Tags: obamacare | paperwork | doctors | medical | aca

Obamacare Regs Have Doctors Drowning in Paperwork: Harvard

By    |   Thursday, 23 October 2014 05:36 PM

An increasing burden of paperwork, tied in part to healthcare reforms driven by Obamacare, now consumes about one-sixth of a typical America physician’s day — impinging on the time doctors can spend caring for patients.
That’s the upshot of a new study led by Harvard Medical School researchers who found the average doctor spends 16.6 percent of his or her working hours on non-patient-related paperwork.
The findings, which are based on a nationally representative survey of physicians, tied the trend to changes in U.S. health policy — including a shift to employment in large practices, the implementation of electronic medical records as part of the Patient Protection and Affordable Care Act, and the increasing prevalence of financial risk sharing.
In a report on the study, published in the International Journal of Health Services, the researcher said the trend is likely to continue, increases doctors' paperwork burdens, cutting into time spent with patients, and decreasing career satisfaction among those in the medical profession.
Lead researchers Steffie Woolhandler, M.D., and David Himmelstein, M.D., are internists in the South Bronx who serve as professors of public health at the City University of New York and lecturers in medicine at Harvard Medical School.
Their conclusions are based on an analysis of confidential data from the 2008 Health Tracking Physician Survey, which collected information from a nationally representative sample of 4,720 physicians who practiced at least 20 hours per week.
"American doctors are drowning in paperwork," said lead author Dr. Woolhandler. "Our study almost certainly understates physicians' current administrative burden. Since 2008, when the survey we analyzed was collected, tens of thousands of doctors have moved from small private practices with minimal bureaucracy into giant group practices where bureaucracy is rampant.

And under the accountable care organizations favored by insurers, more doctors are facing HMO-type incentives to deny care to their patients, a move that our data shows drives up administrative work."
Dr. Himmelstein added: "Our crazy health financing system is demoralizing doctors and wasting vast resources. Turning health care into a business means we spend more and more time on billing, insurance paperwork and the bottom line. We need to move to a simple, nonprofit national health insurance system that lets doctors and hospitals focus on patients, not finances."

Among the researchers’ key findings:
  • The average doctor spent 8.7 hours per week, or 16.6 percent of their working time, on administration. This excludes patient-related tasks such as writing chart notes, communicating with other doctors, and ordering lab tests. It includes tasks such as billing, obtaining insurance approvals, financial and personnel management, and negotiating contracts.
  • In total, patient-care physicians spent 168.4 million hours on such administrative tasks in 2008. The authors estimate that the total cost of physician time spent on administration in 2014 will amount to $102 billion.
  • Physicians who used electronic health records spent more time (17.2 percent for those using entirely electronic records, 18 percent for those using a mix of paper and electronic) on administration than those who used only paper records (15.5 percent).
"Although proponents of electronic medical records have long promised a reduction in doctors' paperwork," they write, "we found the reverse is true."

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Paperwork now consumes about one-sixth of a typical America physician's day - impinging on the time doctors can spend caring for patients.
obamacare, paperwork, doctors, medical, aca
Thursday, 23 October 2014 05:36 PM
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