Physicians and the Tough Task of Delegating to Others

In a physician’s busy day, it is necessary to delegate certain tasks so that all the work gets done, and so the physician can still go home before the dog forgets who he is. But which tasks are appropriate for delegation? And to whom?

I’ll be the first to admit - I’m terrible at it. It’s hard for me to assign tasks to others. Sometimes, it’s because I feel it is easier to do it myself than to explain what needs to be done and how I want it done.

For example, getting prior authorizations. I know many offices let clerical staff do it, but when the reviewer asks clinical questions, how is a secretary supposed to know the answers? OK, some things are easy, and I don’t know why they have to be asked. I mean, after I’ve told you the patient is John Smith and his birthday is October 18, 1945, do you really have to ask if he is male and over the age of 18? But they will also ask about prior therapy, and previous adverse reactions. And sure, I could arm my staff with that info beforehand, but once I’ve gathered that info for them, I might as well have gotten the prior auth myself. I suppose I could just have them hunt me down a human to talk to, as the time-consuming part of getting a prior auth is not answering clinical questions, it is the hold time of five minutes and the four times you have to give your name, address, and phone number, and the patient’s ID, name, and date of birth.

Another thing often delegated is prescription refills. Yes, many offices have staff members do that. But with medical errors occurring so frequently, I am concerned that having non-prescribers approve refills increases that risk. There are many times that I get requests for refills for medications I have stopped, or whose dose I have changed. I also get request for refills of medications I did not prescribe. I myself have made errors, and at least I can take the rap for that, but if prescriptions are being refilled without my supervision, I’m still responsible. Yes, my staff could get the OK from me and then contact the pharmacy, but since filling a scrip with an EHR takes a couple of clicks of a mouse, once I’ve decided a refill is appropriate, actually sending the scrip to the pharmacy is the easy part.

Reporting lab results to patients is another task often given to nonphysicians. I will often delegate that if the labs are normal. And if I know the patient won’t be upset that they are normal. If I think the patient is going to need the labs explained to them, I take that task on myself.

So, there you go, I admit, I am not good at this delegation thing. It’s finally time to head home. Hope the dog recognizes me.