{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T20:18:06Z","timestamp":1765829886731,"version":"3.48.0"},"reference-count":47,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2014,5,23]]},"published-print":{"date-parts":[[2014,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To quantify the time spent by family physicians (FP) on tasks other than direct patient contact, to evaluate job satisfaction, to analyse the association between time spent on tasks and physician characteristics, the association between the number of tasks performed and physician characteristics and the association between time spent on tasks and job satisfaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional, using time-and-motion techniques. Two workdays were documented by direct observation. A significance level of 0.05 was adopted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Multicentric in 104 Portuguese family practices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A convenience sample of FP, with lists of over 1000 patients, teaching senior medical students and first-year family medicine residents in 2012, was obtained. Of the 217 FP invited to participate, 155 completed the study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcomes measured<\/jats:title>\n                    <jats:p>Time spent on tasks other than direct patient contact and on the performance of more than one task simultaneously, the number of direct patient contacts in the office, the number of indirect patient contacts, job satisfaction, demographic and professional characteristics associated with time spent on tasks and the number of different tasks performed, and the association between time spent on tasks and job satisfaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>FP (n=155) spent a mean of 143.6\u2005min\/day (95% CI 135.2 to 152.0) performing tasks such as prescription refills, teaching, meetings, management and communication with other professionals (33.4% of their workload). FP with larger patient lists spent less time on these tasks (p=0.002). Older FP (p=0.021) and those with larger lists (p=0.011) performed fewer tasks. The mean job satisfaction score was 3.5 (out of 5). No association was found between job satisfaction and time spent on tasks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>FP spent one-third of their workday in coordinating care, teaching and managing. Time devoted to these tasks decreases with increasing list size and physician age.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2014-005026","type":"journal-article","created":{"date-parts":[[2014,6,16]],"date-time":"2014-06-16T23:07:10Z","timestamp":1402960030000},"page":"e005026","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["What keeps family physicians busy in Portugal? A multicentre observational study of work other than direct patient contacts"],"prefix":"10.1136","volume":"4","author":[{"given":"M\u00f3nica","family":"Granja","sequence":"first","affiliation":[{"name":"S. Mamede de Infesta Health Centre, Matosinhos Local Health Unit, Matosinhos, Portugal"}]},{"given":"Carla","family":"Ponte","sequence":"additional","affiliation":[{"name":"Porta do Sol Family Health Unit, Matosinhos Local Health Unit, Matosinhos, Portugal"}]},{"given":"Lu\u00eds Filipe","family":"Cavadas","sequence":"additional","affiliation":[{"name":"Lagoa Family Health Unit, Matosinhos Local Health Unit, Matosinhos, Portugal"}]}],"member":"239","published-online":{"date-parts":[[2014,6,15]]},"reference":[{"key":"2025121512121962000_4.6.e005026.1","unstructured":"Richardson WC, Berwick DM, Bisgard JC, et al. Committee on Quality Health Care, Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academy Press, 2001. http:\/\/books.nap.edu\/html\/quality_chasm\/reportbrief.pdf (accessed 1 Dec 2010)."},{"key":"2025121512121962000_4.6.e005026.2","doi-asserted-by":"publisher","DOI":"10.1370\/afm.802"},{"key":"2025121512121962000_4.6.e005026.3","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1590\/S1135-57272008000600004","article-title":"El debate profesional acerca de la escasez de m\u00e9dicos","volume":"82","author":"G\u00e9rvas","year":"2008","journal-title":"Rev Esp Salud P\u00fablica"},{"key":"2025121512121962000_4.6.e005026.4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1497.2005.0178.x"},{"key":"2025121512121962000_4.6.e005026.5","first-page":"116","article-title":"A Gest\u00e3o da Pr\u00e1tica Cl\u00ednica pelo M\u00e9dico de Fam\u00edlia","volume":"9","author":"Baleiras","year":"1992","journal-title":"Rev Port Clin Ger"},{"key":"2025121512121962000_4.6.e005026.6","unstructured":"Decreto-Lei n.