Ever wonder why it can take so long to see your doctor? According to a recent study published in the Annals of Internal Medicine, it could be because he or she is overwhelmed with paperwork.

The study surveyed 57 doctors and found that for every hour they spend seeing patients, they spend an average of two on recordkeeping – either electronic or on paper. On a typical day, they spend only about a quarter of their time (27%) in direct contact with patients and almost half (49.2%) documenting what they did.

When the doctors are with patients, they spend more than a third of the time (37%) on a computer or doing paperwork. Only about half (52.9%) of a patient visit involves direct face-to-face contact.

A large part of the burden on physician time seems to come from the use of electronic health records. Their implementation was strongly encouraged with financial incentives by the Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted in 2009. The idea behind the law was to streamline recordkeeping by replacing handwritten records with computer entries. However, the effect on physician workload may have been the opposite of what was intended.

The study has several limitations. It surveyed only a small number of physicians, who were located in only four states and practiced in only four specialties. They may not be representative of the larger profession.

The study also gave no indication of the amount of time the physicians had devoted to recordkeeping before the advent of electronic records. Many tasks that are now done on a computer, such as ordering medications, reviewing test results, and documenting patient visits, have long been part of a typical physician's workday in other forms.

Electronic records have several clear benefits. They can eliminate errors caused by sloppy handwriting, facilitate coordination of care among providers, and enable researchers to study data on large numbers of patients. However, at least for this group of doctors, they are not making day-to-day medical practice more efficient.

Future research on medical technology should focus on the human element. How can we exploit the potential of electronic health records while avoiding excessive intrusions on physicians' workloads?

In the meantime, bear with your doctor. Medical practice seems to get more complex every day.


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