Time allocation in primary care office visits
Open accessAbstract
Objectives. To use an innovative videotape analysis method to examine how clinic time was spent during elderly patients' visits to primary care physicians. Secondary objectives were to identify the factors that influence time allocations. Data Sources. A convenience sample of 392 videotapes of routine office visits conducted between 1998 and 2000 from multiple primary care practices in the United States, supplemented by patient and physician surveys. Research Design. Videotaped visits were examined for visit length and time devoted to specific topics—a novel approach to study time allocation. A survival analysis model analyzed the effects of patient, physician, and physician practice setting on how clinic time was spent. Principal Findings. Very limited amount of time was dedicated to specific topics in office visits. The median visit length was 15.7 minutes covering a median of six topics. About 5 minutes were spent on the longest topic whereas the remaining topics each received 1.1 minutes. While time spent by patient and physician on a topic responded to many factors, length of the visit overall varied little even when contents of visits varied widely. Macro factors associated with each site had more influence on visit and topic length than the nature of the problem patients presented. Conclusions. Many topics compete for visit time, resulting in small amount of time being spent on each topic. A highly regimented schedule might interfere with having sufficient time for patients with complex or multiple problems. Efforts to improve the quality of care need to recognize the time pressure on both patients and physicians, the effects of financial incentives, and the time costs of improving patient–physician interactions.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Obstetrical visits typically last under 20 minutes, while those with nurse-midwives are slightly longer.
“Obstetrical visits typically last under 20 minutes; however, those with nursemidwives are slightly longer.106”
From The transition to parenthood in obstetrics: enhancing prenatal care for 2-generation impact (2022) · cites this paper as [106]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)
Hu, R. J. (2003) · Elsevier eBooks · doi:10.1016/b0-12-226870-9/01070-4 · Cited by 9,167 · see citing works
Evaluating the quality of medical care
DONABEDIAN, A. (2005) · The Milbank Quarterly · doi:10.1111/j.1468-0009.2005.00397.x · Cited by 6,102 · see citing works
High agreement but low Kappa: I. the problems of two paradoxes
Feinstein, A. R., & Cicchetti, D. V. (1990) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(90)90158-l · Cited by 3,034 · see citing works
(2003) · RePEc: Research Papers in Economics · Cited by 1,844 · see citing works
High agreement but low kappa: II. Resolving the paradoxes
Cicchetti, D. V., & Feinstein, A. R. (1990) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(90)90159-m · Cited by 1,838 · see citing works
The discourse of medicine : dialectics of medical interviews
Mishler, E. G. (1984) · Cited by 1,566 · see citing works
Levinson, W. S. (1997) · JAMA · doi:10.1001/jama.277.7.553 · Cited by 1,512 · see citing works
Physician Gender Effects in Medical Communication
ROTER, D. L., Hall, J. A., & Aoki, Y. (2002) · JAMA · doi:10.1001/jama.288.6.756 · Cited by 1,434 · see citing works
Levinson, W. S. (1997) · JAMA · doi:10.1001/jama.1997.03540310051034 · Cited by 1,124 · see citing works
Handbook of health communication
Thompson, T. L. (2008) · Cited by 1,121 · see citing works
Older Americans 2012: Key Indicators of Wellbeing
Tarver, T. (2013) · Journal of Consumer Health on the Internet · doi:10.1080/15398285.2013.756760 · Cited by 1,047 · see citing works
Communication Patterns of Primary Care Physicians
Roter, D. L. (1997) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1997.03540280088045 · Cited by 939 · see citing works
ROTER, D. L. (1977) · Health Education Monographs · doi:10.1177/109019817700500402 · Cited by 639 · see citing works
Physician Gender and Patient-Centered Communication: A Critical Review of Empirical Research
ROTER, D. L., & Hall, J. A. (2004) · Annual Review of Public Health · doi:10.1146/annurev.publhealth.25.101802.123134 · Cited by 619 · see citing works
Physician Characteristics and Distribution in the Us: 1999
Pasko, T. J., Seidman, B., & Smart, D. R. (1998) · Cited by 563 · see citing works
Hillman, A. L., Pauly, M. V., & Kerstein, J. (1989) · New England Journal of Medicine · doi:10.1056/nejm198907133210205 · Cited by 472 · see citing works
Information giving in medical care
Waitzkin, H. (1985) · Journal of Health and Social Behavior · doi:10.2307/2136599 · Cited by 466 · see citing works
Fiscella, K. A., Meldrum, S. C., Franks, P. J., Shields, C. G., Duberstein, P. R., McDaniel, S. H., & Epstein, R. M. (2004) · Medical Care · doi:10.1097/00005650-200411000-00003 · Cited by 448 · see citing works
Are Patients' Office Visits with Physicians Getting Shorter?
