Primary Care: Is There Enough Time for Prevention?
Open accessAbstract
Objectives. We sought to determine the amount of time required for a primary care physician to provide recommended preventive services to an average patient panel. Methods. We used published and estimated times per service to determine the physician time required to provide all services recommended by the US Preventive Services Task Force (USPSTF), at the recommended frequency, to a patient panel of 2500 with an age and sex distribution similar to that of the US population. Results. To fully satisfy the USPSTF recommendations, 1773 hours of a physician’s annual time, or 7.4 hours per working day, is needed for the provision of preventive services. Conclusions. Time constraints limit the ability of physicians to comply with preventive services recommendations.
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?
A 5 A's approach has been shown to produce significant changes in a variety of health behaviors, including smoking cessation, dietary change, and physical activity.
“A 5 A’s approach has been shown to produce significant changes in a variety of health behaviors, including smoking cessation, dietary change, and physical activity.13,26,38–44”
From Better Population Health Through Behavior Change in Adults: A Call to Action (2013) · cites this paper as [44]
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
Statistical Abstract of the U nited S tates
(2005) · Wiley eBooks · doi:10.1002/0471667196.ess2527 · Cited by 8,872 · see citing works
Treating tobacco use and dependence-Clinical practice guideline
Mc, F. (2000) · Medical Entomology and Zoology · Cited by 3,616 · see citing works
Healthy People 2000: National Health Promotion and Disease Prevention Objectives.
Heidel, R. E. (1991) · Population and Development Review · doi:10.2307/1971966 · Cited by 3,171 · see citing works
Detecting Alcoholism: The CAGE Questionnaire
Ewing, J. A. (1984) · JAMA · doi:10.1001/jama.1984.03350140051025 · Cited by 3,005 · see citing works
The CAGE Questionnaire: Validation of a New Alcoholism Screening Instrument
Mayfield, D. G., McLeod, G. A., & Hall, P. B. (1974) · American Journal of Psychiatry · doi:10.1176/ajp.131.10.1121 · Cited by 2,261 · see citing works
Cigarette smoking among adults — United States, 1988
Bachman, J. G., Johnston, L. D., & O’Malley, P. M. (1992) · Patient Education and Counseling · doi:10.1016/0738-3991(92)90149-d · Cited by 1,710 · see citing works
(U.S.), C. F. D. C. A. P. (1998) · PsycEXTRA Dataset · doi:10.1037/e547602006-001 · Cited by 1,213 · see citing works
The rational clinical examination
Devitt, N. F. (1992) · JAMA · doi:10.1001/jama.268.16.2164c · Cited by 616 · see citing works
Shalmani, H. M. (2014) · Journal of Liver · doi:10.4172/2167-0889.1000147 · Cited by 607 · see citing works
Ventura, S. J., Martin, J. A., Curtin, S. C., & Mathews, T. J. (1999) · PubMed · Cited by 411 · see citing works
Does This Patient Have Breast Cancer?
Barton, M. B., Harris, R., & Fletcher, S. W. (1999) · JAMA · doi:10.1001/jama.282.13.1270 · Cited by 377 · see citing works
Hazardous and Harmful Alcohol Consumption in Primary Care
Reid, M. C., Fiellin, D. A., & O’Connor, P. G. (1999) · Archives of Internal Medicine · doi:10.1001/archinte.159.15.1681 · Cited by 361 · 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
Has the use of cervical, breast, and colorectal cancer screening increased in the United States?
Anderson, L. M., & May, D. S. (1995) · American Journal of Public Health · doi:10.2105/ajph.85.6.840 · Cited by 352 · see citing works
Coffield, A. B., Maciosek, M. V., McGinnis, J. M., Harris, J. R., Caldwell, M. B., Teutsch, S. M., Atkins, D., Richland, J. H., & Haddix, A. C. (2001) · American Journal of Preventive Medicine · doi:10.1016/s0749-3797(01)00308-7 · Cited by 351 · see citing works
(1996) · American Journal of Public Health · doi:10.2105/ajph.86.7.948 · Cited by 314 · see citing works
Brief physician- and nurse practitioner-delivered counseling for high-risk drinkers: does it work?
Ockene, J., Adams, A., Hurley, T., Wheeler, E. V., & Hébert, J. R. (1999) · Archives of Internal Medicine · doi:10.1001/archinte.159.18.2198 · Cited by 279 · see citing works
Same-day appointments: exploding the access paradigm.
Murray, M. F., & Tantau, C. (2000) · PubMed · Cited by 270 · see citing works
Sj, V., Martin, J. A., Sc, C., Mathews, T. J., & Park, M. M. (2000) · PubMed · Cited by 247 · see citing works
Performance of cancer screening in a university general internal medicine practice
McPhee, S. J., Richard, R. J., & Solkowitz, S. N. (1986) · Journal of General Internal Medicine · doi:10.1007/bf02596202 · Cited by 243 · see citing works
Ockene, I. S., Hebert, J. R., Ockene, J. K., Saperia, G. M., Stanek, E., Nicolosi, R., Merriam, P. A., & Hurley, T. G. (1999) · Archives of Internal Medicine · doi:10.1001/archinte.159.7.725 · Cited by 226 · see citing works
Current and Projected Workforce of Nonphysician Clinicians
Cooper, R. A. (1998) · JAMA · doi:10.1001/jama.280.9.788 · Cited by 219 · see citing works
Evaluation of cervical cytology.