\u00b0 176\/2009, de 4 de Agosto. Di\u00e1rio da Rep\u00fablica, 1a s\u00e9rie\u2014N.\u00b0 149, 5043\u20137."},{"key":"2025121512121962000_4.6.e005026.7","unstructured":"Decreto-Lei n.\u00b0 177\/2009, de 4 de Agosto. Di\u00e1rio da Rep\u00fablica, 1a s\u00e9rie\u2014N.\u00b0 149, 5047\u201353."},{"key":"2025121512121962000_4.6.e005026.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMhpr0706165"},{"key":"2025121512121962000_4.6.e005026.9","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-10-200711200-00010"},{"key":"2025121512121962000_4.6.e005026.10","first-page":"388","article-title":"O que ocupa os m\u00e9dicos de fam\u00edlia? Caracteriza\u00e7\u00e3o do trabalho m\u00e9dico para al\u00e9m da consulta","volume":"27","author":"Granja","year":"2011","journal-title":"Rev Port Clin Geral"},{"key":"2025121512121962000_4.6.e005026.11","doi-asserted-by":"publisher","DOI":"10.1370\/afm.404"},{"key":"2025121512121962000_4.6.e005026.12","doi-asserted-by":"publisher","DOI":"10.1370\/afm.391"},{"key":"2025121512121962000_4.6.e005026.13","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-10-200711200-00005"},{"key":"2025121512121962000_4.6.e005026.14","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMon0910793"},{"key":"2025121512121962000_4.6.e005026.15","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-010-1494-7"},{"key":"2025121512121962000_4.6.e005026.16","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-010-1470-2"},{"key":"2025121512121962000_4.6.e005026.17","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1097\/MLR.0b013e3181f53542","article-title":"Temporal and subjective work demands in office-based patient care: an exploration of the dimensions of physician work intensity","volume":"49","author":"Jacobson","year":"2011","journal-title":"Med Care"},{"key":"2025121512121962000_4.6.e005026.18","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/14.4.374"},{"key":"2025121512121962000_4.6.e005026.19","first-page":"577","article-title":"A comparison of work-sampling and time-and-motion techniques for studies in health services research","volume":"28","author":"Finkler","year":"1993","journal-title":"Health Serv Res"},{"key":"2025121512121962000_4.6.e005026.20","unstructured":"Biscaia A . A satisfa\u00e7\u00e3o no trabalho dos m\u00e9dicos de fam\u00edlia dos centros de sa\u00fade portugueses. [Tese de Doutoramento]. Lisboa: Instituto de Higiene e Medicina Tropical, 2010."},{"key":"2025121512121962000_4.6.e005026.21","unstructured":"Biscaia A . Futurar em Positivo\u2014Satisfa\u00e7\u00e3o no Trabalho. Sintra: Grafisol-Edi\u00e7\u00f5es e Papelarias, Lda, 2013."},{"key":"2025121512121962000_4.6.e005026.22","unstructured":"Administra\u00e7\u00e3o Central do Sistema de Sa\u00fade. Invent\u00e1rio de Pessoal do Sector da Sa\u00fade. 2012. http:\/\/www.acss.min-saude.pt\/Portals\/0\/Invent%C3%A1rio_vf.pdf (accessed 27 Oct 2013)."},{"key":"2025121512121962000_4.6.e005026.23","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/S1138-3593(04)74308-7","article-title":"Atenci\u00f3n Primaria de Salud en Europa: tendencias a principios del siglo XXI. Una reflexi\u00f3n con motivo de los XXV a\u00f1os de la Declaraci\u00f3n de Alma Ata","volume":"30","author":"G\u00e9rvas","year":"2004","journal-title":"SEMERGEN\u2014Medicina de Familia"},{"key":"2025121512121962000_4.6.e005026.24","unstructured":"Santos I . N\u00e3o seremos competitivos na investiga\u00e7\u00e3o com os internatos distantes da academia. MGF Not\u00edcias 2013 Outubro 15 Entrevista: 12\u201314."