TOPLINE:

Primary care physicians (PCPs) spent a median of 61.8 hours per week caring for patients, with part-time PCPs investing more time per patient than their full-time colleagues. Panels with older patients, those with greater medical complexity, or more Medicaid enrollees required more time from PCPs.

METHODOLOGY:

• In a cross-sectional observational study, researchers estimated how much time PCPs spent caring for their patient panels and what factors influenced the length of that time.
• They used activity logs from electronic health records and administrative data from 33 clinics in Boston and involved 406 PCPs (62.3% women) who had patient visits for at least 9 months in 2021.
• One clinical full-time equivalent (cFTE) was defined as a PCP practicing eight clinical sessions per week; 1.0 cFTE represented full-time work, and 0.5 cFTE indicated a lower, part-time clinical workload.
• Annual work effort for each PCP was the sum of monthly appointment time and electronic health record time outside scheduled hours; the sum was adjusted to account for clinical work not captured by these sources.

TAKEAWAY:

• Of all PCPs, 31.3% had a cFTE less than 0.5. The PCPs had a median of 944 patients in their panels.
• Median yearly work effort per 1.0 cFTE ranged from 3480.8 hours for PCPs with a cFTE less than 0.5 to 2401.5 hours for PCPs with a cFTE of 0.75-1.25. The median yearly work effort for full-time PCPs was 2844.3 hours, equivalent to 61.8 hours per week. The median time per patient was 1.7 hours per year.
• Panels with older patients, patients with greater medical complexity, more Medicaid enrollees, or more messages from patients required more time from PCPs.

IN PRACTICE:

“[The] findings suggest that even as physicians seek to reduce their clinical effort to increase the sustainability of primary care jobs, their time expenditure per patient will likely not decrease in proportion,” the authors of the study wrote. “These findings can inform efforts to design primary care roles and adjust PCPs’ panels to facilitate the sustainability of primary care careers,” they added.

SOURCE:

This study was led by Lisa S. Rotenstein, MD, MBA, of the University of California at San Francisco and Brigham and Women’s Hospital in Boston. It was published online on October 21, 2025, in Annals of Internal Medicine.

LIMITATIONS:

This study focused on a single health system in the Northeast, thus limiting generalizability. The researchers lacked information about clinic staff and support, such as scribes or advanced practice providers. The analysis used data from 2021 and may have been influenced by effects of the pandemic.

DISCLOSURES:

This study received funding from the Physicians Foundation. One author reported receiving grants and contracts from, holding stocks of, and having other financial ties with multiple organizations, including the American Medical Association, FeelBetter, and Augmedix, Inc. Three other authors reported having similar ties with various organizations, including the Physicians Foundation.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.