Analysis & commentary. A Martian's prescription for primary care: overhaul the physician's workday

Abstract

What would a Martian arriving on earth think about how U.S. primary care physicians spend their time? She or he would probably reach the same conclusions as this essay: that a new model for primary care should not be based on physicians' seeing a high volume of patients. On the contrary, physicians should see a relatively small number of patients, perhaps eight to ten daily. Thus liberated, they could spend more time with patients who need it; could have adequate time to communicate via phone and e-mail with patients, physicians, home health nurses, and other providers; and could actively coordinate the care of the practice's population of patients. Although articles about new care models such as the patient-centered medical home imply that physicians should work differently, they rarely mention this fundamental transformation of the workday. I suggest reasons for this omission and ways to overcome barriers to redesigning physicians' workday.