Study finds solution to a major source of physician burnout

Who hasn’t sat in a medical office, listening to the click of computer keys as the healthcare provider quickly typed notes, wondering what they spend so much time writing about? For physicians, who have always written clinical care notes but must spend more and more time cataloging billing data, this additional documentation is a major source of job dissatisfaction and burnout.

A new study from the University of Maryland School of Public Health highlights a solution that can significantly reduce the amount of time doctors spend writing notes, without losing essential information.

“Providers are already under a lot of pressure and pressure to see more patients while documenting large amounts of information. That’s why we looked at how using medical scribes and other forms of teamwork for documentation can reduce that burden ” said Nate Apathy, assistant professor of Health Policy and Management. Apathy’s current research focuses on sources of technology-based burdens in healthcare and strategies to reduce them.

Apathy’s Study,”EHR time and physician visit volume after adopting team-based documentation support”, was published in JAMA Internal Medicine with collaborators from the University of California, San Francisco and the University of Minnesota.

The results show that collaborating on clinical documentation with other team members can allow physicians and other healthcare providers to spend more time on patient care. In this study, “team-based documentation” refers to scribes or other clinicians contributing to clinical notes, whether in-room or virtually connected, but does not include AI scribes.

The longitudinal study looked at the documentation practices and weekly visit volumes of more than 18,000 outpatient physicians—primarily primary care physicians and some medical and surgical specialists—in more than 300 health care organizations in the United States over a nine-month period. Of this total, 1,024 physicians adopted some form of teamwork for writing clinical notes.

“We found that the most important thing is not just teamwork on documentation, but also how much the non-physician staff do,” Apathy said.

Of those providers who used scribes and other forms of documentation collaboration, all were able to increase the number of weekly patient visits. But only those whose teams wrote at least 40% of the content of their notes actually reduced the time the clinician spent writing notes.

On average, visit volume increased by 6% and documentation time decreased by 9.1%. After a 20-week learning period, visit volume increased by 10.8% and documentation time decreased by 16.2%. For high-intensity users (those who let others write more than 40% of their notes), weekly documentation time dropped by more than an hour (a 28.1% decrease), a relatively large time savings.

“Our research shows that when physicians use teamwork to complete their notes, whether that’s with a medical scribe in the room, a virtual note-taking service, or simply writing notes with other clinical team members in their office, they can see more. patients and, crucially, spend significantly less time with their nose in a computer,” says Apathy.

Before each visit, providers must complete clinical notes that include everything from a patient’s vital signs to test results and insurance billing information. While some of these notes are essential in tracking a patient’s health, spending time on administrative documentation to ensure insurance companies pay the bills is a particularly burdensome burden and can impact the quality of care.

Doctors generally report that they often have to catch up on their notes outside of office hours or between appointments, adding even more stress and hours to an already overloaded profession. The writer can be a lifeline, especially if used enough.

This study is the first to examine the real-world impact of medical writers on such a scale. Apathy says innovations such as virtual scribes are popular among primary care physicians because they are relatively cheap and easy to implement and scale, and the cost of a scribe can be offset by the increased revenue from more patient visits.

Even outside of the COVID pandemic, healthcare workers are reporting high levels of stress and burnout, higher than most other sectors.

“So it’s a triple win: for managing the business side of a clinic, for a healthcare system with huge patient demand and a severe shortage of providers, and for easing the administrative workload of already overburdened physicians,” said Apathy.