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UCLA reports method to improve doctors’ productivity

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Physicians often grouse about the amount of time spent on administrative duties, including data entry, which reduces their time available for patient care. Un addition, the recent implementation of electronic medical records has increased that burden. A new UCLA study has proposed a way to resolve that problem by using a “physician partner.” The findings were published online on May 12 in the journal JAMA Internal Medicine.

The study suggests a simple method for easing the doctors’ burden: a “physician partner” whose job would be focused on administrative tasks, such as entering information into patient records, which consume much of the doctors’ time. The study authors note that a physician partner allows doctors to focus more of their attention on their patients; thus, resulting in increased patient satisfaction.

“Patients want their doctors to spend time with them and give them the attention that makes them feel more confident in their medical care; they don’t want to just sit there while their doctor is on the computer,” explained primary investigator Dr. David Reuben, chief of the division of geriatrics at the David Geffen School of Medicine at UCLA. He added, “This also saves physicians a huge amount of time after patient sessions end, enabling them to spend more time with their families, keep up with the latest developments in medicine and come back refreshed the next day.”

The study involved five physicians, three geriatricians and two general internists. From November 2012 through June 2013, each physician utilized physician partners over a total of 326 four-hour clinic sessions. The partners worked alongside the physicians during patient visits and participated in team discussions, transcribed physician comments into patients’ records, pulled patient information from computer records, completed lab and referral requests, processed new prescriptions or medication refills, updated patient medication lists, scheduled follow-up appointments, and provided patients with their visit summaries.

The investigators found that the physician partners were particularly beneficial for geriatricians, whose visits with patients averaged 2.8 minutes less with the partners than without them. Compared to doctors who did not have a partner, the geriatricians also saved an average of 28.8 minutes over the four-hour sessions with the physician partners. In contrast, sessions for the doctors lacking a physician partner ran longer by an average of 8.1 minutes.

The length of patient visits for the general internists who had a partner was not significantly shorter. However, these doctors did spend less time between patients on visit preparation and note-writing; this allowed them to catch up on other work, such as returning calls and addressing clinical issues involving patients who were not in the office. Thus, they saved almost 40 minutes during the four-hour sessions and had essentially no paperwork remaining at the end of the sessions.

The majority of the patients had a positive response to the physician partners; 79% noted that the partners contributed toward making their visit run smoothly; only 18 percent were uncomfortable with the partners’ presence. Furthermore, 88% of the patients whose doctors had a physician partner in the room strongly agreed that their physician spent enough time with them; in contrast 75% whose physicians did not have a partner were of that opinion.

The authors noted that their study had some limitations. It comprised only five physicians in two practices at one academic health center; thus, there were too few doctors to statistically analyze satisfaction and burnout scales. In addition, the geriatric patients were more likely to feel comfortable with the physician partners in the room than the general medicine patients, perhaps because older patients are more accustomed to having someone else, such as a caregiver or family member, in the room during their doctor visits. In addition, the investigators did not evaluate the quality of care the patients received.

Despite the aforementioned limitations, the authors wrote: “The Physician Partners program provides a potential model to improve physician efficiency in the office setting without compromising patient satisfaction. Implementation and dissemination will depend upon local factors including staff availability and training, adaptation to the patient population and practice characteristics, cost and reimbursement structures, and willingness to invest in change.”