Overworked Doctors Cost Everyone

Hospitals lose money and patients are put at risk when doctors are overworked

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Piling work on doctors to the breaking point can harm everyone involved. Patients aren’t the only ones who lose when doctors are overworked—the hospital’s bottom line does too.

A recent study looked at 7,100 patient records in an urban trauma department over four years. Results showed that the department had lower revenue when doctors were overworked.

"Talk to your doctor about treatment plans before discharge."

Adam Powell, PhD, President of Payer+Provider Syndicate, investigated the impact of workload on trauma department revenue.

Dr. Powell said, “We have found evidence that high workload at the time of discharge reduces the quality of physician notes. It is quite possible that this phenomenon is having an impact on patient care as well.”

Health care professionals and financial analysts are constantly trying new operating systems to make the system more efficient, effective and affordable.

One of the ways hospitals have attempted to lower costs is to have doctors focus more on treating patients and less time on paperwork.

Yet, this system has the potential to backfire. Accurate discharge papers are a vital part of both patient care and the hospital billing process.

For the study, researchers looked at the data of a large urban hospital from 2006-2010. A total of 7,100 patient cases were evaluated for patient and treatment characteristics and billing information.

The more severe the medical condition, the longer the discharge papers took to complete. Doctors under high workloads were less able fully outline what treatment patients received in the hospital.

Well-documented and complete discharge papers on “high-severity” patients resulted in an average 48 percent higher reimbursement to the hospital.

Rushed and incomplete discharge notes resulted in lower billing and less revenue for the hospital.

When patients are discharged, the billing process relies on doctors’ notes to know what exactly to charge a patient for services provided.

If doctors are overworked and discharge notes are not properly detailed, patient bills do not accurately reflect the healthcare given.

Researchers found that when a doctor did discharge paper work on two people per day vs. just one, the bill produced 10 percent less reimbursement for the hospital. When a doctor discharged three patients, revenue dropped by 33 percent per patient.

Another potential fallout here would be that improper discharge notes and orders could affect the patients’ follow-up care negatively, costing the patient and healthcare system further.

Dr. Powell said, “Our study demonstrates that fatigue from high workload can impact the quality of billing, in addition to potentially impacting the quality of care.”

“Hopefully, our study will encourage hospitals to invest in systems to mitigate the impact of high workload on the quality of their work. We have provided evidence that there is a direct financial benefit to doing so.”

“When being discharged, it is important for patients to make sure that they have an adequate understanding of their treatment plan. If patients feel rushed they should ask their providers for clarification.”

This article was published in May in Manufacturing & Service Operations Management. No funding was provided for this study and no conflicts of interest were found.
 

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Review Date: 
September 13, 2012
Last Updated:
September 13, 2012