A recent study published in Health Affairs study suggests that primary care physicians spend 49 percent of their clinical time on face-to-face visits with patients and 51 percent on what study authors call “desktop medicine,” and payment policies should reflect that, according to the American Academy of Family Physicians (AAFP).
“Desktop medicine” is conducted outside of a normal office visit and is done by communication via secure patient portals, responding to online requests for refills or advice, ordering and reviewing tests, and sending staff messages, AAFP said in a press release.
"While working on progress notes could be considered pre- or post-service efforts, desktop medicine activities not linked to a face-to-face visit are not reimbursable under typical fee-for-service contractual and regulatory arrangements," the authors wrote. "Many of those activities – such as care coordination and responding to patients' email – are of high value to the delivery system and to patients, so the staffing, scheduling and design of primary care practices should reflect this value.”
The article, "Electronic Health Record Logs Indicate That Physicians Split Time Evenly Between Seeing Patients and Desktop Medicine,” said the average time spent on face-to-face visits was 3.08 hours versus 3.17 hours for desktop medicine, AAFP said.
"While it may be good or bad that physicians are spending more time documenting care and communicating with other staff members than they are in face-to-face visits with patients, that fact highlights the misalignment of a payment policy that reimburses only office visits, lab work and procedures while overlooking much of desktop medicine work," the authors wrote.