Primary Care Physicians Don't Have Time to Provide Recommended Care for Patients with Chronic Diseases

Main Category: Public Health
Also Included In: Primary Care / General Practice
Article Date: 01 Jun 2005 - 0:00 PDT

email to a friend   printer friendly   opinions  

Current practice guidelines for only ten chronic illnesses require more time than primary care physicians have available for patient care overall. Applying guideline recommendations for ten common chronic diseases to a panel of 2,500 primary care patients, researchers found that 3.5 hours a day were required to provide care for these diseases, assuming the conditions were in stable and good control. When accounting for patients whose illness was poorly controlled, the time demand for chronic disease care increased to more than 10 hours per day - exceeding the total amount of physician time available for patient care by 27 percent.

The authors assert that the time required to fully adhere to current guidelines is a fundamental obstacle to the delivery of appropriate and recommended chronic disease care, and they caution guideline developers to carefully consider the time required to follow recommendations, noting that while guidelines may be reasonable when considered one by one, they are impossibly burdensome in the aggregate.

They suggest that recommendations be written collaboratively to include diseases that are highly correlated in the same guideline. They also suggest that group visits and patient education by print, video and the Internet can complement care by the clinician. Lastly, they call for a team approach to care wherein physician assistants, nurse practitioners and health educations assume some of the time-consuming tasks of patient education and follow-up.
Is There Time for Management of Patients with Chronic Diseases in Primary Care?
By Truls Ostbye, M.D., Ph.D., et al

Annals of Family Medicine is a peer-reviewed research journal that provides a cross-disciplinary forum for new, evidence-based information affecting the primary care discipline. Launched in May 2003, the journal is sponsored by six family medical organizations, including the American Academy of Family Physicians, the American Board of Family Medicine, the Society of Teachers of Family Medicine, the Association of Departments of Family Medicine, the Association of Family Medicine Residency Directors and the North American Primary Care Research Group. Annals is published six times each year and contains original research from the clinical, biomedical, social and health services areas, as well as contributions on methodology and theory, selected reviews, essays and editorials. A board of directors with representatives from each of the sponsoring organizations oversees Annals. Complete editorial content and interactive discussion groups for each published article can be accessed free of charge on the journal's Web site, http://www.annfammed.org.

Contact: Angela Lower
alower@hotmail.com
913-906-6253
American Academy of Family Physicians
http://www.aafp.org

• Additional
• References
• Citations