There has been a lot of talk about Physician Burnout and the causes for it, often blamed on the EHR and burdensome federal and insurer regulations. In addition, although seldom discussed, physicians are often frustrated by the “patient centric” movement away from a “provider focused” model. “Team based” healthcare has been espoused as the answer to both. Everyone in a practice is organized as part of a team with clearly defined roles all focused on getting what the patient needs efficiently.
I recently heard the term “Signature Ready”, from Dr. J. Ulagar, Associate Vice President of Clinical Operations, University of Vermont Medical Network Medical Group. I love the term because it is a simple concept not requiring complex teams or process redesign.
Let me explain. Providers are often burdened by paperwork without demographic information completed. In addition, clinical questions come to them without supporting clinical information of patients. I hear physicians complain that “someone else” could and should be doing this. However, it is quicker to do it themselves rather than hunt for someone else to do it.
Partly this is because it is unclear whose job it is to make sure any patient paperwork has been completed. Partly, it is because the EHR has interrupted previous provider centric workflows. There may be philosophy within the practice that because a signature is legally required, the physician must complete all steps. In the past when a patient called with a question, the chart was pulled, and the most recent note was clipped onto the front of the chart for the physicians. Clinical support staff could call into pharmacies under the physician name. In today’s electronic world, the physician needs to submit prescriptions electronically.
The concept of “Signature Ready” is straight forward. Providers should be spending the vast majority of their time focusing on caring for patients, not completing paperwork. They are the primary revenue generating entities within the practice, thereby, covering practice staff salaries. Once any form of paper or electronic requests are delivered to providers in a completed manner, then all that is required is a signature, agreement with recommendation, or even alteration in recommendation, this work can be taken care of quickly and physicians can get back to patient care.
This isn’t only for the benefit of the physicians. It is in the best interest of the patients. How often do patients call regarding their medication refill requests? All the while, the requests are sitting on the providers’ desks or task lists, and staff are receiving repeated calls asking about the status? How often do the staff need to interrupt providers knowing that the to do stack won’t be touched until the evening, though an answer is needed more quickly?
If the vast majority of administrative work is prepped for the providers such that it only required a signature or nod of accent, the quicker it will be done leaving time for providers to delve into the more complicated issues. And even see a few more patients.