Ratio of Patient Hours to Nonpatient Hours in Physician Practices

AI Hallucinations may exist

Multiple studies have examined how physicians allocate their time between direct patient care (patient hours) and nonpatient activities (such as electronic health record [EHR] work, administrative tasks, and other desk work). The ratio of patient to nonpatient hours varies depending on definitions and methodologies, but several consistent patterns emerge:

• Direct patient care typically accounts for about one-quarter to two-thirds of a physician’s workday.
• Nonpatient hours (EHR, desk work, administrative tasks) often exceed patient-facing time, sometimes by a ratio of 2:1.

Key Study Results

Study/Source	% Patient Hours	% Nonpatient Hours	Ratio (Patient:Nonpatient)	Notes
Sinsky et al. (2016)56	27% (direct face time)	49.2% (EHR/desk)	1:1.8	For every 1 hour of patient care, 2 hours on EHR/desk work
Arndt et al. (2020)2	66.5% (patient care, broader definition)	33.5% (EHR/admin/other)	2:1	Includes multitasking and indirect care as patient care
Gottschalk & Flocke (2005)3	55% (face-to-face)	45% (nonpatient)	1.2:1	14% visit-specific, 23% patient-related but not present, 7.5% admin/other
Tai-Seale et al. (2017)4	~40% (patient-facing)	~60% (nonpatient)	1:1.5	Simulation and self-report in primary care

Interpretation

• Most conservative estimates (direct face-to-face only) suggest that for every hour spent with patients, physicians spend about two hours on nonpatient tasks56.
• Broader definitions (including multitasking, indirect care, and EHR use during visits) increase the proportion of time counted as patient care, raising the ratio closer to 2:1 in favor of patient hours2.
• In primary care, the split is often close to 40% patient-facing and 60% nonpatient-facing time4.

Example Calculation

Using the Sinsky et al. data56:

• For every 1 hour of direct patient care, nearly 2 hours are spent on EHR and desk work.
• Ratio: 1:2 (patient:nonpatient).

Using the broader Arndt et al. definition2:

• 66.5% patient care, 33.5% nonpatient.
• Ratio: 2:1 (patient:nonpatient).

Conclusion

The typical ratio of patient hours to nonpatient hours in physician practices ranges from 1:1.5 to 1:2, depending on how patient care is defined. If only direct face-to-face time is counted, physicians spend about twice as much time on nonpatient activities as on direct patient care. If multitasking and indirect care are included, the ratio can approach or exceed parity, but nonpatient work remains a substantial part of the physician workload23456.

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