McCrory, D., Matchar, D. B., Bastian, L., Datta, S., Hasselblad, V., Hickey, J., Myers, E. R., & Nanda, K. (1999) · PubMed Central · Cited by 196 · see citing works
Long, B. J., Calfas, K. J., Wooten, W. J., Sallis, J. F., Patrick, K., Goldstein, M. G., Marcus, B. H., Schwenk, T. L., Chenoweth, J., Carter, R., et al. (1996) · American Journal of Preventive Medicine · doi:10.1016/s0749-3797(18)30348-9 · Cited by 184 · see citing works
Making “Time” for Preventive Services
Kottke, T. E., Brekke, M. L., & Solberg, L. I. (1993) · Mayo Clinic Proceedings · doi:10.1016/s0025-6196(12)60638-7 · Cited by 178 · see citing works
Ruffin, M. T., Gorenflo, D. W., & Woodman, B. (2000) · The Journal of the American Board of Family Medicine · doi:10.3122/jabfm.13.1.1 · Cited by 139 · see citing works
Trade-offs in high-volume primary care practice.
Zyzanski, S. J., Stange, K. C., Langa, D. M., & Flocke, S. A. (1998) · PubMed · Cited by 109 · see citing works
Opportunistic preventive services delivery. Are time limitations and patient satisfaction barriers?
Stange, K. C., Flocke, S. A., & Goodwin, M. A. (1998) · PubMed · Cited by 99 · see citing works
Reducing alcohol consumption. Comparing three brief methods in family practice.
McIntosh, M. C., Leigh, G., Baldwin, N. J., & Marmulak, J. (1997) · Europe PMC (PubMed Central) · Cited by 81 · see citing works
Hadley, J., Mitchell, J. M., Sulmasy, D. P., & Bloche, M. G. (1999) · PubMed Central · Cited by 79 · see citing works
Adams, A., Ockene, J. K., Wheeler, E. V., & Hurley, T. G. (1998) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.1998.00206.x · Cited by 70 · see citing works
Physicians and Nonphysician Clinicians
Grumbach, K., & Coffman, J. M. (1998) · JAMA · doi:10.1001/jama.280.9.825 · Cited by 65 · see citing works
Kewenter, J., Brevinge, H., Engarås, B., & Haglind, E. (1995) · Endoscopy · doi:10.1055/s-2007-1005655 · Cited by 64 · see citing works
Maciosek, M. V., Coffield, A. B., McGinnis, J. M., Harris, J. R., Caldwell, M. B., Teutsch, S. M., Atkins, D. C., Richland, J. H., & Haddix, A. C. (2001) · American Journal of Preventive Medicine · doi:10.1016/s0749-3797(01)00309-9 · Cited by 63 · see citing works
Health promotion counseling of chronic-disease patients during primary care visits.
Russell, N. K., & ROTER, D. L. (1993) · American Journal of Public Health · doi:10.2105/ajph.83.7.979 · Cited by 60 · see citing works
An ounce of prevention? Evaluation of the 'Put Prevention into Practice' program.
McVea, K. L. S. P., Crabtree, B. F., Medder, J., Susman, J. L., Lukas, L. A., McIlvain, H. E., Davis, C., Gilbert, C. S., & Hawver, M. (1996) · PubMed · Cited by 58 · see citing works
Carney, P. A., Dietrich, A. J., Freeman, D. H., & Mott, L. A. (1993) · Annals of Internal Medicine · doi:10.7326/0003-4819-119-2-199307150-00007 · Cited by 51 · see citing works
The Commonwealth Fund Survey of Physician Experiences with Managed Care
Schoen, C. (1997) · Cited by 43 · see citing works
Disposable, sheathed, flexible sigmoidoscopy: A prospective, multicenter, randomized trial
Rothstein, R. I., & Littenberg, B. (1995) · Gastrointestinal Endoscopy · doi:10.1016/s0016-5107(95)70192-3 · Cited by 42 · see citing works
Chemoprevention strategies for the control of cancer
Lippman, S. M., Benner, S. E., & Hong, W. K. (1993) · Cancer · doi:10.1002/1097-0142(19930801)72:3+ · Cited by 41 · see citing works
Cancer Prevention in Primary Care: Reducing alcohol intake
Austoker, J. (1994) · BMJ · doi:10.1136/bmj.308.6943.1549 · Cited by 37 · see citing works
Campion, E. W. (2001) · New England Journal of Medicine · doi:10.1056/nejm200101183440311 · Cited by 36 · see citing works
Prevention services in primary care: taking time, setting priorities.
Rafferty, M. P. (1998) · PubMed · Cited by 31 · see citing works
Cigarette Smoking Among Adults— United States, 1990
(1992) · JAMA · doi:10.1001/jama.1992.03480230025007 · Cited by 31 · see citing works
Schroy, P. C., Wilson, S. E., & Afdhal, N. H. (1996) · PubMed · Cited by 29 · see citing works
Continued assessment of flexible sigmoidoscopy in a family practice residency.
Ra, J., Quan, M. A., & Wm, R. (1984) · PubMed · Cited by 27 · see citing works
Put prevention into practice: a controlled evaluation
Melnikow, J. A., Kohatsu, N. D., & Chan, B. K. S. (2000) · American Journal of Public Health · doi:10.2105/ajph.90.10.1622 · Cited by 26 · see citing works
Flexible sigmoidoscopy: primary care outcomes after two types of continuing medical education.
