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Getting employed physician to complete paperwork (posted 7/1/08)
 
Q: We are a very busy surgical office. Our employed physician is very disorganized when it comes to paperwork. For example, he doesn’t dictate his op reports, which means he is constantly on the delinquent list at the hospital, which means surgeries can not be scheduled. We allow him appropriate time to complete paperwork after clinical hours, but he heads home instead of finishing up. Any ideas what we can do to help him get things in order?
 
A: A few suggestions:

1. Ask the physician what is getting in the way and what he’d suggest as a solution (e.g., being able to dictate at home, documenting immediately after surgeries, etc.). If he’s not part of the solution, he’s not likely to adopt it anyway.

2. The partnered physicians need to be the one to hold his toes to the fire. Once he’s accepted a solution and benchmarks for performance, the performance should be measured and shown to him monthly.

3. Schedule time during the day (say 15 minutes after every three appointments) during which he can do his notation instead of at the end of the day. Then it makes less sense to spend time doing it at home.

4. Introduce economic/job security threats. Better to lead the horse to water and have him take a good long guzzle, but if you can’t make him do that, make prompt documentation a condition of employment. I’ve seen practices dock physician pay as well, but it doesn’t always work and indicates that you see a problem in documentation that you are not able to fix — a problem should you be audited down the line.
 
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