Physicians are Buried Under an Avalanche of Paperwork
An article in the New York Times, also discussed by Kevin Po on his Kevin MD blog, highlights how doctors are increasingly buried under an avalanche of paperwork. Documenting treatments, dictating doctors’ notes on medical records and other forms of paperwork takes up one-third of a doctor’s workday. Many residents report spending more time on paperwork than on patient care: More than half of residents at the Mayo Clinic in Rochester, Minnesota, reported spending six hours or more daily on paperwork.
This is what happens when you build an entire health care system around third-party payment of medical bills.
Doctors are becoming civil servants, whether they know it or not.
It’s going to get worse.
It is very inefficient to have a third-party adjudicate claims and be at-risk for day-to-day consumer spending on any good or service. It’s unfathomable that the public health advocates, who designed the health care provisions, somehow believe they can improve the system to mandating low cost-sharing. It will just shift the responsibility for deciding which services are worth the money from the patient to an army of clerical staff whose job it is to detect fraud and discourage overutilization.
In blog post you ink to, Dr. Kibbe states that “red tape is the product of the fee-for-service health insurance system.”
Fee-for-service has been erroneously maligned as the cause of our health care ills. The denigration of fee-for-service is symptomatic of the failure to properly understand the free market and the profit motive. Most economic transactions are free-for-service and are functioning just fine.
As you point out in your comment, the paperwork problem is largely due to the 3rd party-payer system which separates the consumer of services from the payer of services. This generates the need to justify charges to the third party–instead of patients determining if the value obtained is worth the price.
The other big driver of documentation is defense against malpractice suits–but records aimed at quality of care should sufficiently address this need.
At some point, you would think doctors would get sick of it and say, “I don’t care if I have to work fast food, but I’m not going to fill out another piece of paper!”
I boggles the mind that so many people just put up with the status quo.
Dr. Haynes is correct. There is nothing wrong with fee-for-service payment. The problem is a third-party payment system that strait jackets the doctors and leaves them unable to repackage and reprice their services.
I once spent 10 minutes trying to explain to a physician that she wouldn’t have to waste time finding out if a mammogram was or was not covered by an insurer as long as her patient paid her in cash.
The scary thing was that I don’t think I managed to make her understand the point. She was so far into the box that she didn’t even know that there was an outside.