![]() Time, in this view, is an essential resource physicians have at their disposal for getting to know patients (including relevant psychosocial circumstances), making thorough diagnoses, and developing effective treatment plans. TIME DOCTOR CAREERS PROFESSIONAL12, 18, 28 – 32 There is agreement that it is crucial to the provision of good medical care to have the professional autonomy to make decisions about how much time a patient needs for an appointment. 6, 26Ĭriticism of time limits imposed on physician patient visits has been frequent. 12 Conversely, physicians who meet or exceed managed care quotas are often given bonuses and other rewards. Physicians who do not see the number of contractually stipulated patients often earn less and, in some cases, are penalized financially. 26 – 33 In many cases, physicians are contractually bound by managed care insurers to limit the amount of time with each patient (typically ranging from 10 to 15 minutes) for the purpose of meeting total caseload quotas. Studies have also shown that managed care limitations on the amount of time physicians are permitted to spend with patients is associated with decreased job satisfaction. 12 – 18 Commentators have argued on the editorial pages of leading medical journals that revitalizing/saving primary care will entail overhauling managed care or devising other aggressive strategies for addressing physician discontent. 11 – 13 Increasing rates of primary care physician attrition coupled with decreasing numbers of medical students who choose to specialize in primary care medicine augurs an impending shortage of primary care providers in the coming decades. 1 – 10 Indeed, a small but significant number of physicians are considering leaving medicine because of managed care and other constraints. In recent years, many studies have documented a strong link between managed care and a decline in physician job satisfaction, especially in primary care medicine. ![]()
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