Docs With Their Eyes on the Clock? The Effect of Time Pressures on Primary Care Productivity

69 Pages Posted: 11 Nov 2018 Last revised: 15 Dec 2020

See all articles by Seth Freedman

Seth Freedman

Indiana University Bloomington - School of Public & Environmental Affairs (SPEA)

Ezra Golberstein

University of Minnesota - Twin Cities

Tsan-Yao Huang

University of Minnesota - Minneapolis

David Satin

University of Minnesota - Twin Cities

Laura Barrie Smith

Urban Institute

Date Written: October 19, 2018

Abstract

This paper examines how time pressure, an important constraint faced by medical care providers, affects productivity in primary care. We generate empirical predictions by incorporating time pressure into a model of physician behavior by Tai-Seale and McGuire (2012). We use data from the electronic health records of a large integrated delivery system and leverage unexpected schedule changes as variation in time pressure. We find that greater time pressure reduces the number of diagnoses recorded during a visit and increases both scheduled and unscheduled follow-up care. We also find some evidence of increased low-value care, decreased preventive care, and decreased opioid prescribing.

JEL Classification: I10

Suggested Citation

Freedman, Seth and Golberstein, Ezra and Huang, Tsan-Yao and Satin, David and Barrie Smith, Laura, Docs With Their Eyes on the Clock? The Effect of Time Pressures on Primary Care Productivity (October 19, 2018). Available at SSRN: https://ssrn.com/abstract=3269929 or http://dx.doi.org/10.2139/ssrn.3269929

Seth Freedman (Contact Author)

Indiana University Bloomington - School of Public & Environmental Affairs (SPEA) ( email )

1315 East Tenth Street
Bloomington, IN 47405
United States

Ezra Golberstein

University of Minnesota - Twin Cities ( email )

420 Delaware St. SE
Minneapolis, MN 55455
United States

Tsan-Yao Huang

University of Minnesota - Minneapolis

110 Wulling Hall, 86 Pleasant St, S.E.
308 Harvard Street SE
Minneapolis, MN 55455
United States

David Satin

University of Minnesota - Twin Cities ( email )

420 Delaware St. SE
Minneapolis, MN 55455
United States

Laura Barrie Smith

Urban Institute ( email )

2100 M Street, NW
Washington, DC 20037
United States

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