Wm, R., & Albers, G. (1986) · PubMed · Cited by 26 · see citing works
Cancer prevention practices among Texas primary care physicians
Spitz, M. R., Chamberlain, R. M., Seder, J., & Fueger, J. J. (1992) · Journal of Cancer Education · doi:10.1080/08858199209528142 · Cited by 24 · see citing works
Medder, J., Kahn, N. B., & Susman, J. L. (1992) · American Journal of Preventive Medicine · doi:10.1016/s0749-3797(18)30823-7 · Cited by 23 · see citing works
Barriers to Clinical Preventive Medicine
Burack, R. C. (1989) · Primary Care Clinics in Office Practice · doi:10.1016/s0095-4543(21)01319-1 · Cited by 23 · see citing works
Anderson, P. (1991) · PubMed · Cited by 22 · see citing works
Groveman, H. D., Sanowski, R. A., & Klauber, M. R. (1988) · PubMed · Cited by 21 · see citing works
Physicians and nurses can be effective educators in coronary risk reduction
Peiss, B., Kurleto, B., & Rubenfire, M. (1995) · Journal of General Internal Medicine · doi:10.1007/bf02600231 · Cited by 19 · see citing works
Put prevention into practice (PPIP): evaluating PPIP in two family practice residency sites.
Yeazel, M. W., Bunner, S. H., Kofron, P. M., & Weiss, P. J. (2002) · PubMed · Cited by 7 · see citing works
Evaluation of an intervention to increase seat belt use.
Gordon, P. (1990) · PubMed · Cited by 6 · see citing works
Rb, L., Wn, B., Mw, S., Rl, G., Jt, F., & De, V. (1989) · PubMed · Cited by 6 · see citing works
An ounce of prevention is a ton of work.
Susman, J. (2002) · PubMed · Cited by 3 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Boyd, C. M., Darer, J., Boult, C., Fried, L. P., Boult, L., & Wu, A. W. (2005) · JAMA · doi:10.1001/jama.294.6.716 · Cited by 2,581 · see citing works
“All elements of the treatment plan cannot easily be addressed in a 15-minute office visit.(55,56) Interactions that could result from concurrent adherence to all 5 CPGs (TABLE 4) include between a medica-”
Background2019 Alzheimer’s disease facts and figures.
Alzheimer's Association (2019) · Alzheimer's & Dementia · doi:10.1016/j.jalz.2019.01.010 · Cited by 2,461 · see citing works
AUDIT‐C as a Brief Screen for Alcohol Misuse in Primary Care
Bradley, K. A., Rubinsky, A. D., Volk, R. J., Williams, E. C., Frank, D., & Kivlahan, D. R. (2007) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.2007.00403.x · Cited by 1,634 · see citing works
Riding the Crest of the Teachable Moment: Promoting Long-Term Health After the Diagnosis of Cancer
Demark‐Wahnefried, W., Aziz, N. M., Rowland, J. H., & Pinto, B. M. (2005) · Journal of Clinical Oncology · doi:10.1200/jco.2005.01.230 · Cited by 1,114 · see citing works
Increasing Vaccination: Putting Psychological Science Into Action
Brewer, N. T., Chapman, G. B., Rothman, A. J., Leask, J., & Kempe, A. (2017) · Psychological Science in the Public Interest · doi:10.1177/1529100618760521 · Cited by 1,233 · see citing works
How Can We Increase Translation of Research into Practice? Types of Evidence Needed
Glasgow, R. E., & Emmons, K. M. (2007) · Annual Review of Public Health · doi:10.1146/annurev.publhealth.28.021406.144145 · Cited by 1,050 · see citing works
Coordinating Care — A Perilous Journey through the Health Care System
Bodenheimer, T. S. (2008) · New England Journal of Medicine · doi:10.1056/nejmhpr0706165 · Cited by 969 · see citing works
“It has been e stimated that it would take a physician 7.4 hours per working day to provide all recommended preventive services to a typical patient panel [ 50 ], plus 10.6 hours per day to provide high-quali ty chronic care [51].”
BackgroundInfluentialThe Impact of Comorbid Chronic Conditions on Diabetes Care
Piette, J. D., & Kerr, E. A. (2006) · Diabetes Care · doi:10.2337/diacare.29.03.06.dc05-2078 · Cited by 727 · see citing works
“Given intensive time constraints, clinicians often must make decisions about where to focus treatment priorities during outpatient encounters (11,49,50).”
Backgroundten Cate, O. T. J., Kusurkar, R. A., & Williams, G. C. (2011) · Medical Teacher · doi:10.3109/0142159x.2011.595435 · Cited by 697 · see citing works
“2008) indicates that it is the lack of efficacy or perceived competence and time pressures (Yarnell et al. 2003) from busy practice that stops clinicians for providing counselling and prescriptions for tobacco dependence.”
BackgroundIs There Time for Management of Patients With Chronic Diseases in Primary Care?
Ostbye, T. (2005) · The Annals of Family Medicine · doi:10.1370/afm.310 · Cited by 698 · see citing works
Boyd, C. M., & Fortin, M. (2010) · Public health reviews · doi:10.1007/bf03391611 · Cited by 680 · see citing works
“demonstrates that a typical family practitioner in the US with a standard panel would not have adequate time in a typical day to deliver the services currently recommended for chronic disease management or preventive services.(95,96) This work highlights two issues.”
BackgroundLedwidge, M., Gallagher, J., Conlon, C., Tallon, E., O’Connell, E., Dawkins, I., Watson, C., O’Hanlon, R., Bermingham, M., Patle, A., et al. (2013) · JAMA · doi:10.1001/jama.2013.7588 · Cited by 664 · see citing works
Priorities Among Effective Clinical Preventive Services
Maciosek, M. V., Coffield, A. B., Edwards, N. M., Flottemesch, T. J., Goodman, M. J., & Solberg, L. I. (2006) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2006.03.012 · Cited by 624 · see citing works
“As a result, the current USPSTF has given “insufficient evidence” ratings to the following services ranked in 2001: (1) counseling the general population of adults and children about physical activity and diet, (2) counseling children about preventive dental practices, (3) counseling adolescents to avoid or quit using…”
BackgroundPhysician 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
Wolff, J. L., Spillman, B. C., Freedman, V. A., & Kasper, J. D. (2016) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2015.7664 · Cited by 585 · see citing works
A Single-Question Screening Test for Drug Use in Primary Care
Smith, P. C., Schmidt, S. M., Allensworth‐Davies, D., & Saitz, R. (2010) · Archives of Internal Medicine · doi:10.1001/archinternmed.2010.140 · Cited by 486 · see citing works
“Time constraints in the primary care setting have been cited as a reason for failure to provide screening and prevention in general (according to one estimate, providing all recommended preventive services to an average primary care panel would require 7.4 hours out of each work day)18.”
