Sinsky: Advanced team-based models of care, where a clerical or clinical assistant helps with record keeping, has been one of the solutions to allowing the physicians to maximize their skills for the benefit of the patients. But there is simply a lot more data entry work than in the past.
We need to reconsider the notion that physicians are the appropriate team member to do data entry. That is not giving society the best return on investment in training of physicians.
One doesn't need 11 years of training to do any of the data entry and retrieval tasks that are so time consuming with EHRs. Very few other industries take their most highly trained individuals and have them spend the majority of their day that another employee or team member could do. It's time for us to reconsider that role in medicine.
HLM: What other solutions do you recommend?
Sinsky: We need EHRs that are designed to delight the users and right now that is not one of the criteria. We need to count up the number of clicks to do the task and compare that across different products. For example, with my EHR it takes 32 clicks to document giving a flu shot. I would love to see vendors compete on the ability to reduce the number of clicks to do a task.
HLM: What are the physicians in your study saying in their diary entries?
Sinsky: The main takeaway, and this is a good thing, is that physicians are driven to deliver quality care for their patients and anything that gets in the way of that is a source of burnout.
The physicians feel responsible for absorbing those external threats to delivering quality care and protecting the patients. But it's come to the point where physicians can no longer keep absorbing more clerical tasks and still do the work for which we have been trained.
HLM: What should be done with your findings?
Sinsky: First of all, it is helpful to see what is going on, the anatomy of the physician's day, to understand the magnitude of the time that is spent on administrative and clerical tasks.
Then we need to have greater adoption of some of the innovations that have been initiated across the country to bring the physician back to full attention for the patient.
I would love it if organizations read this study and then began doing their own pilot innovations with advanced team-based models of care. Regulators can look at the study and start to reflect on the cumulative effects of the many well-intended regulations that are having the unintended opposite effect on the quality of care that patients receive.
John Commins is a senior editor at HealthLeaders.