Nurse Practitioners' Non-Billable Activities

Abstract

(41st Biennial Convention) A descriptive non experimental research study was conducted to describe the type of activities and duration of time that nurse practitioners devote to non-billable work and compare these activities with internists.�One month of NPs office visits and non-billable activities (frequency and duration of time) were collected in two primary care clinics. NPs kept personal logs to track telephone calls, prescription refills, emails to patients or guardians, laboratory reports, imagery reports, and consultations. The findings were NPs reported working 40 hours a week, whereas the physician group used for comparison (Baron, 2010) reported working an average 55 hour work week; therefore, hours for the NPs were prorated to make comparable analyses. Physicians spent 43% of their time in billable office visits and 47% of the time in non-billable activities. NPs spent 21% of their time in non-billable activities and 79% of the time in office visits. Physicians had more visits per week; they reported 18.1 visits per day per physician; whereas, the NPs reported 12.7 visits per day per NP.�Physicians performed many more non-billable activities per day than NPs. The greatest contrast in non-billable activities between the two disciplines occurred in consultation (13.9 vs 1.3), image results (11.1 vs 1.3), phone calls (23.7 vs 3.1), and emails (16.8 vs 2.8). Physicians performed these non-billable activities four to eight times more frequently per day than NPs. The closest similarity of non-billable activities between the two disciplines occurred in interpreting lab results and refilling prescriptions.�NPs saw fewer patients per day than the comparison physician group; however, NPs also spent much less time in non-billable activities compared to physicians. The implication for practice is NPs spend more of their work day in productive, billable activities.