BackgroundInfluentialMultimorbidity in Older Adults With Cardiovascular Disease
Forman, D. E., Maurer, M. S., Boyd, C., Brindis, R., Salive, M. E., Horne, F. M., Bell, S. P., Fulmer, T., Reuben, D. B., Zieman, S., et al. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.03.022 · Cited by 484 · see citing works
“The burden of care that derives from following multiple nonintegrated guidelines is substantial (61,62) and potentially dangerous.”
BackgroundAccuracy of the Pain Numeric Rating Scale as a Screening Test in Primary Care
Krebs, E. E., Carey, T. S., & Weinberger, M. (2007) · Journal of General Internal Medicine · doi:10.1007/s11606-007-0321-2 · Cited by 460 · see citing works
Primary Care Validation of a Single-Question Alcohol Screening Test
Smith, P. C., Schmidt, S. M., Allensworth‐Davies, D., & Saitz, R. (2009) · Journal of General Internal Medicine · doi:10.1007/s11606-009-0928-6 · Cited by 416 · see citing works
Hébert, E. T., Caughy, M. O., & Shuval, K. (2012) · British Journal of Sports Medicine · doi:10.1136/bjsports-2011-090734 · Cited by 399 · see citing works
Revisiting the Time Needed to Provide Adult Primary Care
Porter, J., Boyd, C. M., Skandari, M. R., & Laiteerapong, N. (2022) · Journal of General Internal Medicine · doi:10.1007/s11606-022-07707-x · Cited by 364 · see citing works
“4 h/day for a primary care provider (PCP) to provide preventive care for a 2500 patient panel.(6) A study by Privett et al.”
BackgroundSocial support in an Internet weight loss community
Hwang, K. O., Ottenbacher, A. J., Green, A. P., Cannon-Diehl, M. R., Richardson, O., Bernstam, E. V., & Thomas, E. J. (2010) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2009.10.003 · Cited by 338 · see citing works
Disparities in Diabetes Care: Impact of Mental Illness
Frayne, S. M., Halanych, J. H., Miller, D. R., Wang, F., Lin, H., Pogach, L., Sharkansky, E. J., Keane, T. M., Skinner, K. M., Rosen, C. S., et al. (2005) · Archives of Internal Medicine · doi:10.1001/archinte.165.22.2631 · Cited by 336 · see citing works
Dissatisfaction with Medical Practice
Zuger, A. (2003) · New England Journal of Medicine · doi:10.1056/nejmsr031703 · Cited by 326 · see citing works
Mobile phone messaging for preventive health care
Vodopivec‐Jamšek, V., de Jongh, T. E., Gurol‐Urganci, I., Atun, R. A., & Car, J. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd007457.pub2 · Cited by 316 · see citing works
Quality of Health Care Delivered to Adults in the United States
Spiegel, M., & Pechlaner, C. (2003) · New England Journal of Medicine · doi:10.1056/nejm200311063491916 · Cited by 318 · see citing works
Glasgow, R. E., Magid, D. J., Beck, A., Ritzwoller, D., & Estabrooks, P. A. (2005) · Medical Care · doi:10.1097/01.mlr.0000163645.41407.09 · Cited by 308 · see citing works
Primary Care Intervention to Reduce Alcohol Misuse
Solberg, L. I., Maciosek, M. V., & Edwards, N. M. (2008) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2007.09.035 · Cited by 284 · see citing works
Problems Paying Out-of-Pocket Medication Costs Among Older Adults With Diabetes
Piette, J. D., Heisler, M., & Wagner, T. H. (2004) · Diabetes Care · doi:10.2337/diacare.27.2.384 · Cited by 301 · see citing works
“Other interventions such as ensuring that all prescribed medications are necessary, substituting generic equivalents for brand therapies, or educating patients about mail-order pharmacies and drug assistance programs may take more effort; unfortunately, primary care primary care providers already face daunting demands…”
BackgroundInternational Journal of Collaborative Research on Internal Medicine & Public Health
Valdivia, J. R. M. (2021) · Journal of Womens Health Issues and Care · Cited by 300 · see citing works
The Impact of Prevention on Reducing the Burden of Cardiovascular Disease
Kahn, R., Robertson, R. M., Smith, R. A., & Eddy, D. M. (2008) · Circulation · doi:10.1161/circulationaha.108.190186 · Cited by 299 · see citing works
Goal-setting for behavior change in primary care: An exploration and status report
Bodenheimer, T., & Handley, M. A. (2009) · Patient Education and Counseling · doi:10.1016/j.pec.2009.06.001 · Cited by 286 · see citing works
“Physicians in primary care seldom have time to engage in such discussions and may be unsure how to discuss behavior change with their patients [5,6].”
