How do you fit 26.1 hours worth of primary care into a 24 hour day?

Turns out you can't.

As further evidence of the crushing demands on healthcare systems, a new University of Chicago School of Medicine and Imperial College of London study has determined that current recommendations for care break down to 14.1 hours/day for preventive care, 7.2 hours/day for chronic disease care, 2.2 hours/day for acute care, and 3.2 hours/day for documentation and inbox management.

“There is this sort of disconnect between the care we’ve been trained to give and the constraints of a clinic workday,” said Dr. Justin Porter, assistant professor of medicine at the University of Chicago and lead author of the paper in a statement. “We have an ever-increasing set of guidelines, but clinic slots have not increased proportionately.”

The study, “Revisiting the Time Needed to Provide Adult Primary Care,” is published in the July issue of the Journal of General Internal Medicine.

The research, which ran a simulation based on data from the National Health and Nutrition Examination Survey, did find that a team-based approach, using nurses, PAs and counselors helped ease the overwork, cutting physician care delivery time to just 9.3 hours a day.

“Team-based care is a movement that has been around in medicine for a while and has gathered steam more recently,” said Porter, noting that it offered a “partial solution” to the present time crunch faced in healthcare.

The time crunch translates to unhappy patients, too.

“If you do surveys with patients about what frustrates them about their medical care, you’ll frequently hear, 'My doctor doesn’t spend time with me’ or ‘My doctor doesn’t follow up,’” said Porter. “I think a lot of times this is interpreted as a lack of empathy, or a lack of willingness to care for a patient. But the reality — for the majority of doctors — is simply a lack of time.”

On top of the time-crunch demands for regular care, and the surging staffing requirements from the pandemic, there are also the ongoing hiring challenges faced in healthcare today.

Healthcare workers saw lower wage rates and employment versus other industries throughout 2020 and the first six months of 2021, according to researchers at Indiana University, nonprofit Rand Corporation and the University of Michigan in a March report. Employment for U.S. healthcare staff dropped by 5.2% in 2020 from 22.2 million in 2019 to 21.1 million by mid-2020, and wages were up only 5%, they noted.

In January, the U.S. Department of Health and Human Services was told by nearly 24% of U.S. hospitals — or 1,200 of 5,000 — that they are facing a “critical staffing shortage” as they continue to be slammed by the rising number of COVID-19 cases coming through their doors.

Dr. Ashish Jha, dean of Brown University's School of Public Health, told CNN that Omicron’s fast-spreading nature may even cut into the ability of hospitals to care for non-COVID patients. “All of that is going to be much, much more difficult because we have a large proportion of the population that is not vaccinated, plenty of high-risk people who are not boosted. That combination sets up a large pool of people who, as they get infected, will end up really straining the resources we have in the hospitals today."

And the staffing situation is not improving, apparently.

In July, a U.S. Bureau of Labor Statistics report showed that about 1.5 million healthcare jobs were lost in the first two months of COVID-19 and despite some recovery, sector “employment remains below pre-pandemic levels, with the number of workers down by 1.1%, or 176,000, compared to February 2020,” according to U.S. News.