ArticleBMJ (Clinical research ed.)2018
Much to do with nothing: microsimulation study on time management in primary care.
Article in BMJ (Clinical research ed.), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Lay advisor interventions for hypertension outcomes: A Systematic Review, Meta-analysis and a RE-AIM evaluation.Frontiers in medicine · 2024Pooled it
- Barriers and facilitators to clinical information seeking: a systematic review.Journal of the American Medical Informatics Association : JAMIA · 2019Pooled it
- Talking, not training, increased the accuracy of physicians' diagnosis of their patients' preferences for colon cancer screening.Patient education and counseling · 2024Trial
- Effect of a Peer Comparison and Educational Intervention on Medical Test Conversation Quality: A Randomized Clinical Trial.JAMA network open · 2023Trial
- Feasibility and acceptability of an everyday patient-centered discussion model for primary care: An exploratory, single-center study in the VA primary care setting.PEC innovation · 2026Article
- Implementation strategies in the Exploration and Preparation phases of a colorectal cancer screening intervention in community health centers.Implementation science communications · 2023Article
- Summary and application of the WHO 2020 physical activity guidelines for patients with essential hypertension in primary care.Heliyon · 2022Review
- Extending Advance Care Planning to Black Americans in the Community: A Pilot Study of the PREPARE Program.Journal of pain and symptom management · 2021Article
- Variation in Eligible Patients' Agreeing to and Receiving Lung Cancer Screening: A Cohort Study.American journal of preventive medicine · 2021Article
- Toward a Medical "Ecology of Attention".The New England journal of medicine · 2021Article
- Dealing with the Lack of Time for Detailed Shared Decision-making in Primary Care: Everyday Shared Decision-making.Journal of general internal medicine · 2020Article
- What Exactly Is Shared Decision-Making? A Qualitative Study of Shared Decision-Making in Lung Cancer Screening.Journal of general internal medicine · 2020Article
- Understanding primary care providers' perceptions of cancer prevention and screening in a predominantly rural healthcare system in the upper Midwest.BMC health services research · 2019Article
- Predicting Risk of Potentially Preventable Hospitalization in Older Adults with Dementia.Journal of the American Geriatrics Society · 2019Article
- The Need for Brevity During Shared Decision Making (SDM) for Cancer Screening: Veterans' Perspectives on an "Everyday SDM" Compromise.MDM policy & practiceArticle
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Authors and funding
3 authors.
Funding
Abstract
objectiveTo investigate the credibility of claims that general practitioners lack time for shared decision making and preventive care.
designMonte Carlo microsimulation study.
settingPrimary care, United States.
participantsSample of general practitioners (n=1000) representative of annual work hours and patient panel size (n=2000 patients) in the US, derived from the National Health and Nutrition Examination Survey.
main outcome measuresThe primary outcome was the time needed to deliver shared decision making for highly recommended preventive interventions in relation to time available for preventive care-the prevention-time-space-deficit (ie, time-space needed by doctor exceeding the time-space available).
resultsOn average, general practitioners have 29 minutes each workday to discuss preventive care services (just over two minutes for each clinic visit) with patients, but they need about 6.1 hours to complete shared decision making for preventive care. 100% of the study sample experienced a prevention-time-space-deficit (mean deficit 5.6 h/day) even given conservative (ie, absurdly wishful) time estimates for shared decision making. However, this time deficit could be easily overcome by reducing personal time and shifting gains to work tasks. For example, general practitioners could reduce the frequency of bathroom breaks to every other day and skip time with older children who don't like them much anyway.
conclusionsThis study confirms a widely held suspicion that general practitioners waste valuable time on "personal care" activities. Primary care overlords, once informed about the extent of this vast reservoir of personal time, can start testing methods to "persuade" general practitioners to reallocate more personal time toward bulging clinical demands.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.