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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.
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“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]
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“Number (%) Number (%) Gender Males 1544 (34) 1732 (34) Females 2953 (66) 3338 (66) Race/Ethnicity African-Americans 2039 (45) 2279 (45) European-Americans 2200 (49) 2430 (48) Asian-Americans 23 (1) 42 (1) Native Americans 0 (0) 1 (0) Others 1 (0) 1 (0) Hispanics 28 (1) 22 (0) Not Indicated 20 (0) 27 (1) Missing 186 (4…”
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Backgroundvan Weel-Baumgarten, E. M. (2008) · Family Practice · doi:10.1093/fampra/cmn042 · Cited by 14
Jawad, M., Ingram, S., Choudhury, I., Airebamen, A., Christodoulou, K., & Sharma, A. W. (2016) · BMC Oral Health · doi:10.1186/s12903-016-0252-6 · Cited by 14
“Considering that health promotion discussions within consultation rooms may be time-consuming for physicians [1] and that health promotion in waiting rooms can be associated with increasing levels of patient satisfaction [2, 3], these are promising locations in which to conduct health promotion activities.”
BackgroundAssociation of Time-Based Billing With Evaluation and Management Revenue for Outpatient Visits
Miksanek, T. J., Edwards, S. T., Weyer, G. W., & Laiteerapong, N. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.29504 · Cited by 13
Primary Care Research Is Hard to Do During COVID-19: Challenges and Solutions
Holtrop, J. S., & Davis, M. M. (2022) · The Annals of Family Medicine · doi:10.1370/afm.2889 · Cited by 13
“(2) Limited and Changing Resources and Procedures Many research teams have also found that there was and continues to be less staffing for research efforts.”
BackgroundZhang, C., & Mathur, A. K. (2023) · Transplant International · doi:10.3389/ti.2023.11455 · Cited by 13
“…potential transplant candidates seek care late in the progression of chronic kidney disease, clinicians may be left scrambling to manage the organ failure, overwhelming the clinical interaction with more immediate medical concerns, rather than discussions about donor options or LDKT education [22].”
BackgroundVerbunt, E., Newman, G., Creagh, N. S., Milley, K. M., Emery, J. D., Kelaher, M., Rankin, N. M., & Nightingale, C. E. (2024) · Primary Health Care Research & Development · doi:10.1017/s1463423623000713 · Cited by 13
Using the iPod Touch for Patient Health Behavior Assessment and Health Promotion in Primary Care
Forjuoh, S. N., Ory, M. G., Wang, S., Bordes, J. D., & Hong, Y. A. (2014) · JMIR mhealth and uhealth · doi:10.2196/mhealth.2927 · Cited by 15
“Many clinics are understaffed and underresourced and struggle to meet all of the current competing demands they face [13-15].”
BackgroundDisengagement of general practitioners in cervical cancer screening
Poncet, L., Rigal, L., Panjo, H., Gautier, A., Chauvin, P., Menvielle, G., Cadot, E., & Ringa, V. (2015) · European Journal of Cancer Prevention · doi:10.1097/cej.0000000000000208 · Cited by 13
“Time constraints may be responsible, with physicians unable to comply with preventive care guidelines on the time allowed for each consultation (Wender, 1993; Yarnall et al., 2003) and lack of skill for this specific screening (Wender, 1993).”
BackgroundPain and Addiction in Specialty and Primary Care: The Bookends of a Crisis
Schottenfeld, J. R., Waldman, S. A., Gluck, A. R., & Tobin, D. G. (2018) · The Journal of Law Medicine & Ethics · doi:10.1177/1073110518782923 · Cited by 13
Dowell, A. C., Betty, B., Gellen, C., Hanna, S., Houtte, C. V., MacRae, J., Ranchhod, D., & Thorpe, J. (2022) · Journal of Primary Health Care · doi:10.1071/hc22087 · Cited by 13
Patient preferences for the design of a pharmacy-based colorectal cancer screening program
Brenner, A. T., Waters, A. R., Wangen, M., Rohweder, C. L., Odebunmi, O. O., Marciniak, M. W., Ferrari, R. M., Wheeler, S. B., & Shah, P. D. (2023) · Cancer Causes & Control · doi:10.1007/s10552-023-01687-x · Cited by 13
“Even when a person has access to primary care, limited visit time for preventive services is often a barrier to addressing preventive services [37].”
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Intention to implement a smoking cessation intervention in Dutch general practice
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Evans, M. W., Ndetan, H. T., & Williams, R. D. (2009) · Journal of Chiropractic Education · doi:10.7899/1042-5055-23.1.17 · Cited by 13
Improving Colorectal Cancer Screening Through Research in Primary Care Settings
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“Primary care practitioners are faced with an expanding list of preventive services that they are expected to deliver to patients despite assessments that the time they have available to provide all of the recommended services is woefully inadequate.(50) And as the population of the United States both grows and ages, a…”
BackgroundHealth Education Counseling During Pediatric Well-Child Visits in Physicians’ Office Settings
Hammig, B. J., & Jozkowski, K. N. (2015) · Clinical Pediatrics · doi:10.1177/0009922815584943 · Cited by 13
“With respect to recommendations by the US Preventive Services Task Force, it has been estimated that with a patient population of 2500, a physician would need to dedicate approximately 7 hours per day to preventive services alone.(6) Thus, it is unlikely that pediatric physicians would have adequate time during wellch…”
BackgroundMethodImportance of Ocean Heat Content for Cyclone Studies
Sharma, N., & Ali, M. M. (2014) · Oceanography Open Access · doi:10.4172/2165-7866.1000124 · Cited by 13
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Bailey, S. C., Wallia, A., Wright, S., Wismer, G. A., Infanzon, A. C., Curtis, L. M., Brokenshire, S. A., Chung, A. E., Reuland, D. S., Hahr, A. J., et al. (2019) · Journal of Medical Internet Research · doi:10.2196/13499 · Cited by 13
“Studies have shown that providers would need to spend approximately 18 hours per working day to deliver counseling and care consistent with US Preventive Services Task Force and chronic conditions care management recommendations [36,37].”
Seconds for Care: Evaluation of Five Health Supervision Visit Topics Using a New Method
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Clinical Implications of Patient-Provider Agreements in Opioid Prescribing
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“The detailed interactions and explanations required for the implementation of a specific PPA demand substantial blocks of time from clinical staff already struggling to meet the needs of patient care [17, 18].”
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Metadata
- 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 › Medicine › Family Practice › 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
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