Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Most of the documentation physicians perform don’t help patients

Michael Kirsch, MD
Physician
November 3, 2017
Share
Tweet
Share

Let me post a question that neither I nor readers can answer: How much of what I do during the course of a day directly benefits patients?

Perhaps, I don’t want to really know as I would be dismayed at how much of my effort benefits no one. Ask a nurse who works on a hospital ward, how much of his or her effort is directly applied to patient care. I would recommend that you have a double dose of antacid in hand: one dose for you and the other for the nurse.

Just today, I was gently reproved by a hospital physician administrator for a lapse in one of my recent progress notes, which I write after seeing every hospital patient I consult on. Which of the following transgressions do you think I was cited for? Only one answer is correct.

  • I did not perform an adequate physical examination.
  • I failed to address the results of an abnormal CT scan.
  • I neglected to write the time of day along with the date of the note.
  • I did not discuss the case with the patient’s family.

Just last week at our medical staff meeting, all physicians were told of the requirement to record the exact time, as well as the date, of our hospital visits. This requirement, which is not new, is not to improve patient care. It is a requirement imposed by the Joint Commission, which certifies that a hospital is complying with all rules and regulations. I would like my readers to know that in over a quarter of a century of hospital practice, the visit times were recorded in 1 to 2 percent of all hospital notes. No physician has felt that the lack of recorded visit times negatively affected patient care. Writing down the date may seem to readers to be just a minor irritant which takes only a few seconds. It is, however, a symptom of documentation requirements that have run amok.

When the Joint Commission visits a hospital, the entire medical and administrative staff are on edge. Why? Because there are hundreds of requirements of dubious value that will be assesses. I support the Commission’s mission and recognize that many of the requirements are completely valid. We want clean operating rooms, safe parking lots and a culture of respecting patients’ privacy. But, trust me, many of the mandates from them can be trivial or absurd.

As an example, in our ambulatory surgery center where we do colonoscopies, we are required by the government to declare before every procedure if the patient is facing a fire risk. Please do not ask me to explain this, as I am incapable. Apparently, because we administer oxygen and use cautery, there is a flammability risk.

I want to reassure my current and future patients that to date our endoscopy center has been a flame free zone. Moreover, the only instance where a firefighter was in our office was when he was getting a colonoscopy performed.

The public would be shocked and outraged to learn how much of our time is spent racing on the hamster wheel, a difficult and timewasting exercise that yields no progress.

Michael Kirsch is a gastroenterologist who blogs at MD Whistleblower.

Image credit: Shutterstock.com

Prev

Our laws don't do enough to protect our health data

November 3, 2017 Kevin 0
…
Next

Is assembly line surgery better for the patient?

November 3, 2017 Kevin 17
…

Tagged as: Gastroenterology, Practice Management

Post navigation

< Previous Post
Our laws don't do enough to protect our health data
Next Post >
Is assembly line surgery better for the patient?

ADVERTISEMENT

More by Michael Kirsch, MD

  • Are Ozempic patients on a slow-moving runaway train?

    Michael Kirsch, MD
  • AI-driven diagnostics and beyond

    Michael Kirsch, MD
  • The surprising truth behind virtual visits

    Michael Kirsch, MD

Related Posts

  • Are patients using social media to attack physicians?

    David R. Stukus, MD
  • The complex expectations of patients toward their physicians

    Michael L. Millenson
  • Physicians and patients must work together to improve health care

    Michele Luckenbaugh
  • The risk physicians take when going on social media

    Anonymous
  • Violence in the emergency department puts patients and physicians at risk

    Vidor E. Friedman, MD
  • Let’s order a round of respect: for both patients and physicians

    R. Lynn Barnett

More in Physician

  • How subjective likability practices undermine Canada’s health workforce recruitment and retention

    Olumuyiwa Bamgbade, MD
  • Why judgment is hurting doctors—and how mindfulness can heal

    Jessie Mahoney, MD
  • Why evidence-based management may be an effective strategy for stronger health care leadership and equity

    Olumuyiwa Bamgbade, MD
  • The gift we keep giving: How medicine demands everything—even our holidays

    Tomi Mitchell, MD
  • From burnout to balance: a neurosurgeon’s bold career redesign

    Jessie Mahoney, MD
  • Why working in Hawai’i health care isn’t all paradise

    Clayton Foster, MD
  • Most Popular

  • Past Week

    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
  • Recent Posts

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Decoding your medical bill: What those charges really mean

      Cheryl Spang | Finance
    • The emotional first responders of aesthetic medicine

      Sarah White, APRN | Conditions
    • Why testosterone matters more than you think in women’s health

      Andrea Caamano, MD | Conditions
    • A mind to guide the machine: Why physicians must help shape artificial intelligence in medicine

      Shanice Spence-Miller, MD | Tech
    • How subjective likability practices undermine Canada’s health workforce recruitment and retention

      Olumuyiwa Bamgbade, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
  • Recent Posts

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Decoding your medical bill: What those charges really mean

      Cheryl Spang | Finance
    • The emotional first responders of aesthetic medicine

      Sarah White, APRN | Conditions
    • Why testosterone matters more than you think in women’s health

      Andrea Caamano, MD | Conditions
    • A mind to guide the machine: Why physicians must help shape artificial intelligence in medicine

      Shanice Spence-Miller, MD | Tech
    • How subjective likability practices undermine Canada’s health workforce recruitment and retention

      Olumuyiwa Bamgbade, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Most of the documentation physicians perform don’t help patients
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...