Changes in the Length of Office Visits

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Abstract
The article by Mechanic et al. (Jan. 18 issue)1 challenges the prevailing wisdom that the increased penetration of managed care is associated with a decrease in the length of patients' office visits with physicians. The data to support their conclusions were derived from the National Ambulatory Medical Care Survey (NAMCS) and the monitoring system of the American Medical Association (AMA). Although the numbers superficially suggest that more time is being spent with patients, no measure of the time physicians actually spent talking with and examining patients could be obtained from these studies. Although there may have been an “upward trend in the length of visits for both primary and specialty care,” I would suggest that the apparent increase in duration may be accounted for by the time spent in the completion of paperwork.