Optimal Panel Size: Are We Asking the Right Question?
Authors: Christine A. Sinsky, Marie T. Brown
Journal: Annals of Internal Medicine (2020)

Editorials4 February 2020Optimal Panel Size: Are We Asking the Right Question?Christine A. Sinsky, MD and Marie T. Brown, MDChristine A. Sinsky, MDAmerican Medical Association, Chicago, Illinois (C.A.S., M.T.B.) and Marie T. Brown, MDAmerican Medical Association, Chicago, Illinois (C.A.S., M.T.B.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-3673 Author Insight Video - Christine A. Sinsky, MD In this video, Christine A. Sinsky, MD, offers additional insight into the article, "Optimal Panel Size: Are we Asking the Right Question?" Author Insight Video - Christine A. Sinsky, MD In this video, Christine A. Sinsky, MD, offers additional insight into the article, "Optimal Panel Size: Are we Asking the Right Question?" Author Insight Video - Christine A. Sinsky, MD (3:085) In this video, Christine A. Sinsky, MD, offers additional insight into the article, "Optimal Panel Size: Are we Asking the Right Question?" Author Insight Video - Christine A. Sinsky, MD (3:085) In this video, Christine A. Sinsky, MD, offers additional insight into the article, "Optimal Panel Size: Are we Asking the Right Question?" Author Insight Video - Christine A. Sinsky, MD In this video, Christine A. Sinsky, MD, offers additional insight into the article, "Optimal Panel Size: Are we Asking the Right Question?" SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Health care systems are investing resources into managing primary care physicians' panel sizes in the name of population health and accountable care and in pursuit of standardized work expectations for salaried physicians (1). In some organizations, panel size is calculated monthly, with automatic opening or closing of new patient appointments in response. The algorithms for these calculations are usually unknown to physicians managed in this way, are often proprietary, and usually take a limited number of practice variables into consideration.In their systematic review (2), Paige and colleagues find that "evidence about the association between panel size and aims of ...References1. Kivlahan C, Pellegrino K, Grumbach K, et al. Calculating Primary Care Panel Size. 2017. Accessed at www.ucop.edu/uc-health/_files/uch-chqi-white-paper-panel-size.pdf on 13 November 2019. Google Scholar2. Paige NM, Apaydin EA, Goldhaber-Fiebert JD, et al. What is the optimal primary care panel size? A systematic review. Ann Intern Med. 2020;172:195-201. doi:10.7326/M19-2491 LinkGoogle Scholar3. Bodenheimer T, Sinsky C. From triple to quadruple aim: care of the patient requires care of the provider. Ann Fam Med. 2014;12:573-6. [PMID: 25384822] doi:10.1370/afm.1713 CrossrefMedlineGoogle Scholar4. Bazemore A, Petterson S, Peterson LE, et al. More comprehensive care among family physicians is associated with lower costs and fewer hospitalizations. Ann Fam Med. 2015;13:206-13. [PMID: 25964397] doi:10.1370/afm.1787 CrossrefMedlineGoogle Scholar5. Nyweide DJ, Bynum JPW. Relationship between continuity of ambulatory care and risk of emergency department episodes among older adults. Ann Emerg Med. 2017;69:407-415. [PMID: 27520592] doi:10.1016/j.annemergmed.2016.06.027 CrossrefMedlineGoogle Scholar6. Erickson RA, Erickson RA, Targonski PV, et al. Does the "office nurse" level of training matter in the family medicine office? J Am Board Fam Med. 2012;25:854-61. [PMID: 23136326] doi:10.3122/jabfm.2012.06.110138 CrossrefMedlineGoogle Scholar7. Willard-Grace R, Hessler D, Rogers E, et al. Team structure and culture are associated with lower burnout in primary care. J Am Board Fam Med. 2014;27:229-38. [PMID: 24610185] doi:10.3122/jabfm.2014.02.130215 CrossrefMedlineGoogle Scholar8. Sinsky CA, Dugdale DC. Medicare payment for cognitive vs procedural care: minding the gap. JAMA Intern Med. 2013;173:1733-7. [PMID: 23939411] MedlineGoogle Scholar9. Sinsky CA, Rule A, Cohen G, et al. Metrics for assessing physician activity using EHR log data. JAMIA. 2020. [Forthcoming]. Google Scholar10. Peterson Center on Healthcare. Identification: Uncovering America's Most Valuable Care. 2019. Accessed at https://petersonhealthcare.org/identification-uncovering-americas-most-valuable-care on 18 November 2019. Google Scholar Author, Article, and Disclosure InformationAffiliations: American Medical Association, Chicago, Illinois (C.A.S., M.T.B.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-3673.Corresponding Author: Christine A. Sinsky, MD, American Medical Association, 330 North Wabash Avenue, Suite 39300, Chicago, IL 60611; e-mail, christine.[email protected]org.Current Author Addresses: Drs. Sinsky and Brown: American Medical Association, 330 North Wabash Avenue, Suite 39300, Chicago, IL 60611.This article was published at Annals.org on 21 January 2020. PreviousarticleNextarticle Advertisement Author Insight Video - Christine A. Sinsky, MD In this video, Christine A. Sinsky, MD, offers additional insight into the article, "Optimal Panel Size: Are we Asking the Right Question?" Author Insight Video - Christine A. Sinsky, MD In this video, Christine A. Sinsky, MD, offers additional insight into the article, "Optimal Panel Size: Are we Asking the Right Question?" Author Insight Video - Christine A. Sinsky, MD (3:085) In this video, Christine A. Sinsky, MD, offers additional insight into the article, "Optimal Panel Size: Are we Asking the Right Question?" Author Insight Video - Christine A. Sinsky, MD (3:085) In this video, Christine A. Sinsky, MD, offers additional insight into the article, "Optimal Panel Size: Are we Asking the Right Question?" Author Insight Video - Christine A. Sinsky, MD In this video, Christine A. Sinsky, MD, offers additional insight into the article, "Optimal Panel Size: Are we Asking the Right Question?" FiguresReferencesRelatedDetailsSee AlsoWhat Is the Optimal Primary Care Panel Size? Neil M. Paige , Eric A. Apaydin , Jeremy D. Goldhaber-Fiebert , Selene Mak , Isomi M. Miake-Lye , Meron M. Begashaw , Jessica M. Severin , and Paul G. 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