New Team Models Could Provide Care For Panel Sizes Achievable With The Available Primary Care Workforce
Primary care is facing the dilemma of excessive patient panel sizes – the average primary care physician’s panel size of 2,300 is too large for delivering good care under the traditional practice model – in an environment of primary care workforce shortage, which means panel size will only increase. This mismatch has given rise to a delegated team model of primary care whereby an interdisciplinary mix of team members is responsible for patient care.
Using published estimates of the time it takes for a primary care physician to provide preventive, chronic and acute care, researchers from the University of California at San Francisco offer estimates of what panel sizes might be reasonable if portions of these services were delegated to nonphysician team members. They conclude that depending on the degree of task delegation, a primary care team could reasonably care for panel sizes achievable with the available primary care workforce. Specifically, using three assumptions about the degree of task delegation that could be achieved (77 percent, 60 percent, and 50 percent of preventive care, and 47 percent, 30 percent and 25 percent of chronic care), they estimate a primary care team could care for a panel of 1,947, 1,523, or 1,397 patients.
The authors conclude the replacement of physician-only care with team-based care will require a significant change in the culture and structure of primary care practice, but high-functioning primary care teams have the potential to both ensure access and quality for the nation’s population and provide a reasonable work life for physicians and other team members.
“Estimating a Reasonable Patient Panel Size for Primary Care Physicians With Team-Based Task Delegation”
By Justin Altschuler, MD, et al
University of California at San Francisco
September/October 2012 Annals of Family Medicine