though the average number of doctor visits per person remained steady during the study period at 3.8 per year. This is despite the fact that pushback from managed care made it easier for patients to choose their physicians and to see specialists, Trude writes.
But, the report points out, the labor market was much tighter in 2001 than it is today, so the results do not reflect newer evidence that insured patients have become responsible for a greater portion of their premiums and are likely to have higher co-payments than they did two years ago.
"We know that patients faced with higher out-of-pocket costs will not seek as much care," says Cassil.
"The current mismatch may be temporary and may sort itself out as some other market forces kick in," she adds. She suggests there may be a "temporary imbalance" between physician supply and patient demand.