Bioethics Blogs

Doctor as Data Entry Drone

by Craig Klugman, Ph.D.

Most people choose to go into the health professions to help others, to make a secure living, and to challenge themselves on a daily basis. Few people would rank “doing paperwork” as a reason to choose a career in health. However, according to a new study in the Annals of Internal Medicine, paperwork in the form of electronic health records (EHR) might be the activity on which doctors spend the most time. According to Sinsky et. al, who conducted direct observations, motion studies, and self reports of 57 physicians in 4 specialties in 4 states, doctors spent over 49% of their time on record keeping and 27% on direct patient care.

Two decades ago, physicians only spent one-fifth of their time on record keeping. A 1998 study of emergency departments found 21% of time was spent on records and 32% on patient care. As recently as 2014, another study found that administrative work occupied only one-sixth of physician time. This same study also found that the more time spent on administration, the less happy physicians were in their work. Perhaps this is one reason for the dramatic decline in physician satisfaction of their work life. The trend is clear: Doctors are spending less time with patients and more time with computer records.

The main move to electronic health records came about as part of the Affordable Care Act. A provision in the ACA aimed to “reducing paperwork and administrative costs” began in October 2012: “Using electronic health records will reduce paperwork and administrative burdens, cut costs, reduce medical errors and most importantly, improve the quality of care.” As Sinsky et al’s study demonstrates, the actual effect has been an increase in paperwork and administrative burdens.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.