ADMINISTRATIVE WORK CONSUMES ONE-SIXTH OF U.S. PHYSICIANS' WORKING HOURS AND LOWERS THEIR CAREER SATISFACTION
ADMINISTRATIVE WORK CONSUMES ONE-SIXTH OF U.S. PHYSICIANS' WORKING HOURS AND LOWERS THEIR CAREER SATISFACTION
复制标题
DOI：
10.2190/hs.44.4.a
复制
发表时间：
2014-01-01
影响因子：
3.4
通讯作者：
Himmelstein, David U.
中科院分区：
文献类型：
--
作者：
Woolhandler, Steffie;Himmelstein, David U.
医生经常抱怨行政工作的负担，但很少有研究量化临床医生在行政工作上投入了多少时间。我们量化了美国医生花在行政任务上的时间，以及它与他们职业满意度的关系，基于对4720名美国医生每周工作20小时或更长时间的直接病人护理的全国代表性调查。医生每周平均花费8.7小时（占工作时间的16.6%）在给药上。精神科医生用于管理的时间所占比例最高（20.3%），其次是内科医生（17.3%）和家庭/全科医生（17.3%）。儿科医生花费的时间最少，每周6.7小时，占专业时间的14.1%。大型诊所的医生、医院所有的诊所的医生以及那些有减少服务的经济动机的医生在行政管理上花费了更多的时间。电子医疗记录的更广泛使用带来了更大的行政负担。即使在控制了收入和其他因素之后，花更多时间在行政管理上的医生的职业满意度也较低。目前美国医疗政策的趋势是，在大型医疗机构中转向雇佣，电子医疗记录的实施，以及财务风险分担的日益普及，这些都可能增加医生的文书工作负担，并可能降低他们的职业满意度。
Doctors often complain about the burden of administrative work, but few studies have quantified how much time clinicians devote to administrative tasks. We quantified the time U.S. physicians spent on administrative tasks, and its relationship to their career satisfaction, based on a nationally representative survey of 4,720 U.S. physicians working 20 or more hours per week in direct patient care. The average doctor spent 8.7 hours per week (16.6% of working hours) on administration. Psychiatrists spent the highest proportion of their time on administration (20.3%), followed by internists (17.3%) and family/general practitioners (17.3%). Pediatricians spent the least amount of time, 6.7 hours per week or 14.1 percent of professional time. Doctors in large practices, those in practices owned by a hospital, and those with financial incentives to reduce services spent more time on administration. More extensive use of electronic medical records was associated with a greater administrative burden. Doctors spending more time on administration had lower career satisfaction, even after controlling for income and other factors. Current trends in U.S. health policy a shift to employment in large practices, the implementation of electronic medical records, and the increasing prevalence of financial risk sharing are likely to increase doctors' paperwork burdens and may decrease their career satisfaction.