BackgroundMauksch, L. B. (2008) · Archives of Internal Medicine · doi:10.1001/archinte.168.13.1387 · Cited by 287 · see citing works
“Explore the patient’s perspective when (1) promotingself-management85;(2)examininghealthbehaviorchange62;( 3 ) the patient gives clues about underlying thoughts and feelings75,86; (4) family87 or cultural88 factors influencepatientbeliefsandbehavior;(5) psychosocial problems diminish patient function89; and (6) sympto…”
BackgroundInfluentialCancer screening in the United States, 2011
Smith, R. A., Cokkinides, V. E., Brooks, D. D., Saslow, D., Shah, M., & Brawley, O. W. (2011) · CA A Cancer Journal for Clinicians · doi:10.3322/caac.20096 · Cited by 277 · see citing works
“Second, there is recognition that the current ‘‘sick-care’’ model that dominates primary care is not conducive to delivering recommended preventive care measures, both in terms of available time and personnel, and other enabling factors and incentives.(116,117) In response to the clear need to do better at both chroni…”
BackgroundHoving, C., Visser, A. P., Mullen, P. D., & van den Borne, B. H. P. (2010) · Patient Education and Counseling · doi:10.1016/j.pec.2010.01.015 · Cited by 276 · see citing works
“Nevertheless, GPs report that barriers such as lack of time and fear of endangering the doctor–patient relationship obstruct them in providing patient education on a larger scale [29].”
BackgroundLandon, B. E., Reschovsky, J. D., Pham, H. H., & Blumenthal, D. (2006) · Medical Care · doi:10.1097/01.mlr.0000199848.17133.9b · Cited by 266 · see citing works
“In the last decade, physicians have come under increasing pressures—to see more patients, meet increased administrative requirements, and to keep up with an ever expanding list of recommended therapeutic and preventive treatments.(1,2) Although not unprecedented, these changes are occurring in the setting of flat or d…”
BackgroundRelationship between Number of Medical Conditions and Quality of Care
Higashi, T., Wenger, N. S., Adams, J., Fung, C. H., Roland, M. O., McGlynn, E. A., Reeves, D., Asch, S. M., Kerr, E. A., & Shekelle, P. (2007) · New England Journal of Medicine · doi:10.1056/nejmsa066253 · Cited by 262 · see citing works
Dryden, R., Williams, B., McCowan, C., & Themessl‐Huber, M. (2012) · BMC Public Health · doi:10.1186/1471-2458-12-723 · Cited by 260 · see citing works
“that many practices and outcomes would be difficult to change due to time pressure and other issues [69,70].”
BackgroundQuality–Speed Conundrum: Trade-offs in Customer-Intensive Services
Anand, K. S., Paç, M. F., & Veeraraghavan, S. K. (2010) · Management Science · doi:10.1287/mnsc.1100.1250 · Cited by 259 · see citing works
“Because of high levels of demand, doctors need to rush between patients,3 spending most of their time treating acute illnesses—a process that is also dissatisfying to patients (Yarnall et al. 2003).”
BackgroundDeaths Preventable in the U.S. by Improvements in Use of Clinical Preventive Services
Farley, T. A., Dalal, M. R., Mostashari, F., & Frieden, T. R. (2010) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2010.02.016 · Cited by 251 · see citing works
“However, time-pressured linicians are forced tomake choices aboutwhich of these linical preventive services to offer during brief clinical enounters.(1,2) In the U.”
BackgroundAn Unwelcome Side Effect of Direct-to-Consumer Personal Genome Testing
McGuire, A. L., & Burke, W. (2008) · JAMA · doi:10.1001/jama.2008.803 · Cited by 250 · see citing works
Narva, A. S., Norton, J. M., & Boulware, L. E. (2015) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.07680715 · Cited by 250 · see citing works
The teamlet model of primary care
Bodenheimer, T., & Laing, B. Y. (2007) · The Annals of Family Medicine · doi:10.1370/afm.731 · Cited by 244 · see citing works
“The goals of the teamlet model are fi vefold: (1) to improve the patient experience and enhance patients’ self-management skills by expanding the encounter to include one-on-one time with a trained health coach; (2) to improve process and outcome measures for preventive and chronic care by delegating routine processes…”
BackgroundImplementation of evidence-based alcohol screening in the Veterans Health Administration.
Bradley, K. A., Williams, E. C., Achtmeyer, C. E., Volpp, B. D., Collins, B. J., & Kivlahan, D. R. (2006) · PubMed · Cited by 249 · see citing works
Gupta, S. N., Halm, E. A., Rockey, D. C., Hammons, M., Koch, M. G., Carter, E., Valdez, L., Tong, L., Ahn, C. W., Kashner, M. T., et al. (2013) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2013.9294 · Cited by 245 · see citing works
“06 Spanish 645 (17) 69 (14) 271 (17) Abbreviation: FIT, fecal immunochemical test.”
