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How Physicians Spend Their Work Time: An Ecological Momentary Assessment

In a new Journal of General Internal Medicine study, researchers explore how physicians spend their work time through an ecological momentary assessment (EMA). In recent years, concerns about the amount of time physicians spend on electronic health records (EHRs) has heightened interest in how physicians spend their time overall. Yet, there is relatively little information about this important subject. Thanks to the support of The Physicians Foundation, Fabrizio Toscano, MD; Eloise O’Donnell, MPH; Joan E. Broderick, Ph.D.; Marcella May, MA; Pippa Tucker, MA; Mark A. Unruh, Ph.D.; Gabriele Messina, MD, Ph.D.; and Lawrence P. Casalino, MD, Ph.D., focused their research on four specialties (general internal medicine, family medicine, non-interventional cardiology, orthopedics), and developed a smartphone app which asked physicians from 28 practices across 16 states about how they spend their time at work.

They found that physicians spent 66.5% of their time on direct patient care, a third of which includes multitasking with the EHR. Most of the remaining time was taken by EHR input alone, bringing the total time spent on the EHR close to 45%. The efficiency of doctors spending only two-thirds of their time on direct patient care may be questioned and suggests that a back-to-the drawing board approach to time-use by these highly trained professionals might be useful. Moreover, EHR-use continues to account for a large proportion of physician time, while being widely described as an irritant for physicians and a major cause of physician burnout. Researchers also recommend reducing EHR time or ameliorating the user experience as a primary goal.

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