Allocation of physician time in ambulatory practice


The AMA is advancing research to address practice challenges and increase professional satisfaction among physicians. Ambulatory care in the United States has been subject to pressures to cut costs, meet regulations and transition to Electronic Health Records (EHRs). The unintended effects and consequences include:

  • Increased amount of time spent documenting care and performance metrics
  • Impaired communication with patients
  • Increased career dissatisfaction and burnout of physicians

The AMA, along with Dartmouth-Hitchcock Medical Center, Sharp End Advisory and the Australian Institute of Health Innovation at Macquarie University, conducted a time and motion study to identify and describe how physicians allocate their time during a typical clinical day in ambulatory care practice.

Read the study.

Among the study’s key findings:

  • For every hour physicians provide direct clinical face time to patients, nearly 2 additional hours are spent on EHR and desk work within the clinic day.
  • Outside office hours, physicians spend another 1 to 2 hours of personal time each night doing additional computer and other clerical work.

In conjunction with the time and motion study, researchers interviewed physician and clinical staff participants to explore fundamental sources of physician satisfaction and dissatisfaction, and the effects of administrative work on practices.

Find the report.

This qualitative research found that physicians derive satisfaction from:

  • Providing good medical care
  • Taking care of patients

Sources of dissatisfaction for physicians were:

  • EHR/desk work
  • Complexities of the physician payment system
  • Practice administration

Together, these analyses broadly convey a picture of ordinary life in ambulatory care practices.