The primary care behavioral health (PCBH) model: an overview and operational definition
Reiter, J. T., Dobmeyer, A. C., & Hunter, C. L. (2018) · Journal of Clinical Psychology in Medical Settings · doi:10.1007/s10880-017-9531-x · Cited by 231 · see citing works
Beich, A., Thorsen, T., & Rollnick, S. (2003) · BMJ · doi:10.1136/bmj.327.7414.536 · Cited by 239 · see citing works
Tang, P. C., Overhage, J. M., Chan, A. S., Brown, N. L., Aghighi, B., Entwistle, M., Hui, S. L., Hyde, S., Klieman, L., Mitchell, C. J., et al. (2012) · Journal of the American Medical Informatics Association · doi:10.1136/amiajnl-2012-001263 · Cited by 240 · see citing works
Williams, G. C., Lynch, M., & Glasgow, R. E. (2007) · Health Psychology · doi:10.1037/0278-6133.26.6.728 · Cited by 236 · see citing works
Altschuler, J., Margolius, D., Bodenheimer, T., & Grumbach, K. (2012) · The Annals of Family Medicine · doi:10.1370/afm.1400 · Cited by 232 · see citing works
Kumar, S., Quinn, S. C., Kim, K. H., Musa, D., Hilyard, K. M., & Freimuth, V. S. (2011) · Health Education & Behavior · doi:10.1177/1090198111415105 · Cited by 231 · see citing works
Physicians’ health practices strongly influence patient health practices
Oberg, E., & Frank, E. (2009) · The Journal of the Royal College of Physicians of Edinburgh · doi:10.4997/jrcpe.2009.422 · Cited by 228 · see citing works
Fall-Risk Evaluation and Management: Challenges in Adopting Geriatric Care Practices
Tinetti, M. E., Gordon, C. J., Sogolow, E. D., Lapin, P., & Bradley, E. H. (2006) · The Gerontologist · doi:10.1093/geront/46.6.717 · Cited by 223 · see citing works
Public health impact of antiviral therapy for hepatitis C in the United States†
Volk, M. L., Tocco, R. S., Saini, S. D., & Lok, A. S.-F. (2009) · Hepatology · doi:10.1002/hep.23220 · Cited by 224 · see citing works
Lucey, C. R. (2013) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2013.9074 · Cited by 221 · see citing works
Treatment of Obesity in Primary Care Practice in the United States: A Systematic Review
Tsai, A. G., & Wadden, T. A. (2009) · Journal of General Internal Medicine · doi:10.1007/s11606-009-1042-5 · Cited by 223 · see citing works
Mechanic, D. (2003) · JAMA · doi:10.1001/jama.290.7.941 · Cited by 219 · see citing works
Demark‐Wahnefried, W., Pinto, B. M., & Gritz, E. R. (2006) · Journal of Clinical Oncology · doi:10.1200/jco.2006.06.6175 · Cited by 216 · see citing works
Systematic Review: The Value of the Periodic Health Evaluation
Boulware, L., Marinopoulos, S., Phillips, K. A., Hwang, C. W., Maynor, K. A., Merenstein, D., Wilson, R. F., Barnes, G. J., Bass, E. B., Powe, N. R., et al. (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-146-4-200702200-00008 · Cited by 228 · see citing works
“Regardless of the specific components included, the PHE may provide clinicians time to consider preventive care more fully, thus leading to their instituting preventive measures more frequently (57).”
Connecting With Patients—The Missing Links
Sanders, L., Fortin, A. H., & Schiff, G. D. (2020) · JAMA · doi:10.1001/jama.2019.20153 · Cited by 216 · see citing works
Stull, V. B., Snyder, D. C., & Demark‐Wahnefried, W. (2007) · Journal of Nutrition · doi:10.1093/jn/137.1.243s · Cited by 208 · see citing works
Vaz-Luis, I., Masiero, M., Cavaletti, G., Cervantes, A., Chlebowski, R. T., Curigliano, G., Felip, E., Ferreira, A. R., Ganz, P. A., Hegarty, J., et al. (2022) · Annals of Oncology · doi:10.1016/j.annonc.2022.07.1941 · Cited by 208 · see citing works
Rodondi, N., Peng, T., Karter, A. J., Bauer, D. C., Vittinghoff, E., Tang, S. S. K., Pettitt, D., Kerr, E. A., & Selby, J. V. (2006) · Annals of Internal Medicine · doi:10.7326/0003-4819-144-7-200604040-00006 · Cited by 206 · see citing works
“Proposed explanations for clinical inertia include physicians’ overestimation of their adherence to guidelines (12) or acceptance of elevated risk factor levels in their patients (30), lack of training on achieving therapeutic goals, possible lack of motivation in clinicians to treat asymptomatic chronic conditions (1…”
BackgroundBarriers to Providing Nutrition Counseling Cited by Physicians
Kolasa, K. M., & Rickett, K. (2010) · Nutrition in Clinical Practice · doi:10.1177/0884533610380057 · Cited by 204 · see citing works
Fiscella, K. A., & Epstein, R. M. (2008) · Archives of Internal Medicine · doi:10.1001/archinte.168.17.1843 · Cited by 203 · see citing works
Clinician Attitudes, Screening Practices, and Interventions to Reduce Firearm-Related Injury
Roszko, P. J. D., Ameli, J., Carter, P. M., Cunningham, R. M., & Ranney, M. L. (2016) · Epidemiologic Reviews · doi:10.1093/epirev/mxv005 · Cited by 202 · see citing works
“The lack of high-quality studies examining such best practices for firearm safety screening limits the ability to derive consensus guidelines for clinicians and again highlights the need for additional well-funded research (109).”
BackgroundFamily physicians as team leaders: "time" to share the care.
Yarnall, K. S. H., Østbye, T., Krause, K. M., Pollak, K. I., Gradison, M., & Michener, J. L. (2009) · Europe PMC (PubMed Central) · Cited by 195 · see citing works
Self-citationBetter Population Health Through Behavior Change in Adults: A Call to Action
Spring, B., Ockene, J. K., Gidding, S. S., Mozaffarian, D., Moore, S., Rosal, M. C., Brown, M. D., Vafiadis, D. K., Cohen, D. L., Burke, L. E., et al. (2013) · Circulation · doi:10.1161/01.cir.0000435173.25936.e1 · Cited by 195 · see citing works
Patient and Physician Reminders to Promote Colorectal Cancer Screening
Sequist, T. D., Zaslavsky, A. M., Marshall, R., Fletcher, R. H., & Ayanian, J. Z. (2009) · Archives of Internal Medicine · doi:10.1001/archinternmed.2008.564 · Cited by 192 · see citing works
“During office visits, physicians may have insufficient time to discuss the growing number of recommended preventive services.(12) Physicians report patient requests and reminder systems as 2 main factors that facilitate screening.”
