New York, NY — As editor-in-chief of the Bellevue Literary Review, the first literary magazine to be based out of a hospital, Dr. Danielle Ofri has long explored illness and health care as rich narrative terrain. But her latest work, an op-ed in last week’s New York Times, tells a real-life story that’s crippling hospitals and health systems across the country. Doctors and nurses are spent—and, Ofri explains, it’s plain to see why.
First of all, they’re expected to handle mountains of administrative tasks, which eat away at their time, forcing them to work longer and longer shifts in order to see the patients who need them. For example, if a procedure their patient needs isn’t covered, it’s often left to the doctor to spend hours on the phone figuring out some kind of agreement with the insurance provider. In addition, the amount of medical attention a patient needs may demand much more time than what’s provided by the window dictated by the health system. Nowadays, primary care physicians, like Ofri, are working particularly hard, as patients have more comorbidities today than ever before: they’re managing more conditions, trying to adhere to more regimens, and need more attention.
“If doctors and nurses clocked out when their paid hours were finished, the effect on patients would be calamitous,” Ofri writes. “Doctors and nurses know this, which is why they don’t shirk. The system knows it, too, and takes advantage.”
One of the biggest contributing factors to doctors’ burgeoning workloads is the electronic medical record (EMR). According to Ofri—who points to a study showing that, on average, for every hour a doctor spends with patients, they spend two hours typing into an EMR—the EMR process is slowing doctors down exponentially and forcing many to work over the weekend. (This trend is so pronounced that apps are coming out to enable doctors to enter information into EMRs via voice command and on the go.)
Doctors and nurses are so committed to doing good that, usually, they’ll simply do the additional labor. Such a work ethic isn’t typically expected of other professionals. “In a factory, if 30 percent more items were suddenly dropped onto an assembly line, the process would grind to a halt,” writes Ofri. “Imagine a plumber or a lawyer doing 30 percent more work without billing for it. But in health care there is a wondrous elasticity — you can keep adding work and magically it all somehow gets done. The nurse won’t take a lunch break if the ward is short of staff members. The doctor will ‘squeeze in’ the extra patients.”
Why This Matters
Our nation’s health care providers are burned out, much more so than other professionals. This burnout leads to more safety incidents and poorer patient outcomes. The situation is not just dire—it’s devastating: statistically speaking, doctors are a population at risk, committing suicide at a rate about double that of the general public.
As Ofri writes, “This status quo is not sustainable—not for medical professionals and not for our patients.”
As physicians struggle with decreased autonomy and steeper mental health challenges, life science leaders must look for new ways to help relieve the burden of our HCPs. Any steps toward removing administrative friction, streamlining information delivery, and listening to the needs of individual practices will make for better care and better providers.