title: What keeps family physicians busy in Portugal? A multicentre observational study of work other than direct patient contacts.
abstract: OBJECTIVE
  To quantify the time spent by family physicians (FP) on tasks other than direct patient contact, to evaluate job satisfaction, to analyse the association between time spent on tasks and physician characteristics, the association between the number of tasks performed and physician characteristics and the association between time spent on tasks and job satisfaction.
  
  
  METHODS
  Cross-sectional, using time-and-motion techniques. Two workdays were documented by direct observation. A significance level of 0.05 was adopted.
  
  
  METHODS
  Multicentric in 104 Portuguese family practices.
  
  
  METHODS
  A convenience sample of FP, with lists of over 1000 patients, teaching senior medical students and first-year family medicine residents in 2012, was obtained. Of the 217 FP invited to participate, 155 completed the study.
  
  
  METHODS
  Time spent on tasks other than direct patient contact and on the performance of more than one task simultaneously, the number of direct patient contacts in the office, the number of indirect patient contacts, job satisfaction, demographic and professional characteristics associated with time spent on tasks and the number of different tasks performed, and the association between time spent on tasks and job satisfaction.
  
  
  RESULTS
  FP (n=155) spent a mean of 143.6 min/day (95% CI 135.2 to 152.0) performing tasks such as prescription refills, teaching, meetings, management and communication with other professionals (33.4% of their workload). FP with larger patient lists spent less time on these tasks (p=0.002). Older FP (p=0.021) and those with larger lists (p=0.011) performed fewer tasks. The mean job satisfaction score was 3.5 (out of 5). No association was found between job satisfaction and time spent on tasks.
  
  
  CONCLUSIONS
  FP spent one-third of their workday in coordinating care, teaching and managing. Time devoted to these tasks decreases with increasing list size and physician age.
authors.affiliation: S. Mamede de Infesta Health Centre, Matosinhos Local Health Unit, Matosinhos, Portugal.
authors.forename: Mónica
authors.initials: M
authors.lastname: Granja
authors.affiliation: Porta do Sol Family Health Unit, Matosinhos Local Health Unit, Matosinhos, Portugal.
authors.forename: Carla
authors.initials: C
authors.lastname: Ponte
authors.affiliation: Lagoa Family Health Unit, Matosinhos Local Health Unit, Matosinhos, Portugal.
authors.forename: Luís Filipe
authors.initials: LF
authors.lastname: Cavadas
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005194:Family Practice; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D011174:Portugal; D013997:Time Factors; D014937:Work
keywords: Primary Care