Quality of Health Care Delivered to Adults in the United States

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Abstract
In the study by McGlynn et al. (June 26 issue),1 participants received only about half of recommended care. It may be possible to double efficiency by working harder and smarter, as Steinberg suggests in his accompanying editorial,2 but this is unlikely. Physicians would need 7.4 hours per working day to fully satisfy all the recommendations of the U.S. Preventive Services Task Force.3 This is the time to be allotted to prevention only. Now add the time needed for other tasks, such as care of the sick, continuing medical education, and administration. Completing all these tasks according to recommendation would probably require working more than 15 to 20 hours per working day. It follows that eight hours per working day would allow physicians to satisfy only half of the current recommendations, as suggested by the findings of McGlynn et al.