EMR Clerical Demands Lead to Physician Burnout

Researchers from the American Medical Association (AMA; Chicago, IL, USA), Dartmouth-Hitchcock Medical Center (Lebanon, NH, USA), and other institutions conducted a study to describe how physician time is spent in ambulatory practice. To do so they undertook an observational time and motion study of 57 U.S. physicians in family medicine, internal medicine, cardiology, and orthopedics who were observed for 430 hours; 21 of the physicians also completed self-reported after-hours diaries.

The researchers measured the proportion of time spent on four different activities--direct clinical face time, electronic health record (HER) work, administrative tasks, and other tasks--as well as self-reported after-hours work. They found that during office hours, physicians spent 27% of their total time on direct clinical face time with patients, and 49.2% of their time on EHR and deskwork activities. Outside of office hours, physicians spent another one to two hours of personal time each night on data entry demands. The study was published September 6, 2016, in Annals of Internal Medicine.

“This study reveals what many physicians are feeling – data entry and administrative tasks are cutting into the doctor-patient time that is central to medicine, and a primary reason many of us became physicians,” said Steven Stack, MD, immediate past president of the AMA. “Unfortunately, these demands are not being reconciled with patient priorities and clinical workflow. Clerical tasks and poorly-designed EHRs have physicians suffering from a growing sense that they are neglecting their patients as they try to keep up with an overload of type-and-click tasks.”

The study quantifies a previous AMA study conducted with the RAND Corporation (Pittsburgh, PA, USA), which confirmed that poorly designed EHRs and administrative obstacles that impede high-quality patient care are leading contributors to physician burnout. Another AMA collaborative study with the Mayo Clinic found that 54.4% of physicians reporting at least one symptom of burnout in 2014, up from 45.5% in 2011. In comparison, prevalence of burnout among the general working population was about 28.5%.

Related Links:
American Medical Association
Dartmouth-Hitchcock Medical Center
RAND Corporation