title: Estimating a reasonable patient panel size for primary care physicians with team-based task delegation.
abstract: PURPOSE Primary care faces the dilemma of excessive patient panel sizes in an environment of a primary care physician shortage. We aimed to estimate primary care panel sizes under different models of task delegation to nonphysician members of the primary care team.  METHODS We used published estimates of the time it takes for a primary care physician to provide preventive, chronic, and acute care for a panel of 2,500 patients, and modeled how panel sizes would change if portions of preventive and chronic care services were delegated to nonphysician team members.  RESULTS Using 3 assumptions about the degree of task delegation that could be achieved (77%, 60%, and 50% of preventive care, and 47%, 30%, and 25% of chronic care), we estimated that a primary care team could reasonably care for a panel of 1,947, 1,523, or 1,387 patients.  CONCLUSIONS If portions of preventive and chronic care services are delegated to nonphysician team members, primary care practices can provide recommended preventive and chronic care with panel sizes that are achievable with the available primary care workforce.
authors.affiliation: Center for Excellence in Primary Care, Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California 94110, USA.
authors.forename: Justin
authors.initials: J
authors.lastname: Altschuler
authors.forename: David
authors.initials: D
authors.lastname: Margolius
authors.forename: Thomas
authors.initials: T
authors.lastname: Bodenheimer
authors.forename: Kevin
authors.initials: K
authors.lastname: Grumbach
mesh_terms: D000488:Allied Health Personnel / Q000458:organization & administration; D002908:Chronic Disease; D032022:Delegation, Professional / Q000458:organization & administration; D006801:Humans; D010361:Patients / Q000706:statistics & numerical data; D058007:Physicians, Primary Care / Q000458:organization & administration*; D011216:Practice Management, Medical / Q000458:organization & administration*; D011320:Primary Health Care; D000078329:Workforce