},{"key":"2025121512121962000_4.6.e005026.25","first-page":"257","article-title":"A necessidade de nos afirmarmos na investiga\u00e7\u00e3o","volume":"27","author":"Braga","year":"2011","journal-title":"Rev Port Clin Geral"},{"key":"2025121512121962000_4.6.e005026.26","first-page":"395","article-title":"Precisamos investir na investiga\u00e7\u00e3o","volume":"19","author":"Santos","year":"2003","journal-title":"Rev Port Clin Geral"},{"key":"2025121512121962000_4.6.e005026.27","doi-asserted-by":"publisher","DOI":"10.3109\/13814780309160401"},{"key":"2025121512121962000_4.6.e005026.28","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2003.20627.x"},{"key":"2025121512121962000_4.6.e005026.29","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.18.3.180"},{"key":"2025121512121962000_4.6.e005026.30","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1497.2005.40009.x"},{"key":"2025121512121962000_4.6.e005026.31","first-page":"274","article-title":"A utiliza\u00e7\u00e3o do correio electr\u00f3nico na comunica\u00e7\u00e3o com os utentes da USF Porta do Sol","volume":"27","author":"Ponte","year":"2011","journal-title":"Rev Port Clin Geral"},{"key":"2025121512121962000_4.6.e005026.32","first-page":"639","article-title":"O uso do e-mail na comunica\u00e7\u00e3o com o m\u00e9dico de fam\u00edlia: catorze meses de experi\u00eancia","volume":"25","author":"Granja","year":"2009","journal-title":"Rev Port Clin Geral"},{"key":"2025121512121962000_4.6.e005026.33","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.329.7463.439"},{"key":"2025121512121962000_4.6.e005026.34","doi-asserted-by":"publisher","DOI":"10.1007\/s10198-006-0014-5"},{"key":"2025121512121962000_4.6.e005026.35","first-page":"689","article-title":"Fontes de informa\u00e7\u00e3o sobre medicamentos em Cl\u00ednica Geral\/Medicina Geral e Familiar","volume":"22","author":"Santiago","year":"2006","journal-title":"Rev Port Clin Geral"},{"key":"2025121512121962000_4.6.e005026.36","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000352"},{"key":"2025121512121962000_4.6.e005026.37","unstructured":"Minist\u00e9rio da Sa\u00fade. Despacho n.\u00b0 8213-B\/2013 Di\u00e1rio da Rep\u00fablica, 2.a s\u00e9rie\u2014N.\u00b0 119\u201424 de junho de 2013."},{"key":"2025121512121962000_4.6.e005026.38","unstructured":"Pedro TL . M\u00e9dicos denunciam caos no sistema inform\u00e1tico da sa\u00fade. P\u00fablico 2013. http:\/\/www.publico.pt\/sociedade\/noticia\/medicos-denunciam-caos-no-sistema-informatico-da-saude-1597717 (accessed 15 Nov 2013)."},{"key":"2025121512121962000_4.6.e005026.39","first-page":"377","article-title":"Carga de trabalho, uso do tempo, prescri\u00e7\u00e3o de antibi\u00f3ticos e referencia\u00e7\u00e3o em consulta de Cl\u00ednica Geral","volume":"14","author":"Miranda","year":"1997","journal-title":"Rev Port Clin Geral"},{"key":"2025121512121962000_4.6.e005026.40","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.16.5.383"},{"key":"2025121512121962000_4.6.e005026.41","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-002700"},{"key":"2025121512121962000_4.6.e005026.42","first-page":"1012","article-title":"The relationship between consultation length, process and outcomes en general practice: a systematic review","volume":"52","author":"Wilson","year":"2002","journal-title":"Br J Gen Pract"},{"key":"2025121512121962000_4.6.e005026.43","first-page":"418","article-title":"Patient and physician satisfaction with an outpatient care visit","volume":"45","author":"Probst","year":"1997","journal-title":"J Fam Pract"},{"key":"2025121512121962000_4.6.e005026.44","doi-asserted-by":"publisher","DOI":"10.1370\/afm.1531"},{"key":"2025121512121962000_4.6.e005026.45","first-page":"271","article-title":"Stress, satisfaction and burnout among Dutch medical specialists","volume":"168","author":"Visser","year":"2003","journal-title":"CMAJ"},{"key":"2025121512121962000_4.6.e005026.46","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2012-001050"},{"key":"2025121512121962000_4.6.e005026.47","unstructured":"Santana P Peixoto H Loureiro A . Estudo de Evolu\u00e7\u00e3o Prospectiva de M\u00e9dicos no Sistema Nacional de Sa\u00fade\u2014relat\u00f3rio final. Universidade de Coimbra, 2013. http:\/\/www.nortemedico.pt\/download.php?path=pdf&filename=SRNOM_20130918162117_Estudo_Evolucao_Prospectiva_Medicos_Relatorio_Final.pdf (accessed 21 Sep 2013)."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2014-005026","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T20:12:31Z","timestamp":1765829551000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2014-005026"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,6]]},"references-count":47,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2014,6,15]]},"published-print":{"date-parts":[[2014,6]]}},"alternative-id":["10.1136\/bmjopen-2014-005026"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2014-005026","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2014,6]]}}}