"Physician Partners" Help Improve Patient Care

By Jane Farrell

A “physician partner” who can handle a doctor’s administrative tasks will help lighten the practitioner’s burden and increase patient care satisfaction, according to a study from UCLA.

The study, published in the journal JAMA Internal Medicine, focused on the implementation of electronic medical records.

"Patients want their doctors to spend time with them and give them the attention that makes them feel more confident in their medical care — they don't want to just sit there while their doctor is on the computer," said David Reuben, chief of the division of geriatrics at the university’s David Geffen School of Medicine and the study's primary investigator. "This [having a physician partner] also saves physicians a huge amount of time after patient sessions end, enabling them to spend more time with their families, keep up with the latest developments in medicine and come back refreshed the next day."

In the study, three geriatricians and two internists in academic practices each used physician partners over a total of 326 four-hour clinic sessions. The partners worked alongside the physicians during patient visits, transcribed physician comments into patients' records and pulled patient information from computer records. They also completed lab and referral requests, processed new prescriptions or refills, updated medication lists, scheduled follow-up appointments and provided patients with visit summaries.

Because of the partner, geriatricians saved an average of 28.8 minutes over the four-hour sessions, compared with doctors who didn’t have a partner. Sessions for doctors without partners ran over by an average of 8.1 minutes.

The internists, however, did not have a significantly shorter time with patients. But they did spend less time between patients on writing notes and on preparation for visits. That free time, the study found, gave them time to return calls and deal with issues involving patients who weren’t in the office.

As for the patients, 79 percent said the partners helped make their visit run more smoothly, with 18 percent uncomfortable with a partner’s presence. Eighty-eight percent of patients strongly agreed that their physicians spent enough time with them when accompanied by a partner, compared with 75 percent of patients whose physicians worked without a partner.

Among patients, 79 percent thought the physician partners contributed toward making their visit run smoothly, and only 18 percent were uncomfortable with the partners' presence. In addition, 88 percent of the patients whose doctors had a physician partner in the room strongly agreed that their physician spent enough time with them, compared with 75 percent whose physicians did not have a partner.

The researchers acknowledged that the study was limited because it didn’t address the quality of care the patients received. Still, they said, "the Physician Partners program provides a potential model to improve physician efficiency in the office setting without compromising patient satisfaction," the researchers write. "Implementation and dissemination will depend upon local factors including staff availability and training, adaptation to the patient population and practice characteristics, cost and reimbursement structures, and willingness to invest in change."