26.7 hours per day — this is the amount of time it takes for a primary care physician to provide all recommended acute, chronic, and preventive care for a patient panel of 2,500 patients, according to recent studies. Recent surveys put the average patient panel size between 2,300 and 2,900 patients, which is increased from previous estimates just 10 years ago.
To break the numbers down: this estimates 14.2 hours per day for preventive care, 7.2 hours per day for chronic disease management, 2.2 hours per day for acute care, and 3.2 hours per day for documentation and inbox management. Even if team-based care approaches are implemented, the hours needed are still more than 9 hours per day. Estimated hours needed are still more than nine hours per day.
The projections for physician shortages also appear to be worsening. Current data from the Association of American Medical Colleges estimates a shortage of 86,000 physicians in the United States by 2036. This may push the average patient panel numbers even higher.
Patient panels and burnout
With numbers like these, it is no wonder physician burnout is at an all-time high. In 2021, 62.8% of physicians reported experiencing symptoms of burnout, which was up almost 15% from the year before. While the evidence is insufficient to make solid recommendations regarding optimal patient panel size, based on a systematic review of the available literature, it’s clear that the current panel size standards are untenable and unsustainable. To combat burnout, there has been a rise in alternatives to the traditional patient care models. Team-based care and direct primary care models are on the rise.
Panel size and health outcomes
Research has shown that a higher patient panel size results in fewer cancer screening tests, decreased continuity, and decreased comprehensiveness. Larger patient panel size has also been associated with decreased time with patients, an increased rate of referral to specialists, and a lower likelihood of meeting primary and secondary preventative care quality metrics. While preventative care may suffer from higher patient panel sizes, there is no data to suggest that chronic disease care management or clinical outcomes are negatively impacted by increased patient panel sizes.
Panel size and satisfaction
For years, we’ve known that physician satisfaction is associated with the time they have to build patient relationships and do their job, and the satisfaction of the physician contributes to patient satisfaction. Patient-centered communication is one of the keys to overall patient satisfaction. Larger panel sizes are associated with decreased patient satisfaction because of longer wait times for care. This may also result in a reduced likelihood of positive outcomes.
The promise of value-based care
Value-based care (VBC) is an alternative payment model to the traditional fee-for-service model. Created through the Patient Protection and Affordable Care Act in 2015, VBC enrolls doctors, hospitals and other contracted providers who are paid based on the health outcomes of the patients. This means that the healthcare team is rewarded for improving patient health outcomes and decreasing complications associated with their medical conditions. This healthcare model aims to decrease the overall costs and burdens of healthcare on the system while improving satisfaction: for both the patient and the physician.
Value-based care and engagement
Value-based care allows physicians and other healthcare providers to engage with patients more deeply, allowing them to focus on quality of care and patient experience over quantity of care. Value-based care organizations frequently provide additional support for healthcare providers, such as care coordinators, social workers, and community health workers, who help coordinate the patient’s care and provide a more team-based approach. There may also be more opportunities for patient engagement through disease prevention programs and increased options for patients to receive care and communicate with their healthcare team.
All of these additional tools allow for a more whole-person approach to patient care. With a smaller patient panel and more tools for patient care, the healthcare team can spend additional time learning about the possible barriers to patient care, including non-medical factors such as trouble with transportation or difficulty getting healthy food. It also allows for better alignment of healthcare goals.
The power of value-based care
Value-based care allows you, the physician, to provide more comprehensive, effective, and higher-quality care while decreasing your burnout and improving your work-life balance. You can emphasize personalized care and quality over quantity with a smaller patient panel.
Experience the difference that value-based care can make in your practice and for your patients. Join the ChenMed family and become part of a healthcare revolution that prioritizes patient outcomes, reduces physician burnout, and fosters a supportive and collaborative environment. Learn more about how ChenMed is transforming healthcare and how you can participate in this change by visiting ChenMed today.
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