Mechanic, D., McAlpine, D. D., & Rosenthal, M. (2001) · New England Journal of Medicine · doi:10.1056/nejm200101183440307 · Cited by 357 · see citing works
Problems and Prospects in the Study of Physician-Patient Interaction: 30 Years of Research
Heritage, J. C., & Maynard, D. W. (2006) · Annual Review of Sociology · doi:10.1146/annurev.soc.32.082905.093959 · Cited by 347 · see citing works
When the treatment goal is not cure: are cancer patients equipped to make informed decisions?
Gattellari, M., Voigt, K. J., Butow, P. N., & Tattersall, M. H. N. (2002) · Journal of Clinical Oncology · doi:10.1200/jco.2002.20.2.503 · Cited by 344 · see citing works
Physician Characteristics and Distribution in the U.S. 1997/98
Rich, E. C. (1998) · Annals of Internal Medicine · doi:10.7326/0003-4819-128-4-199802150-00053 · Cited by 335 · see citing works
Resource-based relative values. An overview
Hsiao, W. C. (1988) · JAMA · doi:10.1001/jama.260.16.2347 · Cited by 293 · see citing works
Suchman, A. L. (2006) · Journal of General Internal Medicine · doi:10.1111/j.1525-1497.2006.00308.x · Cited by 217 · see citing works
Detecting sequential patterns and determining their reliability with fallible observers.
Bakeman, R. A., McArthur, D., Quera, V., & Robinson, B. F. (1997) · Psychological Methods · doi:10.1037/1082-989x.2.4.357 · Cited by 214 · see citing works
Gilchrist, V. J., Stange, K. C., Flocke, S. A., McCord, G., & Bourguet, C. C. (2004) · Medical Care · doi:10.1097/01.mlr.0000114916.95639.af · Cited by 172 · see citing works
Doing Attributions in Medical Interaction: Patients' Explanations for Illness and Doctors' Responses
Gill, V. T. (1998) · Social Psychology Quarterly · doi:10.2307/2787034 · Cited by 168 · see citing works
How Many Problems Do Family Physicians Manage at Each Encounter? A WReN Study
Beasley, J. W. (2004) · The Annals of Family Medicine · doi:10.1370/afm.94 · Cited by 164 · see citing works
Physicians’ psychosocial beliefs correlate with their patient communication skills
Levinson, W., & Roter, D. (1995) · Journal of general internal medicine · doi:10.1007/bf02599834 · Cited by 152 · see citing works
Testing for Statistical Discrimination in Health Care
Balsa, A. I., McGuire, T. G., & Meredith, L. S. (2005) · Health Services Research · doi:10.1111/j.1475-6773.2005.00351.x · Cited by 136 · see citing works
Self-citationWasserman, R. C., & Inui, T. S. (1983) · Medical Care · doi:10.1097/00005650-198303000-00003 · Cited by 106 · see citing works
Eide, H., Quera, V., Graugaard, P. K., & Finset, A. (2003) · Social Science & Medicine · doi:10.1016/j.socscimed.2003.10.011 · Cited by 104 · see citing works
The Columbia guide to standard American English
(1993) · Choice Reviews Online · doi:10.5860/choice.31-1313 · Cited by 85 · see citing works
Tai‐Seale, M., Bramson, R., Drukker, D. M., Hurwicz, M., Ory, M. G., Tai-Seale, T., Street, R. L., & Cook, M. A. (2005) · Medical Care · doi:10.1097/01.mlr.0000185734.00564.c1 · Cited by 66 · see citing works
Self-citationPredictors of Overall Quality of Care Provided to Vulnerable Older People
Min, L. C., Reuben, D. B., MacLean, C. H., Shekelle, P., Solomon, D. H., Higashi, T., Chang, J. T., Roth, C. P., KAMBERG, C. J., Adams, J., et al. (2005) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2005.53520.x · Cited by 60 · see citing works
Multi-dimensional interaction analysis: A collaborative approach to the study of medical discourse
Charon, R., Greene, M. G., & Adelman, R. D. (1994) · Social Science & Medicine · doi:10.1016/0277-9536(94)90207-0 · Cited by 58 · see citing works
The effect of patient health status on physician practice style.
Bertakis, K. D., Callahan, E. J., Helms, L. J., et al. (1993) · PubMed · Cited by 55 · see citing works
Time use during acute and chronic illness visits to a family physician
Yawn, B. P., Goodwin, M. A., Zyzanski, S. J., & Stange, K. C. (2003) · Family Practice · doi:10.1093/fampra/cmg425 · Cited by 53 · see citing works
Informed Decision Making in Outpatient Practice: Time to Get Back to Basics
Braddock III, C. H., Edwards, K. A., Hasenberg, N. M., Laidley, T. L., & Levinson, W. (1999) · JAMA · doi:10.1001/jama.282.24.2313 · Cited by 19 · see citing works
Organizational structure and medical practice in health maintenance organizations.
Wolinsky, F. D., & Ba, C. (1981) · PubMed · Cited by 2 · see citing works
Flagged first, then by citations
Research works printed but not linked: 3
- Time Allocation in Primary Care 1891 14756773, 2007, 5, · DOI
- Ickes, W., C. Marangoni, and S. Garcia. 1997. ''Studying Empathic Accuracy in a Clinically Relevant Context.'' In Empathic Accuracy, edited by W. Ickes, pp. 282- 310. New York: Guilford Press.
