, Volume 20, Issue 11, pp 1057-1062

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Many physicians and health care leaders express concern about the amount of time available for clinical practice. While debates rage on about how much time is truly available, the perception that time is inadequate is now pervasive. This perception has ethical significance, because it may cause clinicians to forego activities and behaviors that promote important aspects of the patient-physician relationship, to shortcut shared decision making, and to fall short of obligations to act as patient advocates. Furthermore, perceived time constraints can hinder the just distribution of physician time. Although creating more time in the clinical encounter would certainly address these ethical concerns, specific strategies—many of which do not take significantly more time—can effectively change the perception that time is inadequate. These approaches are critical for clinicians and health systems to maintain their ethical commitments and simultaneously deal with the realities of time.

The authors have no conflicts of interest to report.
This paper is based on a position paper written by Clarence H. Braddock, III, MD, MPH and Lois Snyder, JD for the Ethics and Human Rights Committee of the American College of Physicians, and approved by the American College of Physicians Board of Regents on March 31, 2003. The position paper is available on the American College of Physicians website. Members of the Committee were: William E. Golden, MD (chair), University of Arkansas for Medical Sciences, Little Rock, AR; Harmon H. Davis, II, MD (vice chair), Internal Medicine Group, PC, Cheyenne, WY: David A. Fleming, MD, University of Missouri, Columbia, MO; Vincent E. Herrin, MD, National Naval Medical Center, Bethesda, MD; Jay A. Jacobson, MD, University of Utah School of Medicine, Salt Lake City, UT; Stephen R. Jones, MD, Legacy Good Samaritan Hospital, Portland OR; Allen S. Keller, MD, New York University School of Medicine, New York, New York; Steven Z. Pantilat, MD, University of California San Francisco, San Francisco, California; Daniel P. Sulmasy, OFM, MD, PhD, Saint Vincent Hospital and Medical Center, New York, New York.