Productivity, quality, and patient satisfaction: comparison of part-time and full-time primary care physicians

J Gen Intern Med. 2001 Oct;16(10):663-7. doi: 10.1111/j.1525-1497.2001.01111.x.

Abstract

Context: Although few data are available, many believe that part-time primary care physicians (PCPs) are less productive and provide lower quality care than full-time PCPs. Some insurers exclude part-time PCPs from their provider networks.

Objective: To compare productivity, quality of preventive care, patient satisfaction, and risk-adjusted resource utilization of part-time and full-time PCPs.

Design: Retrospective cohort study.

Setting: Boston.

Participants: PCPs affiliated with 2 academic outpatient primary care networks.

Measurements: PCP productivity, patient satisfaction, resource utilization, and compliance with screening guidelines.

Results: Part-time PCP productivity was greater than that of full-time PCPs (2.1 work relative value units (RVUs)/bookable clinical hour versus 1.3 work RVUs/bookable clinical hour, P< .01). A similar proportion of part-time PCPs (80%) and full-time PCPs (75%) met targets for mammography, Pap smears, and cholesterol screening (P = .67). After adjusting for clinical case mix, practice location, gender, board certification status, and years in practice, resource utilization of part-time PCPs (138 dollars [95% confidence interval (CI), 108 dollars to 167 dollars]) was similar to that of full-time PCPs (139 dollars [95% CI, 108 dollars to 170 dollars], P = .92). Patient satisfaction was similar for part-time and full-time PCPs.

Conclusions: In these academic primary care practices, rates of patient satisfaction, compliance with screening guidelines, and resource utilization were similar for part-time PCPs compared to full-time PCPs. Productivity per clinical hour was markedly higher for part-time PCPs. Despite study limitations, these data suggest that academic part-time PCPs are at least as efficient as full-time PCPs and that the quality of their work is similar.

Publication types

  • Multicenter Study

MeSH terms

  • Academic Medical Centers
  • Adult
  • Benchmarking
  • Boston
  • Efficiency / classification*
  • Female
  • Guideline Adherence
  • Health Resources / statistics & numerical data
  • Humans
  • Internal Medicine* / statistics & numerical data
  • Male
  • Middle Aged
  • Patient Satisfaction / statistics & numerical data*
  • Personnel Staffing and Scheduling
  • Physicians, Family / statistics & numerical data*
  • Preventive Health Services / standards
  • Primary Health Care / statistics & numerical data
  • Quality of Health Care / statistics & numerical data*
  • Retrospective Studies
  • Workforce