Length of Office Visits for Gastrointestinal Disease: Impact of Physician Specialty

OBJECTIVES: Physician-visit length is an important determinant of patient satisfaction and outcomes. Our objective was to compare visit length for gastrointestinal disorders between gastroenterologists and primary-care providers (PCPs). METHODS: From the National Ambulatory Medical Care Survey, visits to office-based physician practices between 1993 and 2004 were identified and multivariate regression was used to identify predictors of visit duration. RESULTS: There were 3135, 3391, and 3964 office visits associated with gastrointestinal disease, corresponding to 71, 140, and 180 million visits nationwide in 1993-1996, 1997-2000, and 2001-2004 respectively. Visit duration to all physicians increased from 17.3 minutes in 1993-1996 to 20.2 minutes in 2001-2004. Among gastroenterologists, visit length remained constant, from 21.0 minutes in 1993-1996 to 22.3 minutes in 2001-2004. On multivariate regression, age >50 years (1.8 minutes), new-patient encounters (7.4 minutes), and visits in 1997-2000 (2.7 minutes) and 2001-2004 (3.4 minutes) were associated with longer visit length. Encounters with gastroenterologists (3.3 minutes) were associated with longer visit duration than those with PCPs. The greatest adjusted difference in visit length between the two was seen for visits associated with constipation (5.7 minutes favoring gastroenterologists) and irritable bowel syndrome (2.4 minutes). CONCLUSIONS: There has been an overall increase in length of physician visits associated with gastrointestinal disease. Both patient and provider factors predict visit length.