The 27-hour day.
Take a typical panel of 2,500 adults. Give every one of them the care the guidelines recommend. Researchers did the math: it comes to 26.7 hours a day.
There are 24. Drag the panel. Add a team. See what fits.
The day ran out 2.7 hours ago.
- Preventive care14.1 hScreenings, vaccines, counseling
- Chronic disease care7.2 hDiabetes, blood pressure, and the rest
- Acute care2.2 hThe cough, the rash, the sprain
- Charting and inbox3.2 hThe part nobody schedules
Hours from Porter et al., Journal of General Internal Medicine, 2023, for a panel of 2,500 adults that looks like the US population. Scaling to other panel sizes is our simplification.
The math was never close.
Alone, the doctor is short by a whole extra day, every day. Nobody is lazy. The job is bigger than the clock.
A team cuts it by two thirds.
Nurses, MAs, pharmacists, and health coaches take the work they can finish. It still doesn’t fit in eight hours.
Panel size is a clinical decision.
How many patients one doctor carries decides what each of them gets. It is usually set by a spreadsheet.
More on this in The 27-hour day and The 15-minute visit is a settlement.