We all know that physicians work hard. They grind their way through medical school, then sacrifice much of their twenties or thirties in residency before launching into their respective practices. And they often land in practices that require long hours and/or difficult call schedules. Then, many physicians are finding out that their work schedule only tells part of the story. Many physicians see their evenings then spent with yet more after-hours work each day. The truth is, many practices depend on physicians donating their time. While we, as a society, embrace and reward hard work, but physician burnout is a real risk with real consequences.

A study in 2016 reviewed the typical workday of physicians in four specialties: family medicine, internal medicine, cardiology, and orthopedics. The researchers observed that through a typical office day the physicians spent, on average, 27% of their time on clinical face time and 49% of their time on administrative work: EHR and desk work. You would probably not be surprised to learn that even in the exam room, physicians were spending just about half of their time interacting with their patient; and 37% of their time on the EHR or some administrative task. And, at the end of the day many physicians were performing 1-2 additional hours of administrative and EHR tasks after hours. Many of these tasks include responding to patients with questions about their care or requesting medication refills.  

This is all, of course, an extension of the blessing and curse of electronic health records, but also of the constant drive to maximize patient contacts in a day in order to generate revenue. The pressure is often external, but, many would recognize it is a reflection of individuals’ drive.

On the one hand patients may feel better connected to their physician thanks to email and telephone access to them after hours; on the other hand, constant contact with patients, EHR, and inability to step away from work contributes to physician burnout.