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Longer Appointment Times in Clinic Where Trainees Present

WEDNESDAY, Nov. 15, 2017 -- The presence of trainees in an outpatient ophthalmology clinic is associated with longer appointment times, even for appointments for which the trainee is not present, according to a study published online Nov. 9 in JAMA Ophthalmology.

Isaac H. Goldstein, from Oregon Health & Science University in Portland, and colleagues conducted a single-center cohort study to quantify the correlation between the presence of trainees and efficiency in an outpatient ophthalmology clinic. Data were included for 49,448 patient appointments with 33 attending physicians and 40 trainees.

The researchers found that appointments with trainees were significantly longer than appointments in clinic sessions without trainees (mean, 105 versus 80.3 minutes). Even in appointments for which the trainee was not present, the presence of a trainee in a clinic session was correlated with longer mean appointment time (mean, 87.2 versus 80.3 minutes). Among the 33 study physicians, three, one, and 29 had shorter, no change in, and longer mean appointment times when a trainee was present. The presence of a resident and a fellow was associated with a lengthening of appointment times of 17 and 13.5 minutes, respectively.

"These results highlight a potential challenge of maintaining clinical efficiency in academic medical centers and raise questions about physician reimbursement models," the authors write.

One author disclosed ties to the pharmaceutical industry.

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Posted: November 2017