Clinical quality cannot be sacrificed for the bottom line. However, we’ve all heard the expression, “there is no mission without margin.” Where does this leave the busy primary care provider today in our nation’s Community Health Centers? The pressures they feel today are intense; even before COVID-19, we faced a looming provider shortage that put many of the communities we serve at risk. Primary care providers are at a premium and have been for some time. While we’ve elevated midlevels to lighten the load, the demand for PCPs is still very high.
But how many patients are too many? With most clinicians chronically pressed for time, does the current patient load allow them enough time to spend with the chronically ill patient with multiple treatment modalities?
How Many Patients is Too Many?
MedCity News suggests the average patient load for a primary care provider should be around 1,000 patients. Many providers would laugh at this; the reality is closer to 2,500. The American Association for Physician Leadership says it’s even higher, at 3,000.
The math for carrying this type of patient panel was generally pretty simple on fee-for-service arrangements. The more daily encounters, the more revenue, so two dozen a day or more to maintain an average income of $175,000 annually sounds about right. To see more patients, most primary care and specialty providers shortened their face-time with patients to about 8 to 12 minutes. MedCity News suggests that is, “Too little time for someone with multiple chronic illnesses on five to seven prescription medications and possibly impaired by age with reduced vision, hearing, and memory.”
Most doctors would agree they have a point. But what does this do to the clinician—and their patients?
The American Association for Physician Leadership says:
“To deliver all the recommended preventive, chronic, and acute care services needed by 3,000 patients with a typical U.S. age and disease distribution, a doctor would have to work 17 hours a day — seven days a week, all year, without a break.”
Obviously, this is a ridiculous mandate for any clinician. Is it no wonder burnout rates among physicians is so high?
Work/Life Balance for Your Clinical Teams
One study from the University of California tried to realistically assess the number of patients a primary care provider could see each day. They found that if the doctor does everything from screening, counseling, immunizing, prescriptions, and treatment of chronic and acute care conditions and works 43 hours per week, the provider can realistically accommodate a maximum panel of just 983 patients.
The study suggested some ways to improve the work/life balance of these overtaxed clinical providers:
- Up to 77% of a doctor’s time is spent on preventative care, which could be delegated to midlevels or non-clinical team members.
- 47% of a doctor’s time is spent on managing chronic conditions that could shift to medical assistants, RN’s, pharmacists, or even health educators working understanding physician orders.
Clearly, something must be done to improve the workloads of our talented clinical team members. UHC Solutions can help with support staff in the form of temporary healthcare providers to help your facility lighten the load. Start the conversation with our team today.
