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Documentation and the Deterioration of Doctors’ Work-Life Balance
The notorious demands of documentation. If you’re a clinician, you are more than acutely aware of just how much time and energy goes into keeping every patient encounter well-documented. From analyzing medical histories to reviewing test results and handling medication requests to composing treatment plans, there’s simply no room for omission when it comes to documentation.
But, at what price? For most physicians today, the demand of documentation is chipping away at even more of their precious time.
In “The Not So Balanced Work-Life Balance of Physicians,” we looked at how the scales of work and life are largely tipped towards work for most clinicians today. More and more physicians are finding it difficult to take control of that work-life balance, as now, more than ever, documentation demands are making it nearly impossible to ever get ahead.
Want proof? In a study published in Annals of Internal Medicine, 57 U.S. physicians in family medicine, internal medicine, cardiology, and orthopedics were observed for 430 hours. The researchers found physicians spent 27% of their total time on direct clinical face time with patients and 49.2% of their time on Electronic Health Record (EHR) and desk work.
The study also found that while in the examination room with patients, physicians spent 53% of their time on direct clinical face time and 37% on EHR and desk work. The 21 physicians who also completed after-hours diaries reported one to two hours of after-hours work each night, devoted mostly to EHR tasks.
Where Physicians Lose Time
If you ever have the need to explain this increasingly difficult challenge to your patients, or maybe your family, this article by Dr. Monique Tello offers a good account. In it, she details the list of everything that must be captured during and after a routine office visit. It is lengthy, to say the least.
“During your 20 minutes, I have to catch up on anything that’s happened since your last visit, review and update your medications, listen to any current ailments that you’d like addressed, and answer your questions from the list you brought. I need to make sure I’m not missing anything you might be due for, like vaccinations, bone density, or cancer screening tests (Pap smears, mammograms, colonoscopies). We may need to discuss screening for sexually transmitted diseases, and birth control. I may also need to review your specialists’ notes and recommendations. I have to examine you, which can include paying special attention to your areas of complaints, like that rash, or a swollen knee. I need to note any previous abnormal test results, then discuss and order labs. For these and any other tests, I have to fuss with our high-tech electronic system to match an acceptable diagnosis with the order, or your insurance may not pay.
“Before you leave I need to make sure you understand any new prescriptions or treatment plans, and that you’re all set with your medication refills. Often, people also bring forms they need filled out, like those work health status checklists, family medical leave paperwork, or preoperative requirements,” she wrote.
Of course, once the patient visit is over, the clinician and their back-office staff must document everything that was discussed and get key information where it needs to go—including prescriptions to the pharmacy, a visit summary to the insurance company, referrals to a specialist…and of course, document all of these details into the patient chart.
Add all of this documentation up, and it becomes quite clear how a single patient encounter can quickly turn into a lot of work. That’s why, at the end of the day—literally—these never-ending documentation demands leave clinicians with no choice but to stretch their day long into the evening and beyond.
Physicians Angels provides virtual scribe and virtual back-office services to thousands of physicians throughout the United States. Our goal is to give physicians their time back, allow them to better manage their work/life balance, increase the quality of patient care, and in most cases, increase their revenue production. To learn more, contact Physicians Angels.