Allocation of Physician Time in Ambulatory Practice

Sinsky, C., Colligan, L., Li, L., Prgomet, M., Reynolds, S., Goeders, L., Westbrook, J., et al. (2016). Allocation of Physician Time in Ambulatory Practice: A Time and Motion Study in 4 Specialties. Annals of Internal Medicine, 165(11), 753-760.

Type

Journal article

Intellectual base

Primary research

Year

2016

DOI

10.7326/m16-0961

Link

https://doi.org/10.7326/M16-0961

Cited from

engineering_design, organizational_management

Cited by

2 citations across 2 artifacts.

Each citation links to the sentence it supports in the citing article.

Primes

• Accidental Vs Essential Complexity
  • The no-silver-bullet forecast transfers to physician-burnout discourse, predicting real gains on the accidental side, such as record-workflow load, and bounded gains on the essential side, the irreducible difficulty of reasoning about a multi-system patient — and the forecast and the recurring disappointment match.

    This sourceDocuments the large share of physician time consumed by electronic-health-record and clerical work (49.2% on EHR/desk work vs 27.0% direct clinical face time) — the accidental workflow load attackable by record-system redesign, distinct from the essential difficulty of clinical reasoning.

• Coordination-Overhead Inversion
  • Clinical record-keeping: electronic health records once supported care; their compliance apparatus (billing-code attestation, documentation-quality reviews, optimisation committees) now consumes clinician hours exceeding patient-contact hours in many specialties.

Verification

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