Journal of General Internal Medicine

, Volume 16, Issue 10, pp 663–667 | Cite as

Productivity, quality, and patient satisfaction

Comparison of part-time and full-time primary care physicians
  • David G. Fairchild
  • Karen Sax McLoughlin
  • Soheyla Gharib
  • Jan Horsky
  • Michelle Portnow
  • James Richter
  • Nancy Gagliano
  • David W. Bates
Original Articles

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 [95% confidence interval (CI), $108 to $167]) was similar to that of full-time PCPs ($139 [95% CI, $108 to $170], 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.

Key words

productivity quality of care patient satisfaction part-time physicians women in medicine 

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Copyright information

© Blackwell Science Inc 2001

Authors and Affiliations

  • David G. Fairchild
    • 1
    • 5
  • Karen Sax McLoughlin
    • 3
  • Soheyla Gharib
    • 2
    • 5
  • Jan Horsky
    • 1
  • Michelle Portnow
    • 3
  • James Richter
    • 4
    • 5
  • Nancy Gagliano
    • 4
    • 5
  • David W. Bates
    • 1
    • 5
  1. 1.Received from the Division of General MedicineBoston
  2. 2.Department of MedicineDivision of Women’s HealthBoston
  3. 3.the Brigham and Women’s Physician Hospital OrganizationBrigham and Women’s HospitalBoston
  4. 4.the Massachusetts General Physician OrganizationMassachusetts General HospitalBoston
  5. 5.Harvard Medical SchoolBoston

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