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OBJECTIVES: To model physician productivity as a function of clinic (support system) characteristics and physician characteristics and to model the time a physician spends with the patient as a function of patient characteristics.

DESIGN: Observational study.

SETTING: A general medicine clinic of a university-affiliated Veterans Affairs medical center.

PATIENTS: A cohort of 2,520 patients having 2,721 consecutive outpatient visits to 56 physicians.

MAIN OUTCOME MEASURES: Physician productivity defined as patients seen/physician/hour and time (minutes) spent with the patient.

RESULTS: Physicians saw a mean (±SD) of 1.62±0.68 patients/hour. Clinic characteristics explained 8.2% of the variability of session-specific physician productivity. Controlling for clinic characteristics, a factor representing the …