Academy of Chiropractic’s
MD Relationship Program
#1 Program and Office Infrastructure
From: William J Owens Jr DC DAAMLP
Building an efficient infrastructure is a critical part of having a successful and profitable practice. Once of the biggest TIME SUCKS is completing patient notes. Most if not ALL EMRs are not designed for complex cases or significant volume [150+ per week]. This issue is hitting ALL healthcare professionals regardless of their specialty. A recent trade article by Greg Slabodkin titled“PCPs spend more than half of workdays interacting with EHRs”was an analysis of the time Primary Care Physicians at a large academic healthcare facility spent each day on clerical and administrative tasks. The information was compiled by researchers at the University of Wisconsin.
The author stated,“Clinicians spent 355 minutes (5.9 hours) of an 11.4-hour workday in the EHR per weekday per 1.0 clinical full-time equivalent: 269 minutes (4.5 hours) during clinic hours and 86 minutes (1.4 hours) after clinic hours,” states the study. “Clerical and administrative tasks including documentation, order entry, billing and coding, and system security accounted for nearly one-half of the total EHR time (157 minutes, 44.2 percent). Inbox management accounted for another 85 minutes (23.7 percent).” This is WHY see the doctor patient relationship starting to erode, most doctors have their eyes on the EMR and NOT on the patient. This is why, in our office, we use a paper check sheet for initial and re-evaluation examinations. That allows us to spend time with the patient face to face, compile all the clinical data which in turn allows transcription once the patient encounter is completed. This is automated in Software Motif, however you can create this system in YOUR EMR. Software Motif’s daily progress notes are very simple to do and I do those as the patient encounter is ending along with any orders or referrals.
“Two-thirds of the time on the computer was allocated to clerical and inbox work,” finds the study. In particular, researchers note that“much of a family medicine physician’s workday (84 minutes) is spent on documentation, so it is imperative to find ways to reduce documentation burden.” This is a BIG issue and one that AGAIN demonstrates why PCP do not want to handle Personal Injury Patients or spine cases. The level of documentation is significant and DIFFERENT than internal medicine issues. THEY HAVE NOT TIME! That is why they love to refer once they trust you clinically. You can start to see why TYPE of TREATMENT is not really that important to them. It is about CASE MANAGEMENT and receiving the stresses of a busy Primary Care medical practice.
The author finally states, “Unfortunately, clerical and administrative demands are not being reconciled with patient priorities and clinical workflow,” Barbe added. “Poorly designed and implemented EHRs have physicians suffering from a growing sense that they are neglecting their patients and working more outside of clinic hours as they try to keep up with an overload of type-and-click tasks.” That is why we have worked so hard to re-create Software Motif. Using both PAPER and EMR along with transcription is the way to get around all this stress and lack of patient interaction. Once you hit a certain volume, you MUST TAKE ACTION to address these issues. If you are behind in your notes or spending time after hours completing charts, CALL ME, I can help you.