Endocrine Abstracts

Introduction: In a US study of general practitioners, 50%-60% of their working time was found to be dedicated to paperwork and electronic medical record-keeping (including electronic prescription – EPC writing)¹.

Aim: Given the mandatory use of EPC in Greece, we wanted to assess the time required for this in the daily practice of our outpatient endocrinology clinic.

Method: In one of the outpatient (OUP) clinics of the Department of Endocrinology, Diabetes and Metabolism of a secondary women’s hospital, the time corresponding to EPC was compared to the time spent in the OUP (regarding history taking, clinical examination & laboratory results’ assessment). At the daytime OUP clinic, four specialists and three fellows, all with > 5 years of EPC experience, examine all regular and emergency cases (there are no personal appointments). In the OUP, EPC is handled exclusively by physicians who take care of the individuals examined. The Webtime Tracker application was used to estimate EPC time, while the time required for EPC in days of general and gestational endocrinology (GE + G) clinics was compared to time spent on EPC in days of type 1 & 2 diabetes patients clinics (GE + D). Differences in EPC time were assessed by the Kruskal Wallis (KW) test, setting the statistical significance at the level of 0.05.

Results: In 101 man-hours of an OUP clinic (GE + G: 77 hours and GE + D: 24 hours), 471 subjects were examined (GE + G: 366 and GE + D: 105 subjects, respectively). The percentage of time spent on EPC was 33% overall (Q25–75: 25% –40%). More specifically, the distribution of EPC time was GE + G: 35% (Q25–75: 25% –41%) & GE + D: 32% (Q25–75: 24% –37%), respectively (KW P > 0.1).

Discussion: A significant proportion of OUP work time was devoted to EPC, without differences on the type of clinic. In health systems, everyone is creating information that produces more bureaucracy, while doctors do not plan much of the latter². Hospital doctors in Greece receive little help to serve bureaucracy and hospitals do not invest in their secretarial and administrative support. If these problems are not addressed, doctors will have less and less time to examine and treat patients.

References

1. https://www.forbes.com/sites/brucelee/2016/09/07/doctors-wasting-over-two-thirds-of-their-time-doing-paperwork/.

2. Sweet V. Slow Medicine, New York, Riverhead Books, 2018.