Why Time Matters
Why Enough Time With Your Primary Care Provider Matters
Primary care visits often involve much more than discussing a single symptom. A provider may need to review medications, discuss chronic conditions, evaluate new concerns, interpret test results, address preventive care, provide education, and develop a treatment plan — all during the same appointment.
Recent research suggests that when appointment times are shortened without reducing the amount or complexity of care expected during the visit, both patients and healthcare providers can be negatively affected.
Shorter Visits Can Affect Patient Safety
One of the biggest concerns with rushed primary care is the possibility that important information may be missed.
A 2024 study published in the Journal of General Internal Medicine examined how time pressure affects patient safety in primary care. Physicians described situations in which taking additional time with a patient helped identify important medical concerns or prevented potential harm.
These situations included:
- Medication problems that required additional counseling
- Serious illnesses that needed immediate evaluation
- Symptoms involving both physical and mental health
- Complicated social or family circumstances affecting a patient's care
- Subtle symptoms or examination findings that required further investigation
The researchers concluded that heavily packed schedules can make it more difficult for primary care providers to adequately address complicated or time-sensitive medical problems.
Rushed Visits Can Reduce Communication and Patient Education
Good primary care involves more than diagnosing an illness and prescribing medication. Patients need time to explain what they are experiencing, ask questions, understand their diagnosis, and learn how to manage their health.
A 2024 study published in JAMA Network Open found that primary care physicians experiencing significant time pressure reported having to limit important parts of patient care, including:
- Patient education
- Clear communication
- Discussing multiple concerns
- Understanding a patient's full medical situation
- Learning about social circumstances that may affect health
- Building trust and maintaining the patient-provider relationship
When providers do not have enough time, they may be forced to concentrate on the most urgent problem while postponing other important concerns.
Short Visits May Affect Medical Decision-Making
Researchers have also found measurable differences in prescribing patterns based on visit length.
A large 2023 study published in JAMA Health Forum examined more than 8 million primary care visits involving over 4 million patients.
Researchers found that shorter visits were associated with a greater likelihood of certain potentially inappropriate prescriptions, including:
- Antibiotics for upper respiratory infections when antibiotics may not have been appropriate
- Prescribing opioids and benzodiazepines together for patients being treated for pain
The study does not prove that every short appointment leads to inappropriate treatment. However, the results suggest that having adequate time may help providers make more thoughtful and appropriate treatment decisions.
Rushing May Actually Lead to More Testing and Referrals
Shorter appointments are sometimes viewed as a way to make healthcare more efficient. Research suggests, however, that insufficient appointment time may sometimes have the opposite effect.
In the 2024 JAMA Network Open study, physicians reported that when they did not have enough time to fully evaluate a patient's problem, they sometimes ordered additional tests or specialist referrals that might have been avoided with a more complete evaluation.
Some physicians also reported sending patients to urgent care or the emergency department when there was not enough time available to safely address the problem during the scheduled visit.
In other words, saving several minutes during an office appointment does not necessarily save time or healthcare resources overall.
Primary Care Providers Are Already Expected to Accomplish a Great Deal
Modern primary care includes preventive screenings, chronic disease management, acute illness, medication management, counseling, documentation, reviewing test results, responding to patient messages, coordinating specialty care, and many other responsibilities.
A study examining the amount of time necessary to provide all recommended primary care services found that a physician caring for a typical panel of 2,500 patients would theoretically need approximately 26.7 hours per day to personally complete all recommended care.
Even with significant responsibilities delegated to a healthcare team, researchers estimated that approximately 9.3 hours per day would still be required.
The study demonstrates a major challenge in modern primary care: there is often more recommended medical work than can realistically fit into a traditional workday.
Time Pressure Also Affects Healthcare Providers
Appointment length does not only affect patients. It also affects the people caring for them.
Research has linked inadequate appointment time with:
- Increased stress
- Emotional exhaustion
- Burnout
- Working through lunch
- Completing documentation after clinic hours
- Working during evenings or days off
- Reduced professional satisfaction
- Greater desire to reduce clinical hours or leave a practice
A prospective study involving physicians and advanced practice clinicians found that 67% believed they needed more time for new-patient visits, while 53% believed they needed more time for follow-up appointments.
Time pressure during new-patient visits was associated with greater stress and an increased intention to leave the practice. Time pressure during follow-up visits was associated with burnout.
There Is No Single Appointment Length That Is Right for Every Patient
This research does not mean that every patient requires a long appointment.
Some straightforward concerns can be appropriately handled during shorter visits. Research has shown that carefully selected, low-risk patients with uncomplicated problems may be treated effectively during shorter appointments.
The important issue is matching the amount of time available to the needs of the patient.
A patient with one simple concern may require significantly less time than someone who has several chronic illnesses, takes multiple medications, recently left the hospital, has new unexplained symptoms, or needs extensive counseling.
Primary care should therefore not be approached as though every patient and every visit requires exactly the same amount of time.
Our Approach to Primary Care
At Capital City Family Medicine, we believe good primary care requires enough time to listen, think, explain, and develop a plan with our patients.
Our goal is not simply to see the greatest number of patients possible in a day. Our goal is to provide thoughtful, thorough, and individualized care while recognizing that different patients require different amounts of time.
That means allowing appropriate time to:
- Listen to your concerns
- Review your medical history and medications
- Address chronic medical conditions
- Evaluate new symptoms
- Discuss treatment options
- Explain test results
- Answer questions
- Provide preventive care and education
- Make sure you understand the plan before you leave
Healthcare should be efficient, but efficiency should not come at the expense of careful medical decision-making or meaningful communication between patients and their healthcare providers.
References
- Nguyen OT, et al. Primary Care Physicians' Experiences With and Adaptations to Time Constraints. JAMA Network Open. 2024.
- Satterwhite S, et al. "Good Care Is Slow Enough to Be Able to Pay Attention": Primary Care Time Scarcity and Patient Safety. Journal of General Internal Medicine. 2024.
- Neprash HT, et al. Association of Primary Care Visit Length With Potentially Inappropriate Prescribing. JAMA Health Forum. 2023.
- Porter J, et al. Revisiting the Time Needed to Provide Adult Primary Care. Journal of General Internal Medicine. 2023.
- Prasad K, et al. Time Pressure During Primary Care Office Visits: A Prospective Evaluation of Data From the Healthy Work Place Study. Journal of General Internal Medicine. 2020.
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