Perceptions of time constraints among primary care physicians in Germany

Olaf Von Dem Knesebeck,Gabriella Marx,Martin Scherer,Sarah Koens

doi:10.1186/s12875-019-1033-5

Olaf Von Dem Knesebeck, Gabriella Marx + Show 2 more

Open Access

https://doi.org/10.1186/s12875-019-1033-5

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Abstract

BackgroundTime constraints during patient visits play a major role for the work stress of primary care physicians. Several studies suggest that there is a critical situation in terms of time constraints in primary care in Germany. Therefore, the following research questions are addressed: (1) What is the time allocated and needed for different types of consultations among primary care physicians in an urban area in Germany? (2) What is the extent of time stress? (3) Are there differences in time stress according to physician characteristics (gender and length of experience) and practice type (single vs. group/shared practice)?MethodsData stem from a face-to-face survey of primary care doctors in Hamburg and adjacent regions. A sample of 128 physicians stratified by a combination of physicians’ gender and length of experience (≤15 years or > 15 years) was used. Physicians were asked about the time needed (in minutes) to provide high quality of care for patients regarding six types of consultations: (1) new patient appointment, (2) routine consultation, (3) complete physical examination, (4) symptom-oriented examination, (5) check-up, and (6) home visit (without drive). Afterwards, they were asked about the average minutes allocated for the six consultations. Time stress was measured by calculating minutes needed minus minutes available.ResultsAverage perceived time needed was higher than time allocated for all six types of consultation. However, there were differences in the magnitude of time stress between the consultation types. Time stress was most pronounced and most prevalent in case of a new patient visit. No significant differences in time stress between male and female primary care physicians were found, while less experienced physicians reported more time stress than those with more experience (> 15 years). Physicians working in a single practice had less time stress than those working in a group or shared practice in case of a check-up visit.ConclusionsPerceived time needed is higher than time allocated for various types of consultation among primary care physicians in Germany. Time stress in primary care is particularly pronounced in case of new patient appointments. Early-career physicians are particularly affected by time stress.

Highlights

Time constraints during patient visits play a major role for the work stress of primary care physicians
The following research questions will be addressed: (1) What is the time allocated and needed for different types of consultations among primary care physicians in an urban area in Germany? (2) What is the extent of time stress? (3) Are there differences in time stress according to physician characteristics and practice type?
Time needed is higher than time available. This holds especially true for a new patient visit, whereas time stress is least pronounced in case of a symptom-oriented examination (0.7 min) and a home visit (0.8 min)

Summary

Introduction

Time constraints during patient visits play a major role for the work stress of primary care physicians. Several studies suggest that there is a In this regard, the international survey of the Commonwealth Fund showed that German primary care physicians were working about 51 h per week in 2009 of which 70% (i.e. 35.5 h) were spent with patient contacts [6]. Average reported time per patient contact in Germany was 7.8 min in 2006 [7] and increased to 9.1 in 2009 [6] In another international study, consultation time was measured with a stop watch; average time for Germany was 7.6 von dem Knesebeck et al BMC Family Practice (2019) 20:142 min [9]. Consultation time was measured with a stop watch; average time for Germany was 7.6 von dem Knesebeck et al BMC Family Practice (2019) 20:142 min [9] These values were lowest when compared to the other participating countries. They criticised that there was too much time required for administrative tasks and documentation [6, 10]

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