Is patients' perception of time spent with the physician a determinant of ambulatory patient satisfaction?

Background: Time management in ambulatory patient visits is increasingly cr itical. Do patients who perceive a longer visit with internists report incr eased satisfaction? Methods: Prospective survey of 1486 consecutively encountered ambulatory vi sits to 16 primary care physicians (PCPs) in an academic primary care clini c. Patients were queried regarding demographics, health status, perception of time spent before and after ambulatory visits, whether the physician app eared rushed, and visit satisfaction. Physicians were queried regarding tim e spent, estimated patient satisfaction, and whether they felt rushed. Results: In 69% of 1486 consecutive visits, patient previsit expectation of visit duration was 20 minutes or less. Patient and PCP postvisit estimates of time spent significantly exceeded patient previsit time expectation. Pa tients who estimated that they spent more time than expected with the PCP w ere significantly more satisfied with the visit. When patient postvisit est imate of time spent was less than the previsit expectation, visit satisfact ion was significantly lower independent of time spent. Patient worry about health and lower self-perceived health status were significantly associated with patient expectation for longer visits. Primary care physicians felt r ushed in 10% of encounters. Although PCPs estimated patient satisfaction wa s significantly lower when they felt rushed, patient satisfaction was ident ical when PCPs did and did not feel rushed. Patients indicated that PCPs ap peared rushed in 3% of encounters, but this perception did not affect patie nt satisfaction. Conclusion: Perceived ambulatory visit duration and meeting or exceeding pa tient expectation of time needed to be spent with the physician are determi nants of patient satisfaction in an ambulatory internal medicine practice.