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April 2003, Vol 93, No. 4 | American Journal of Public Health 635-641
© 2003 American Public Health Association

RESEARCH AND PRACTICE

Primary Care: Is There Enough Time for Prevention?

Kimberly S. H. Yarnall, MD, Kathryn I. Pollak, PhD, Truls Østbye, MD, PhD, Katrina M. Krause, MA and J. Lloyd Michener, MD

All of the authors are with the Department of Community and Family Medicine, Duke University Medical Center, Durham, NC. Kimberly S. H. Yarnall and Kathryn I. Pollak are also with the Cancer Prevention, Detection, and Control Program, Duke University Medical Center.

Correspondence: Requests for reprints should be sent to Kimberly S. H. Yarnall, MD, Box 3886, Duke University Medical Center, Durham, NC 27710 (e-mail: yarna001{at}mc.duke.edu).

Objectives. We sought to determine the amount of time required for a primary care physician to provide recommended preventive services to an average patient panel.

Methods. We used published and estimated times per service to determine the physician time required to provide all services recommended by the US Preventive Services Task Force (USPSTF), at the recommended frequency, to a patient panel of 2500 with an age and sex distribution similar to that of the US population.

Results. To fully satisfy the USPSTF recommendations, 1773 hours of a physician’s annual time, or 7.4 hours per working day, is needed for the provision of preventive services.

Conclusions. Time constraints limit the ability of physicians to comply with preventive services recommendations.




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 Arch Intern MedHome page
S. M. Frayne, J. H. Halanych, D. R. Miller, F. Wang, H. Lin, L. Pogach, E. J. Sharkansky, T. M. Keane, K. M. Skinner, C. S. Rosen, et al.
Disparities in Diabetes Care: Impact of Mental Illness
Arch Intern Med, December 12, 2005; 165(22): 2631 - 2638.
[Abstract] [Full Text] [PDF]

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 CMAJHome page
N. Pimlott
Preventive care: so many recommendations, so little time
Can. Med. Assoc. J., November 22, 2005; 173(11): 1345 - 1346.
[Full Text] [PDF]

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 JAOA: Journal of the American Osteopathic AssociationHome page
A. J. Linz, P. F. Haas, L. F. Fallon Jr, and R. J. Metz
Impact of Concierge Care on Healthcare and Clinical Practice
J Am Osteopath Assoc, November 1, 2005; 105(11): 515 - 520.
[Full Text] [PDF]

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 BMJHome page
L. Getz, J. A Sigurdsson, I. Hetlevik, A. L. Kirkengen, S. Romundstad, and J. Holmen
Estimating the high risk group for cardiovascular disease in the Norwegian HUNT 2 population according to the 2003 European guidelines: modelling study
BMJ, September 10, 2005; 331(7516): 551.
[Abstract] [Full Text] [PDF]

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 ANN INTERN MEDHome page
W. Burke
Taking Family History Seriously
Ann Intern Med, September 6, 2005; 143(5): 388 - 389.
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 AJPHHome page
T. Ostbye, D. H. Taylor Jr, W. S. Yancy Jr, and K. M. Krause
Associations Between Obesity and Receipt of Screening Mammography, Papanicolaou Tests, and Influenza Vaccination: Results from the Health and Retirement Study (HRS) and the Asset and Health Dynamics Among the Oldest Old (AHEAD) Study
Am J Public Health, September 1, 2005; 95(9): 1623 - 1630.
[Abstract] [Full Text] [PDF]

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 JCOHome page
W. Demark-Wahnefried, N. M. Aziz, J. H. Rowland, and B. M. Pinto
Riding the Crest of the Teachable Moment: Promoting Long-Term Health After the Diagnosis of Cancer
J. Clin. Oncol., August 20, 2005; 23(24): 5814 - 5830.
[Abstract] [Full Text] [PDF]

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 JAMAHome page
C. M. Boyd, J. Darer, C. Boult, L. P. Fried, L. Boult, and A. W. Wu
Clinical Practice Guidelines and Quality of Care for Older Patients With Multiple Comorbid Diseases: Implications for Pay for Performance
JAMA, August 10, 2005; 294(6): 716 - 724.
[Abstract] [Full Text] [PDF]

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 Arch Intern MedHome page
P. G. O'Malley and P. Greenland
The Annual Physical: Are Physicians and Patients Telling Us Something?
Arch Intern Med, June 27, 2005; 165(12): 1333 - 1334.
[Full Text] [PDF]

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 Ann Fam MedHome page
K. C. Stange and P. A. Nutting
In This Issue: Bursting the Bubble on Chronic Disease Management, the Meaning of Healing, PBRN Methods Supplement, and the Annals' 2-Year Anniversary
Ann. Fam. Med, May 1, 2005; 3(3): 194 - 196.
[Full Text] [PDF]

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 Ann Fam MedHome page
T. Ostbye, K. S. H. Yarnall, K. M. Krause, K. I. Pollak, M. Gradison, and J. L. Michener
Is There Time for Management of Patients With Chronic Diseases in Primary Care?
Ann. Fam. Med, May 1, 2005; 3(3): 209 - 214.
[Abstract] [Full Text] [PDF]

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 BMJHome page
T. Bodenheimer, K. MacGregor, and N. Stothart
Nurses as leaders in chronic care
BMJ, March 19, 2005; 330(7492): 612 - 613.
[Full Text] [PDF]

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Reimbursement differential between cognitive and procedural preventive medicine
Christine A. Sinsky
AJPH Online, 30 Jun 2003 [Full text]

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