title: Between-visit workload in primary care.
abstract: BACKGROUND
  The time spent and complexity of work done by primary internal medicine physicians between office visits has not been well studied.
  
  
  OBJECTIVE
  To measure the time and complexity of this care.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  General internists practicing on primary care teams with electronic medical records at a tertiary Veterans Health Administration Medical Center.
  
  
  METHODS
  Ten physicians.
  
  
  METHODS
  The project was designed to measure physician work between office visits. The electronic record was used to record the number and complexity of work events by physicians for 1 month. Complexity of work was measured on five levels ranging from Level I with no change in management, Level II with change in management of one disease, Level III of two diseases, Level IV of three diseases, and Level V of four or more diseases. Time sampling was done over 5 days to determine the time spent by level of complexity. Total time per physician was calculated by multiplying the number of events each physician captured by the average time for that physician for that level of complexity.
  
  
  RESULTS
  Physicians worked a median of 7.9 h per week between office visits. Work was apportioned among Level I (18.3%), Level II (38.3%), Level III (36.5%), Level IV (4.6%), and Level V (2.3%).
  
  
  CONCLUSIONS
  Single VA population and self-reported data. Findings may not be generalizable to other practice settings.
  
  
  CONCLUSIONS
  Primary internists spent a median of 7.9 h per week in work between office visits with 82% of the time involved in changes in management.
authors.affiliation: Atlanta Veterans Administration Medical Center and The Emory University School of Medicine, Decatur, GA 30033, USA. oemmett@comcast.net
authors.forename: Emmett
authors.initials: E
authors.lastname: Doerr
authors.forename: Kevin
authors.initials: K
authors.lastname: Galpin
authors.forename: Cedrella
authors.initials: C
authors.lastname: Jones-Taylor
authors.forename: Steven
authors.initials: S
authors.lastname: Anander
authors.forename: Charles
authors.initials: C
authors.lastname: Demosthenes
authors.forename: Susan
authors.initials: S
authors.lastname: Platt
authors.forename: Sanjay
authors.initials: S
authors.lastname: Ponkshe
mesh_terms: D003430:Cross-Sectional Studies; D006801:Humans; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data; D010820:Physicians / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000379:methods* / Q000706:statistics & numerical data; D013997:Time Factors; D016526:Workload / Q000706:statistics & numerical data