Taking a Hard Look at Administrative Tasks
Written by Editor   
Tuesday, December 05, 2017 08:38 AM

In April, the American College of Physicians (ACP) released a position paper titled Putting Patients First by Reducing Administrative Tasks in Health Care, published in the Annals of Internal Medicine.

The paper, part of ACP’s Patients Before Paperwork initiative, is a thoughtful look at the many administrative tasks that physicians and doctors face every day. It presents a framework for evaluating these tasks and calls on health plans, regulators, vendors, and others to consider this framework when they impose new requirements on doctors.

It calls for stakeholders to work with doctors to assess the burden of each administrative task, consider less-burdensome alternatives (or eliminate tasks altogether), and for tasks that are implemented, explore ways of minimizing the negative impact on doctors and patients.

Administrative burdens are a major source of unhappiness. It is difficult for doctors to find meaning in the work they do when so much of that work lacks meaning. Other contributors to unhappiness include the user unfriendliness of electronic health records, time pressures, decreasing autonomy, increasing demands of a sicker and more internet-savvy patient population, and payment inequities.

Another major source of unnecessary work burden cited is the near ubiquitous need for a physician’s signature. Over the decades the medical profession has fought hard to ensure that the medical physician was THE regulator of the dispensation of all things medical.  This article asks “does every hearing aid battery, cane, pair of diabetic shoes, mastectomy bra, ear wash, influenza vaccination, or lipid profile order need to pass through the physician’s inbox for a signature?”  How many times are we asked to sign documents that have little to do with medical care, but more to do with playing “anti-fraud police" or the shifting of liability to the physician?

At the heart of these forms is our conscription into the army of watchdogs who are supposed to root out fraud and abuse. But the regulations that led to this wasteful paperwork originating as well-intentioned efforts to protect patients, have devolved into a blizzard of forms that consume significant staff time without a meaningful impact on patient care.