- Maynard, D. 2003. Bad News, Good News: Order in Everyday Talk and Clinical Settings. Chicago: University of Chicago Press.
Cited by
Sorted by citations
Tai-Seale, M., Olson, C. W., Li, J., Chan, A. S., Morikawa, C., Durbin, M., Wang, W., & Luft, H. S. (2017) · Health Affairs · doi:10.1377/hlthaff.2016.0811 · Cited by 379 · see citing works
Self-citationOh, H. J., Lauckner, C., Boehmer, J., Fewins-Bliss, R., & Li, K. (2013) · Computers in Human Behavior · doi:10.1016/j.chb.2013.04.017 · Cited by 256 · see citing works
Stein, N., & Brooks, K. (2017) · JMIR Diabetes · doi:10.2196/diabetes.8590 · Cited by 191 · see citing works
The complexity, diversity, and science of primary care teams.
Fiscella, K., & McDaniel, S. H. (2018) · American Psychologist · doi:10.1037/amp0000244 · Cited by 155 · see citing works
Health-focused conversational agents in person-centered care: a review of apps
Parmar, P., Ryu, J., Pandya, S., Sedoc, J., & Agarwal, S. (2022) · npj Digital Medicine · doi:10.1038/s41746-022-00560-6 · Cited by 113 · see citing works
Allen, M. R., Webb, S., Mandvi, A., Frieden, M., Tai-Seale, M., & Kallenberg, G. (2024) · BMC Primary Care · doi:10.1186/s12875-024-02282-y · Cited by 100 · see citing works
Self-citationChung, C.-F., Wang, Q., Schroeder, J., Cole, A., Zia, J., Fogarty, J., & Munson, S. A. (2019) · Proceedings of the ACM on Interactive, Mobile, Wearable and Ubiquitous Technologies · doi:10.1145/3314394 · Cited by 93 · see citing works
A Qualitative Study of Coping in Mothers of Children with an Autism Spectrum Disorder
Kuhaneck, H. M., Burroughs, T., Wright, J., Lemanczyk, T., & Darragh, A. R. (2010) · Physical & Occupational Therapy In Pediatrics · doi:10.3109/01942638.2010.481662 · Cited by 93 · see citing works
Szmuilowicz, E. D., & Aleppo, G. (2022) · Postgraduate Medicine · doi:10.1080/00325481.2022.2110507 · Cited by 27 · see citing works
The transition to parenthood in obstetrics: enhancing prenatal care for 2-generation impact
Monk, C., Dimidjian, S., Galinsky, E., Gregory, K. D., Hoffman, M. C., Howell, E. A., Miller, E. S., Osborne, C., Rogers, C. E., Saxbe, D. E., et al. (2022) · American Journal of Obstetrics & Gynecology MFM · doi:10.1016/j.ajogmf.2022.100678 · Cited by 19 · see citing works
Explaining Variability in Electronic Health Record Effort in Primary Care Ambulatory Encounters
Overhage, J. M., Qeadan, F., Choi, E. H. E., Vos, D., & Kroth, P. J. (2024) · Applied Clinical Informatics · doi:10.1055/s-0044-1782228 · Cited by 13 · see citing works
- Authors
- Tai‐Seale, M., McGuire, T. G., & Zhang, W.
- Affiliations
- Texas A&M Health Science Center (US)
- Harvard University (US)
- Texas A&M University (US)
- Corresponding author
- Tai‐Seale, Ming
- ORCID
- Tai‐Seale, Ming
- Venue
- Health Services Research
- Publisher
- Wiley
- Published
- 2007-01-24
- Volume
- 42
- Issue
- 5
- Pages
- 1871-1894
- ISSN
- 0017-9124 (ISSN-L)
- 1475-6773
- PMC
- PMC2254573
- OpenAlex
- W2106691710
- Cited by
- 472
- References
- 40
- Citations by year
- 2026: 22 · 2025: 29 · 2024: 42 · 2023: 34 · 2022: 39 · 2021: 29 · 2020: 28 · 2019: 44 · 2018: 37 · 2017: 18 · 2016: 17 · 2015: 20 · 2014: 13 · 2013: 26 · 2012: 9
- FWCI
- 29.43
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Health Services Research (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (AG15737, R44AG015737)
- National Institute of Mental Health (K01MH001935, MH01935)
- Topics
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Keywords
- time allocation, elderly patients, visit duration, videotape analysis, physician time use, patient-physician interaction, time pressure, financial incentives, clinic scheduling
- MeSH terms
- Aged, Communication, Female, Humans, Male, Office Visits, Physician-Patient Relations, Practice Patterns, Physicians', Primary Health Care, Quality of Health Care, United States, Videotape Recording, Time Management, Health Care Surveys
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
