Office visits may be lengthening partly because doctors are seeing more older, sicker patients, the researchers said.
Also, patients are taking more responsibility for their care, which means longer visits, said Dr. Greg Sachs, professor of medicine and director of the division of general internal medicine and geriatrics at the Indiana University School of Medicine, who was familiar with the study findings.
"People are coming in with more questions, more information and an expectation to be more involved in making decisions about their care," he said.
That means that doctors must work longer hours and see more patients to maintain their income, Sachs said.
Health care professionals "are looking for creative solutions to free up doctor time, and doctors are really working a lot harder," he said. "Things like having nurse practitioners or physician's assistants assist in the care of patients frees up physician time for more complex patients," Sachs added.
Group visits -- in which multiple patients with the same condition are seen simultaneously to discuss care and self-management -- are another strategy, Sachs said.
But fewer people are choosing family medicine as a career, largely because of lifestyle and work demands, he said.
Improving quality of care will probably require wider use of electronic medical records and better reimbursement of family doctors, the researchers noted.
In another report in the same issue of the journal, research shows that the waits at emergency rooms have grown longer.
In 2006, one in four emergency patients waited longer to see a physician than recommended at triage, an increase from one in five in 1997, researchers found.
"Emergency departments are increasingly overcrowded, thereby strainin
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