All your unpaid tasks

April 30, 2010

The frustration felt by countless primary-care physicians has been quantified in a new study that shows just how much urgent, but uncompensated care doctors perform. Each day, a primary-care doc performs more than three dozen of these tasks - answering phone and e-mail messages, reading lab results, and refilling prescriptions - for which they are not paid.

The frustration felt by countless primary-care physicians has been quantified in a new study that shows just how much urgent, but uncompensated care doctors perform. Each day, a primary-care doc performs more than three dozen of these tasks - answering phone and e-mail messages, reading lab results, and refilling prescriptions - for which they are not paid, according to the Washington Post.

It is little wonder, then, why primary-care is increasingly unpopular. The study in the New England Journal of Medicine offers a snapshot of one practice: a five-physician practice in Philadelphia which used its EHR to analyze the daily work of each practitioner.

The physicians saw an average of 18 patients per day and the week was 50 to 60 hours. Each physician got 24 phone calls a day, about three-quarters of which were fielded by the doctor, Washington Post reports. A third of the calls concerned an acute medical problem and resulted in a prescription. The doctors also received about 17 e-mails a day, about half of which sought explanations of test results.

Plus, each doc processed a dozen Rx refills each day, in addition to refills that were part of a patient’s visit. They also reviewed 20 lab reports and 11 diagnostic imaging reports. And they responded to 14 reports from consultants.

Sound familiar?

Richard Baron, MD, writes about the study in NEJM: “At a time when the primary care system is collapsing and U.S.medical-school graduates are avoiding the field, it is urgentthat we understand the actual work of primary care and findways to support it. Our snapshot reveals both the magnitudeof the challenge and the need for radical change in practice design and payment structure."