
Medscape Practice Workflow Report 2017: Physicians' Bottlenecks, Challenges, and Time
Physicians face numerous practice management challenges throughout their day: EHR use, time management, patient no-shows, and practice efficiency. Medscape's "Practice Workflow Report: Physicians' Bottlenecks, Challenges, and Time" is the result of a survey sent to physicians about these and many other practice challenges. Over 1150 physicians across more than 25 specialties responded and provided some surprising findings.
Medscape Practice Workflow Report 2017: Physicians' Bottlenecks, Challenges, and Time
Physicians clearly have very busy days. Slightly more than three quarters of physicians see 11 to 30 patients per day, while 40% tally 11 to 20; 14% have a roster of 31 or more patients each day, and 9% of physicians see 1 to 10.
Medscape Practice Workflow Report 2017: Physicians' Bottlenecks, Challenges, and Time
Primary care physicians (PCPs) and specialists have many challenges, but not having enough patients is not one of them. Forty-two percent of PCPs and 39% of specialists see 11 to 20 patients daily, while 41% of PCPs and 34% of specialists see 21 to 30 patients. One in 10 PCPs see 31 or more patients, as do 16% of specialists.
Medscape Practice Workflow Report 2017: Physicians' Bottlenecks, Challenges, and Time
No-shows can put a dent in a practice's bottom line. In a typical week, the majority of physicians' appointments include up to 10% no-shows. Still, almost a quarter of physicians say that 11% to 20% of their patients are no-shows. Within recent years, it's become more common to phone patients to remind them of their appointment and to charge them for no-shows.
Medscape Practice Workflow Report 2017: Physicians' Bottlenecks, Challenges, and Time
Physicians typically fall behind on appointments several times a week or more. Over one third (36%) of physicians fall behind several times a week, while 28% do so daily.
Medscape Practice Workflow Report 2017: Physicians' Bottlenecks, Challenges, and Time
More PCPs (35%) lag behind daily compared with specialists (25%), while slightly more specialists (37% vs 33%) fall behind several times a week. Six percent of PCPs and specialists indicated that they are always on time.
Medscape Practice Workflow Report 2017: Physicians' Bottlenecks, Challenges, and Time
Although falling behind schedule is often inevitable, it does affect the day. Almost half (45%) of physicians fall behind by 16 to 30 minutes, 37% are 15 minutes or less behind schedule, and 17% create waits of 31 minutes or more.
Medscape Practice Workflow Report 2017: Physicians' Bottlenecks, Challenges, and Time
The most common reason for over three quarters (79%) of physicians is their major concern: to spend sufficient time with patients, even if it throws them off schedule. Almost two thirds (66%) say patients contribute to the situation by arriving late and needing to spend time filling out forms.
Medscape Practice Workflow Report 2017: Physicians' Bottlenecks, Challenges, and Time
While many physicians inevitably fall behind schedule, there are also many who have found specific ways to stay on time.
Medscape Practice Workflow Report 2017: Physicians' Bottlenecks, Challenges, and Time
More than half of physicians are either very or somewhat satisfied with their practice's efficiency. Still, a large percentage think that there is room for improvement and that their practice could operate more efficiently.
Medscape Practice Workflow Report 2017: Physicians' Bottlenecks, Challenges, and Time
While some physicians have been relatively slow to adopt new technology, 43% of our survey respondents indicated that better technology would improve their office's efficiency. In second place: more non-physician clinical staff.
Medscape Practice Workflow Report 2017: Physicians' Bottlenecks, Challenges, and Time
A leisurely lunch would be a luxury for most physicians. Almost half (44%) of employed physicians and 40% of self-employed physicians take less than 30 minutes. Surprisingly, over a quarter (27%) of self-employed and 28% of employed physicians skip a lunch break entirely.
Medscape Practice Workflow Report 2017: Physicians' Bottlenecks, Challenges, and Time
Lunch breaks, if any, are short. Almost half (44%) of specialists and 39% of PCPs take less than 30 minutes.
Medscape Practice Workflow Report 2017: Physicians' Bottlenecks, Challenges, and Time
Far more physicians phone patients whenever they find a convenient moment rather than scheduling it into their day. Almost two thirds (61%) of physicians phone patients, but not at a particular time.
Medscape Practice Workflow Report 2017: Physicians' Bottlenecks, Challenges, and Time
Despite the increased use of higher technology, the phone is still the tool of choice to communicate with patients outside of the office. Over 90% of physicians use the phone, 34% email, 8% text, and 2% use videoconferencing. Of note: Our survey results showed that twice as many self-employed physicians (13%) text with patients compared with employed physicians (6%).
Medscape Practice Workflow Report 2017: Physicians' Bottlenecks, Challenges, and Time
In addition to documenting visits, the EHR has many functionalities that help doctors in their practices. Half of physicians use their EHR to identify patients who need a follow-up visit, and 42% use the EHR to determine which patients need additional treatments. It's worth noting that 12% of self-employed and 4% of employed physicians have no EHR system.
Medscape Practice Workflow Report 2017: Physicians' Bottlenecks, Challenges, and Time
EHR vendors have been quick to add dictation and voice-recognition software capabilities to EHR systems, but two thirds of physicians are still not using them, often citing errors and problems with transcriptions.
Medscape Practice Workflow Report 2017: Physicians' Bottlenecks, Challenges, and Time
While many physicians find the EHR a burden, they are also increasingly making use of its features that allow several benefits in the patient care realm.
Medscape Practice Workflow Report 2017: Physicians' Bottlenecks, Challenges, and Time
Patient portals offer patients and practices many conveniences. More primary care physicians (85%) have patient portals than specialists (78%).
Medscape Practice Workflow Report 2017: Physicians' Bottlenecks, Challenges, and Time
Doctors are increasingly offering patient portals, but patients have yet to make much use of them. In 69% of practices with a patient portal, no more than 25% of patients are using them. Twenty percent of practices have no patient portal.
Medscape Practice Workflow Report 2017: Physicians' Bottlenecks, Challenges, and Time
Primary care and specialty practices are pretty much neck and neck as far as patients using their practice portals. In over two thirds (67%) of primary care practices and 71% of specialty practices that offer patient portals, a maximum of only 25% of patients are logging on.
Medscape Practice Workflow Report 2017: Physicians' Bottlenecks, Challenges, and Time
Patient portals offer a myriad of functions. The three most popular are reviewing diagnostic test results (65%), communicating with clinicians regarding health information (60%), and requesting prescription refills (59%).
Medscape Practice Workflow Report 2017: Physicians' Bottlenecks, Challenges, and Time
Most patients have no complaints about physicians' EHR use. Over half (54%) of physicians don't receive negative comments from their patients about using the EHR during appointments. Physicians who do receive complaints tend to get them only occasionally (36%). Only 9% of physicians receive negative comments frequently.
Medscape Practice Workflow Report 2017: Physicians' Bottlenecks, Challenges, and Time
In physicians' practices, the full-time medical staff includes an average of 3.6 physicians, 3.6 medical assistants, 1.7 registered nurses, 0.3 physician assistants, and 0.8 nurse practitioners.
Medscape Practice Workflow Report 2017: Physicians' Bottlenecks, Challenges, and Time
In physicians' practices, the full-time office staff includes an average of 2.5 receptionists, 1.4 billers and coders, 0.8 office managers, and 0.7 medical record clerks.
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