Productivity, quality, and patient satisfaction: comparison of part-time and full-time primary care physicians.
BACKGROUND
Although few data are available, many believe that part-time primary care physicians (PCPs) are less productive and provide lower quality care than full-time PCPs. Some insurers exclude part-time PCPs from their provider networks.


OBJECTIVE
To compare productivity, quality of preventive care, patient satisfaction, and risk-adjusted resource utilization of part-time and full-time PCPs.


METHODS
Retrospective cohort study.


METHODS
Boston.


METHODS
PCPs affiliated with 2 academic outpatient primary care networks.


METHODS
PCP productivity, patient satisfaction, resource utilization, and compliance with screening guidelines.


RESULTS
Part-time PCP productivity was greater than that of full-time PCPs (2.1 work relative value units (RVUs)/bookable clinical hour versus 1.3 work RVUs/bookable clinical hour, P< .01). A similar proportion of part-time PCPs (80%) and full-time PCPs (75%) met targets for mammography, Pap smears, and cholesterol screening (P = .67). After adjusting for clinical case mix, practice location, gender, board certification status, and years in practice, resource utilization of part-time PCPs (138 dollars [95% confidence interval (CI), 108 dollars to 167 dollars]) was similar to that of full-time PCPs (139 dollars [95% CI, 108 dollars to 170 dollars], P = .92). Patient satisfaction was similar for part-time and full-time PCPs.


CONCLUSIONS
In these academic primary care practices, rates of patient satisfaction, compliance with screening guidelines, and resource utilization were similar for part-time PCPs compared to full-time PCPs. Productivity per clinical hour was markedly higher for part-time PCPs. Despite study limitations, these data suggest that academic part-time PCPs are at least as efficient as full-time PCPs and that the quality of their work is similar.
Fairchild
D G
DG
Division of General Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA. dfairchild@partners.org
McLoughlin
K S
KS
Gharib
S
S
Horsky
J
J
Portnow
M
M
Richter
J
J
Gagliano
N
N
Bates
D W
DW
D000046:Academic Medical Centers; D000328:Adult; D019985:Benchmarking; D001900:Boston; D004526:Efficiency / Q000145:classification*; D005260:Female; D019983:Guideline Adherence; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D007388:Internal Medicine / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010561:Personnel Staffing and Scheduling; D010821:Physicians, Family / Q000706:statistics & numerical data*; D011314:Preventive Health Services / Q000592:standards; D011320:Primary Health Care / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D000078329:Workforce