OBJECTIVES: Determine whether physicians spend more time with patients prescribed high-risk medications -- anticoagulants, anticonvulsants, antiarrythmics, antidiabetics and beta agonists -- that require either additional patient education about correct use and adverse effects or increased monitoring by providers. METHODS: Patient visit data to physicians from the 2003 National Ambulatory Medical Care Survey (n = 17,078) were used in multiple regression (SPSS 12.0, á = 0.05). Visit time was the dependent variable. Independent variables included indicator variables for prescribing each high-risk medication and visit circumstances hypothesized to require more time -- 1). patient was new to the practice; 2). patient's condition was new; and 3). physician was not the patient's primary physician. Interactions between high risk medication prescribing and visit circumstances were also examined. Control variables included modified Charlson index, diagnostic and counseling services provided, patient and provider demographics. RESULTS: Visits lasted an average of 19 minutes. Significantly higher visit times were found for patients prescribed either anticonvulsants, anticoagulants or antidiabetics. Visit times were additionally higher if 1). the condition was new and the patient was prescribed anticonvulsants or antidiabetics, or 2). the patient was new to the practice and was prescribed anticonvulsants. Patients not seeing their primary physician had lower visit times if they were prescribed anticoagulants or antidiabetics. No visit time increases were associated with antiarrythmics or beta agonists. CONCLUSION: Visit times increased with the prescribing of certain high-risk medications in our study and during certain visit circumstances. However, increases were not uniformly found across all high-risk medications examined. This gap in care suggests that less expensive healthcare providers like pharmacists are needed to enter into collaborative working relationships with physicians to provide counseling, education and monitoring for these medications.