BackgroundRecommendations to improve the usability of drug-drug interaction clinical decision support alerts
Payne, T. H., Hines, L. E., Chan, R. C., Hartman, S., Kapusnik-Uner, J., Russ, A. L., Chaffee, B. W., Hartman, C. A., Tamis, V., Galbreth, B., et al. (2015) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocv011 · Cited by 191 · see citing works
“50 There are many issues beyond the scope of this Workgroup that need to be addressed in order to achieve the desired improvements in DDI decision support associated with our recommendations.”
BackgroundThe Invisible Epidemic: Neglected Chronic Disease Management During COVID-19
Wright, A. T., Salazar, A., Mirica, M., Volk, L. A., & Schiff, G. D. (2020) · Journal of General Internal Medicine · doi:10.1007/s11606-020-06025-4 · Cited by 189 · see citing works
Primary Care Visit Duration and Quality
Chen, L. M. (2009) · Archives of Internal Medicine · doi:10.1001/archinternmed.2009.341 · Cited by 186 · see citing works
“9X (or both), (2) reason-for-visit classification code 31000, or (3) a preventive or non–illness care code as the NAMCS major reason for the visit.”
BackgroundMethodInfluentialDietrich, A. J., Tobin, J. N., Cassells, A. N., Robinson, C. M., Greene, M. A., Sox, C. H., Beach, M. L., DuHamel, K. N., & Younge, R. G. (2006) · PubMed · doi:10.7326/0003-4819-144-8-200604180-00006 · Cited by 188 · see citing works
“These infrastructures could add screening support for patients who are already enrolled, or they could expand services to others while making minimal additional demands on primary care practices (24).”
BackgroundPrevalence of Parental Concerns About Childhood Vaccines
Kempe, A., Daley, M. F., McCauley, M. M., Crane, L. A., Suh, C. A., Kennedy, A., Basket, M. M., Stokley, S. K., Dong, F., Babbel, C. I., et al. (2011) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2010.12.025 · Cited by 184 · see citing works
The Association of Obesity and Cervical Cancer Screening: A Systematic Review and Meta‐analysis
Maruthur, N. M., Bolen, S. D., Brancati, F. L., & Clark, J. M. (2008) · Obesity · doi:10.1038/oby.2008.480 · Cited by 184 · see citing works
“Fourth, obesity-related comorbid conditions may hinder performance of purely preventive services (7,30,31).”
BackgroundSchor, E. L. (2004) · PEDIATRICS · doi:10.1542/peds.114.1.210 · Cited by 183 · see citing works
Computer-based brief motivational intervention for perinatal drug use
Ondersma, S. J., Chase, S. K., Svikis, D. S., & Schuster, C. R. (2005) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2005.02.004 · Cited by 180 · see citing works
“Further, it has been estimated that full compliance with all preventive activities recommended by the U.S. Preventive Services Task Force would require 4.4 hours per working day for primary care physicians working with adults (Yarnall, Pollak, Ostbye, Krause, & Michener, 2003).”
BackgroundInfluentialStengel, M. R., Kraschnewski, J. L., Hwang, S. W., Kjerulff, K. H., & Chuang, C. H. (2012) · Women s Health Issues · doi:10.1016/j.whi.2012.09.004 · Cited by 179 · see citing works
Dexheimer, J. W., Talbot, T. R., Sanders, D. L., Rosenbloom, S. T., & Aronsky, D. (2008) · Journal of the American Medical Informatics Association · doi:10.1197/jamia.m2555 · Cited by 178 · see citing works
“and clinicians struggle with finding time to be compliant with offering the numerous recommended examinations and procedures when a patient's primary visit reason is unrelated to prevention.”
BackgroundInteractive behavior change technology
Glasgow, R. E., Bull, S. S., Piette, J. D., & Steiner, J. F. (2004) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2004.04.026 · Cited by 180 · see citing works
Principles of the Patient-Centered Medical Home and Preventive Services Delivery
Ferrante, J. M., Balasubramanian, B. A., Hudson, S. V., & Crabtree, B. F. (2010) · The Annals of Family Medicine · doi:10.1370/afm.1080 · Cited by 178 · see citing works
Physician work hours and the gender pay gap—evidence from primary care.
Ganguli, I., Sheridan, B., Gray, J., Chernew, M., Rosenthal, M. B., & Neprash, H. (2020) · New England Journal of Medicine · doi:10.1056/nejmsa2013804 · Cited by 173 · see citing works
Preventing CKD in Developed Countries
Luyckx, V. A., Cherney, D. Z. I., & Bello, A. K. (2019) · Kidney International Reports · doi:10.1016/j.ekir.2019.12.003 · Cited by 183 · see citing works
Physical activity counseling in primary care: Who has and who should be counseling?
Tulloch, H., Fortier, M., & Hogg, W. (2006) · Patient Education and Counseling · doi:10.1016/j.pec.2005.10.010 · Cited by 175 · see citing works
Computer-Based Brief Intervention
Ondersma, S. J., Svikis, D. S., & Schuster, C. R. (2007) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2006.11.003 · Cited by 167 · see citing works
Alcohol Use Disorders in Primary Health Care: What Do We Know and Where Do We Go?
