Trainees Associated with Improved Wait Times and Patient Satisfaction in a Multidisciplinary Clinic.

OBJECTIVE: To determine variables associated with longer wait times and decreased patient satisfaction. To determine the association of trainees with clinic wait times and patient satisfaction scores in an academic center. STUDY DESIGN: Cross-sectional study. METHODS: We recruited 266 study participants from an interdisciplinary Head and Neck Cancer outpatient clinic setting. Trained observers recorded observations related to wait times, time with individual health care practitioners, and total time spent in clinic. An 11-question survey was given to patients at the end of their visit assessing each patient's satisfaction with their visit, subjective wait time, and their likelihood to recommend the health care provider. RESULTS: Increased objective wait times were associated with new patients (p = 0.006) and based on the physician they saw (p < 0.001). Patients who saw a trainee spent less time waiting to see a physician (p = 0.023), more total time with a physician (p = 0.001), and reported higher wait time satisfaction scores (p = 0.001). There was no difference in total visit time if patients saw a trainee (p = 0.42). Patient satisfaction with wait time was correlated with all other aspects of patient satisfaction (p < 0.001). On multivariable analysis, the subjective wait time was associated with the likelihood to recommend (p < 0.001). CONCLUSION: Prolonged objective wait times in a multidisciplinary oncology outpatient setting were associated with several factors including specific physicians and new patient status. Trainee interaction with patients led to shorter wait times and improved patient satisfaction scores with wait times. Satisfaction with wait time was positively correlated with all aspects of patient satisfaction and 'likelihood to recommend' scores. LEVEL OF EVIDENCE: NA Laryngoscope, 134:178-184, 2024.

Average Operative Times for 1,313 Primary Total Hip Arthroplasty and 1,300 Primary Total Knee Arthroplasty Over 39 Months Are Roughly Equal to Medicare Attributed Operative Times.

BACKGROUND: Primary arthroplasty current procedural terminology codes have been proposed for reexamination due to concern that the intraservice skin-to-skin time is overestimated at 100 minutes. We sought to determine actual intraservice times for primary total hip arthroplasty (THA) and primary total knee arthroplasty (TKA). METHODS: We queried hospital administrative databases to determine average intraservice times for 4 fellowship-trained arthroplasty surgeons at an urban, academic institution. RESULTS: There were 1313 primary THA performed over the study period. The mean intraservice time was 102 minutes (standard deviation 26 minutes). There were no consistent trends over time. There were 1300 primary TKA performed over the study period. The mean intraservice time was 116 minutes (standard deviation 25 minutes). There were no consistent trends over time. CONCLUSIONS: We found an average operative time that was very close to the current benchmarked times for THA and 16% longer than the benchmarked times for TKA. The incentives of for-profit insurance companies and third-party organizations must be considered when considering requests for a rereview of the physician work and carefully weighed against real data, such as presented here, and the impact on access to care for patients.