A Team-based Model of Primary Care Delivery and Physician-patient Interaction.
BACKGROUND
Interprofessional team-based models of primary care delivery may improve efficiency and increase patient-centered time with the physician. The purpose of our study is to evaluate the effect of a new team-based primary care delivery model implemented in our health system on physician-patient face-to-face time and patient experience of the visit compared with usual care.


METHODS
We conducted time-motion analyses of ambulatory visits with 20 primary care physicians across 8 practice sites in our health system from June through August 2014. Ten physicians practicing in the team-based model and 10 physicians practicing usual care at the same practice sites were included. The time that the physician was in the room and the duration of physician-patient face-to-face interaction were measured. After each visit, patients answered questions regarding satisfaction with their visit.


RESULTS
A total of 98 patient visits were observed (44 in the team-based model and 54 in usual care). Total time that the physician and patient spent together at the visit did not differ significantly between the models. However, total duration of face-to-face interaction and proportion of the visit spent in face-to-face interaction were significantly greater in the team-based model. Patient satisfaction did not differ between the 2 models.


CONCLUSIONS
A team-based model of primary care delivery increased physician-patient face-to-face time during the office visit, but did not affect patient satisfaction.
Center for Value-Based Care Research, Medicine Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address: misraa@ccf.org.
Anita D
AD
Misra-Hebert
Case Western Reserve University School of Medicine, Cleveland, Ohio.
Andrew
A
Rabovsky
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio.
Chen
C
Yan
Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio.
Bo
B
Hu
Center for Value-Based Care Research, Medicine Institute, Cleveland Clinic, Cleveland, Ohio.
Michael B
MB
Rothberg
D017598:Efficiency, Organizational; D006801:Humans; D009819:Office Visits; D010348:Patient Care Team; D017060:Patient Satisfaction; D010823:Physician Assistants; D010817:Physician-Patient Relations; D011320:Primary Health Care / Q000379:methods* / Q000458:organization & administration; D013996:Time and Motion Studies
Ambulatory care; Physician–patient relationship; Primary health care