Rehm, J., Anderson, P., Manthey, J., Shield, K. D., Struzzo, P., Wojnar, M., & Gual, A. (2016) · Alcohol and Alcoholism · doi:10.1093/alcalc/agv127 · Cited by 163 · see citing works
Multiple Skin Cancer Risk Behaviors in the U.S. Population
Coups, E. J., Manne, S. L., & Heckman, C. J. (2008) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2007.09.032 · Cited by 170 · see citing works
The Increasing Number of Clinical Items Addressed During the Time of Adult Primary Care Visits
Abbo, E. D., Zhang, Q., Zelder, M., & Huang, E. S. (2008) · Journal of General Internal Medicine · doi:10.1007/s11606-008-0805-8 · Cited by 163 · see citing works
Myer, G. D., Faigenbaum, A. D., Edwards, N. M., Clark, J. F., Best, T. M., & Sallis, R. E. (2015) · British Journal of Sports Medicine · doi:10.1136/bjsports-2014-093661 · Cited by 163 · see citing works
Hargraves, D., White, C., Frederick, R., Cinibulk, M., Peters, M., Young, A., & Elder, N. (2017) · Public Health Reviews · doi:10.1186/s40985-017-0077-0 · Cited by 161 · see citing works
“However, in the USA, it has long been documented that there is insufficient time for all the preventive care needed [7].”
BackgroundPREVENTIVE CARE FOR CHILDREN IN THE UNITED STATES: Quality and Barriers
Chung, P. J., Lee, T. C., Morrison, J. L., & Schuster, M. A. (2005) · Annual Review of Public Health · doi:10.1146/annurev.publhealth.27.021405.102155 · Cited by 161 · see citing works
Translating Effective Clinic-Based Physical Activity Interventions into Practice
Estabrooks, P. A., & Glasgow, R. E. (2006) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2006.06.019 · Cited by 161 · see citing works
A Silent Response to the Obesity Epidemic
Kraschnewski, J. L., Sciamanna, C., Stuckey, H. L., Chuang, C. H., Lehman, E. B., Hwang, K. O., Sherwood, L. L., & Nembhard, H. B. (2012) · Medical Care · doi:10.1097/mlr.0b013e3182726c33 · Cited by 161 · see citing works
Using Action Plans to Help Primary Care Patients Adopt Healthy Behaviors: A Descriptive Study
Handley, M., MacGregor, K., Schillinger, D., Sharifi, C., Wong, S., & Bodenheimer, T. (2006) · The Journal of the American Board of Family Medicine · doi:10.3122/jabfm.19.3.224 · Cited by 159 · see citing works
Hendriks, M. R., Bleijlevens, M. H. C., van Haastregt, J. C. M., Crebolder, H. F. J. M., Diederiks, J. P. M., Evers, S., Mulder, W. J., Kempen, G. I. J. M., van Rossum, E., Ruijgrok, J. M., et al. (2008) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2008.01803.x · Cited by 157 · see citing works
From knowledge to practice in chronic cardiovascular disease: a long and winding road
Majumdar, S. R., McAlister, F. A., & Furberg, C. D. (2004) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2003.12.043 · Cited by 156 · see citing works
“Preventive Services Task Force before they could even start on their patients’ acute or chronic problems ( 33 ).”
BackgroundDrowning in a Sea of Advice: Pediatricians and American Academy of Pediatrics Policy Statements
Belamarich, P. F., Gandica, R., Stein, R. E. K., & Racine, A. D. (2006) · PEDIATRICS · doi:10.1542/peds.2006-0652 · Cited by 153 · see citing works
Providers' Perspectives on Challenges to Contraceptive Counseling in Primary Care Settings
Akers, A. Y., Gold, M. A., Borrero, S. B., Santucci, A. K., & Schwarz, E. B. (2010) · Journal of Women s Health · doi:10.1089/jwh.2009.1735 · Cited by 153 · see citing works
“19–21 Hence, providers often feel forced to decide whom to provide services to on a case-by-case basis.”
Duration of a Well-Child Visit: Association With Content, Family-Centeredness, and Satisfaction
Halfon, N., Stevens, G. D., Larson, K., & Olson, L. M. (2011) · PEDIATRICS · doi:10.1542/peds.2011-0586 · Cited by 152 · see citing works
Willard-Grace, R., Chen, E. H., Hessler, D., DeVore, D., Prado, C., Bodenheimer, T., & Thom, D. H. (2015) · The Annals of Family Medicine · doi:10.1370/afm.1768 · Cited by 143 · see citing works
- Authors
- Yarnall, K. S. H., Pollak, K. I., Østbye, T., Krause, K. M., & Michener, J. L.
- Affiliations
- Duke University (US)
- Venue
- American Journal of Public Health
- Publisher
- American Public Health Association
- Published
- 2003-04
- Volume
- 93
- Issue
- 4
- Pages
- 635-641
- ISSN
- 0090-0036 (ISSN-L)
- 1541-0048
- PMC
- PMC1447803
- OpenAlex
- W2166751697
- Cited by
- 1,641
- References
- 59
- Citations by year
- 2026: 22 · 2025: 23 · 2024: 40 · 2023: 50 · 2022: 77 · 2021: 66 · 2020: 71 · 2019: 67 · 2018: 74 · 2017: 87 · 2016: 79 · 2015: 105 · 2014: 84 · 2013: 95 · 2012: 98
- FWCI
- 57.56
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Public Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01mh056846-03)
- National Institute of Mental Health (5 R01 MH56846-03)
- National Cancer Institute (CA 14236, P01 CA 72099, P01CA072099, P30CA014236)
- National Institute of General Medical Sciences (R01GM056846)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Keywords
- preventive services, primary care, physician time constraints, USPSTF recommendations, time allocation, patient panel
- MeSH terms
- Adolescent, Adult, Aged, Appointments and Schedules, Child, Child, Preschool, Counseling, Female, Health Services Research, Humans, Infant, Infant, Newborn, Male, Middle Aged, Preventive Health Services, Primary Health Care, Primary Prevention, Time and Motion Studies, United States, Models, Statistical
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
