Paperwork prevents doctors from spending time with patients

Just how bad is paperwork for doctors?

In a recent New York Times piece, surgeon Pauline Chen gives us some stark numbers.

Paperwork takes up “as much as a third of a physician’s workday.” That’s a lot, and is coming at the expense of face to face time with patients.

Worse, look how it’s affecting medical residents.

Researchers at the Mayo Clinic found that most residents spent as much as 6 hours per day documenting, with only a fraction of that time spent with patients. Furthermore, administrative time also eats away at their educational activities, such as lectures and didactic sessions.

For those who hope that electronic medical records to be a solution, there’s bad news on that front as well. Dr. Chen notes a worrisome trend as doctors simply use these systems to cut and paste notes:

Residents may rely on notes written by other doctors instead of talking to the patients themselves. These other notes may have also been pieced together from previous notes rather than from actual interactions with the patient. As a list, a paragraph or whole sections get pasted into progressively more documents, important information, like a reaction to a certain treatment, can be lost in the transfer. Clinicians who rely mostly on computer notes for their information are at risk of inadvertently choosing the wrong therapeutic course of action for a patient.

The answer is to outsource some of the paperwork requirements away from doctors, to support staff. For instance, completing discharge paperwork and scheduling follow-up appointments should be arranged by administrative staff. Medications can be reconciled by nurses, under the supervision of doctors. Even notetaking can be streamlined — perhaps by the use of scribes who can more efficiently enter data into the computer.

This takes money, of course, and that’s not something most financially pressured hospitals are willing to spend on. But they should, so doctors can spend more time with their patients, instead of in front of a computer.