The harried life of a resident and intern. Scurrying from patient to patient, learning how to practice medicine, by actually practicing medicine.
Ahem. Well no, they’re mostly tapping away at computer screens, spending as little as 8 minutes per hour on direct patient care. How much can they learn through record retrieval and data entry?
Two small studies point to how little time residents and interns spend with patients and begs the question, when their training is over are they ready to be doctors?
Researchers shadowed internal medicine interns at Johns Hopkins University and the University of Maryland to see how they spend their time in a hospital setting. They tracked time with patients, families, interactions with hospital staff, sleeping, eating and even walking around the hospital. Their conclusions, interns spend:
- 12% of their time in direct patient care,
- 64% in indirect patient care,
- 15% in educational activities and
- 9% in miscellaneous activities.
Researchers compared their numbers with those taken prior to 2003 and found interns spend less time with patients (also less time sleeping) and more time talking with other providers and documenting. They also noted the “increased complexity of medical inpatients, the growing volume of patient data, and increased supervision” all contribute to less time with patients.
A second, similar study was conducted at Penn State Hershey Medical Center. The researchers there showed residents and interns spend about 17 percent of their day in direct patient care and between 30 percent and 38 percent of their time on computers.
They also noted a “graying” of roles at the hospital where residents and interns doing similar tasks possibly eroding their educational opportunities.
Physicians and EMRs
For hospitalists with a handy supply of residents or interns, the idea of passing along EMR work is enticing. Data entry irritates nearly all doctors at every level. In the words on one physician in the Sermo community,
“I’m leaving at the age of 65. The final blow to me was the EMR. I was hopeful that it would live up to the hype but after a good college try of three years it is obvious that it isn’t even close. Too slow, too much worthless data, a lot more mistakes than paper, no connectivity between systems, more difficult to find data. I’m more of a data entry clerk than a doctor.”
There is even a new niche in the medical community, medical scribes tasked with trailing physicians and performing data entry for patient cases. Scribes enter data and request tests electronically. Doctors review and sign off on charts once the data enters the system. A recent Sermo Physician Poll showed that 12 percent of physicians use them, and 34 percent want to try them.
Is Patient Time a Concern At All Levels?
As much as young doctors complain of lack of time with patients, so do established physicians. Is this an issue for all patient-focused staff? How much have computers taken away from face-to-face time? Or is it other factors such as disease complexities and an array of treatment options not available in years past? As a physician, do you want to spend more time with patients?
We will be discussing this and more inside the physician exclusive community, Sermo. If you’re an M.D. or D.O. please join the conversation.