title: It's about time: physicians' perceptions of time constraints in primary care medical practice in three national healthcare systems.
abstract: BACKGROUND
  As physicians are pressured to deliver an increasing number of preventive services, follow guidelines, engage in evidence-based practice, and deliver patient-centered care in managerially driven organizations, they struggle with how much control they have over their time.
  
  
  METHODS
  A secondary analysis was conducted with data from 3 parallel studies of clinical decision making in Germany, the United Kingdom, and the United States with 128 physicians per country. Physicians reported how much time they were allocated and how much time they needed for high-quality care for new patient appointments, routine consultations, and complete physicals. They also reported how much control they had over their time in the office and spending adequate time with patients.
  
  
  RESULTS
  German, British, and American physicians were allocated (on average) 16/11/32 minutes for a new patient appointment, 6/10/18 minutes for a routine visit, and 12/20/36 minutes for a complete physical, but felt that they needed more time. Over half of German and American physicians felt that they always or usually had control over the hours they were required to be in their office or spending sufficient time with their patients while less than half of British physicians felt this way.
  
  
  CONCLUSIONS
  German physicians had the least time allocated and needed for most types of appointment. American physicians had the most time allocated and needed for each type of appointment. However, British physicians felt they had the least control over time in their office and spending sufficient time with patients.
authors.affiliation: Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Konrad
authors.forename: Carol L
authors.initials: CL
authors.lastname: Link
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Shackelton
authors.forename: Lisa D
authors.initials: LD
authors.lastname: Marceau
authors.forename: Olaf
authors.initials: O
authors.lastname: von dem Knesebeck
authors.forename: Johannes
authors.initials: J
authors.lastname: Siegrist
authors.forename: Sara
authors.initials: S
authors.lastname: Arber
authors.forename: Ann
authors.initials: A
authors.lastname: Adams
authors.forename: John B
authors.initials: JB
authors.lastname: McKinlay
mesh_terms: D000328:Adult; D001071:Appointments and Schedules; D005194:Family Practice / Q000458:organization & administration*; D005260:Female; D005858:Germany; D015276:Health Care Rationing; D006801:Humans; D008297:Male; D008875:Middle Aged; D009819:Office Visits; D010818:Practice Patterns, Physicians'; D017009:Professional Autonomy; D011787:Quality of Health Care; D017748:Time Management; D006113:United Kingdom; D014481:United States