4 ms·

I'm not sure that's relevant to the article - it sounds like a general lament about the US healthcare system that could have been attached to any article on US

by scott_s 11y ago

I'm not sure that's relevant to the article - it sounds like a general lament about the US healthcare system that could have been attached to any article on US healthcare. Have we established that doctors in the US have to deal with more documentation than doctors in other industrialized healthcare systems? I think establishing that is required to turn this discussion into one about the problems of the US healthcare system versus others. Regarding the content, this doctor provides compelling arguments that the documentation doctors have to require takes a large toll on the doctors themselves and their patients, but I'm curious if we can look at data to corroborate that. For example, maybe the copious note taking improves patient care because more information is available to more people, and is not trapped in the head of one doctor. Note I am not saying that is necessarily true, but we've been presented with arguments and anecdotes - very compelling ones, which I am inclined to agree with. But it is probably not wise to change healthcare policy without looking at what data we can.

Retric 11y ago
> Have we established that doctors in the US have to deal with more documentation than doctors in other industrialized healthcare systems? Yes. The authors cite data showing that physicians in Canada spend far less time on administration than do U.S. doctors, http://www.eurekalert.org/pub_releases/2014-10/pfan-pco102314.php http://www.eurekalert.org/pub_releases/2014-10/pfan-pco10231... Administrative work consumes one-sixth of U.S. physicians' working hours Note, this is non patient related Administrative work. Now what? IMO, the simplest solution is for doctors to bill based on administrative requirements.
- scott_s 11y ago
  Yes, very interesting. But it is non-patient administrative work, so I'm not sure if it applies to the submitted article. That does, however, support the argument that in general, the US system requires more administrative work, yet (I believe), the US and Canadian systems achieve about the same health outcomes. And I also believe the Canadian system is cheaper. It's then reasonable to conclude that the many layers of the US healthcare system are the cause. It would be reasonable for patient-related notes to be correlated with other administrative work, but it's not necessarily so.
  - Retric 11y ago
    The article points out that most of these notes are not related to patent care. A seasoned supervisor told me that, when he was a resident working in the psychiatric emergency room, he used to see more than three times as many patients as we residents see now. “How?” I asked him, with an incredulous lilt in my voice that could barely be masked. “Our notes could be shorter back then,” was his reply. (Insurance, regulations and electronic health records weren’t issues back then.)
    - scott_s 11y ago
      Correct, and I understood that, so I was not clear. My question was on whether or not patient notes are also associated with more-bureaucracy-for-the-same-health-outcome. At higher cost. Maybe more patient notes actually lead to better health outcomes, even though they're an annoyance for doctors and cause them to see less patients.
      - Retric 11y ago
        Got it, it's a good point and worth looking at. Doctors taking lot's of notes while in with a patent could also lead to worse outcomes as they are distracted. However, ~50% increase in healthcare costs would need to have a huge impact on patent outcomes or drastic fraud reduction to be worth it.

by scott_s 11y ago

Retric 11y ago

> Have we established that doctors in the US have to deal with more documentation than doctors in other industrialized healthcare systems? Yes. The authors cite data showing that physicians in Canada spend far less time on administration than do U.S. doctors, http://www.eurekalert.org/pub_releases/2014-10/pfan-pco102314.php http://www.eurekalert.org/pub_releases/2014-10/pfan-pco10231... Administrative work consumes one-sixth of U.S. physicians' working hours Note, this is non patient related Administrative work. Now what? IMO, the simplest solution is for doctors to bill based on administrative requirements.

scott_s 11y ago
Yes, very interesting. But it is non-patient administrative work, so I'm not sure if it applies to the submitted article. That does, however, support the argument that in general, the US system requires more administrative work, yet (I believe), the US and Canadian systems achieve about the same health outcomes. And I also believe the Canadian system is cheaper. It's then reasonable to conclude that the many layers of the US healthcare system are the cause. It would be reasonable for patient-related notes to be correlated with other administrative work, but it's not necessarily so.
- Retric 11y ago
  The article points out that most of these notes are not related to patent care. A seasoned supervisor told me that, when he was a resident working in the psychiatric emergency room, he used to see more than three times as many patients as we residents see now. “How?” I asked him, with an incredulous lilt in my voice that could barely be masked. “Our notes could be shorter back then,” was his reply. (Insurance, regulations and electronic health records weren’t issues back then.)
  - scott_s 11y ago
    Correct, and I understood that, so I was not clear. My question was on whether or not patient notes are also associated with more-bureaucracy-for-the-same-health-outcome. At higher cost. Maybe more patient notes actually lead to better health outcomes, even though they're an annoyance for doctors and cause them to see less patients.
    - Retric 11y ago
      Got it, it's a good point and worth looking at. Doctors taking lot's of notes while in with a patent could also lead to worse outcomes as they are distracted. However, ~50% increase in healthcare costs would need to have a huge impact on patent outcomes or drastic fraud reduction to be worth it.