Bottom Line: The time of day of a primary care appointment was associated with the likelihood of a physician ordering cancer screenings and of patients completing those screenings in this study of 33 practices with patients eligible for breast or colorectal cancer screening. The likelihood of physicians ordering cancer screenings decreased as the clinic day progressed and so did the likelihood of patients completing those screenings within one year of the office visit. This observational study cannot explain the cause behind these associations but clinician and patient factors may explain it, such as shorter interactions with patients if physicians fall behind and cancer screenings not being discussed. Screening test order rates were highest at 8 a.m. and lowest at 5 p.m. The results of this study may not be generalizable because it was conducted at a single health system and variation in screening orders and patient completion may be related to factors unaccounted for in this study. Future interventions that aim to increase cancer screenings should consider how the timing of primary care visits might influence physician and patient behavior.
Authors: Mitesh S. Patel, M.D., M.B.A., M.S., University of Pennsylvania, Philadelphia, and coauthors
(doi:10.1001/jamanetworkopen.2019.3403)
Editor’s Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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