Admin Days

[Ubba]

It's fair to say that 0.5-1 day of admin time is standard in most practices at this point. (For new fellows who may not be familiar with this from their training programs, admin time is generally for patient callbacks, note catching-up, billing, and similar tasks outside of direct patient care.)

I'm curious as to what this admin time looks for various practices. A few areas for which it would be helpful to get broad input:

1. How much admin time does your practice give?

2. Are you expected to be on-site for all or part of your admin day? Are there practices in which you are free to be wherever you want (even out of state, for example), as long as you're accessible by phone and can access the EMRs?

3. Does your admin weekday rotate or is it fixed? (If fixed, it would seem that the physicians who have Mon or Fri have substantially superior QOL to the physicians who have one of Tues - Thurs.)

Input on other related issues also welcome.

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[gutonc]

It's fair to say that 0.5-1 day of admin time is standard in most practices at this point. (For new fellows who may not be familiar with this from their training programs, admin time is generally for patient callbacks, note catching-up, billing, and similar tasks outside of direct patient care.)

I'm curious as to what this admin time looks for various practices. A few areas for which it would be helpful to get broad input:

1. How much admin time does your practice give?

FT is 4d/wk + 1 admin day. This is true for my current job, my prior job and 3 of the other FT gigs I am familiar with in the area.

2. Are you expected to be on-site for all or part of your admin day? Are there practices in which you are free to be wherever you want (even out of state, for example), as long as you're accessible by phone and can access the EMRs?

Speaking only for my current and prior jobs, you need to be available and you are expected to check into EMR periodically. Nobody actually rides herd on that of course, so some people take advantage of it.

3. Does your admin weekday rotate or is it fixed? (If fixed, it would seem that the physicians who have Mon or Fri have substantially superior QOL to the physicians who have one of Tues - Thurs.)

Fixed. Always Friday. If anyone tries to take my Friday away, I will quit.

That said, a mid-week break can also be kind of nice.

 

[Ubba]

FT is 4d/wk + 1 admin day. This is true for my current job, my prior job and 3 of the other FT gigs I am familiar with in the area.

Speaking only for my current and prior jobs, you need to be available and you are expected to check into EMR periodically. Nobody actually rides herd on that of course, so some people take advantage of it.

Fixed. Always Friday. If anyone tries to take my Friday away, I will quit.

That said, a mid-week break can also be kind of nice.

Regarding availability, do you mean available to come in for an urgent sick patient visit/coverage, or available by phone? I ask because this is relevant in factoring geography into my prospective job rankings.

 

[gutonc]

Regarding availability, do you mean available to come in for an urgent sick patient visit/coverage, or available by phone? I ask because this is relevant in factoring geography into my prospective job rankings.

Admin is admin. Clinical is clinical. If they expect me to come in to see patients, they better be paying me to come in to see patients.

I have had this situation before. In my prior job, we would have on or off-site coverage if there was no physician at the site for the day (we had 5 clinics, each with 2-5 docs, so there were some scenarios where there might be a clinic uncovered by a doc on site that day). For on-site coverage (meaning you were in the clinic and had a schedule that day, usually 10 or fewer patients), the per diem pay when I left was $2200/d for a full day. If you were off-site, usually just on call for the nurses or for consults, either by phone or in person, you were paid to be on call (IIRC, it was $350-400 a day to be available...I may be misremembering). If you had to come in to the hospital to see a consult, your pay got converted to the "in-clinic" per diem rate.

 

[Plutarch02]

I'm in a practice where we have 1 admin day, we don't come into the office but we answer inbox messages. I have a few friends who do 0.5 admin days but it always ends up bleeding over to most a day. I say fight for a full day off it's necessary when you're dealing with a lot of death etc.

 

[TexasMed22]

How many hours are you guys actually working on an average admin day? I was talking to one of our local private guys and he said he regularly works for ~12 hours (at home) on his admin day. Is that standard?

 

[gutonc]

How many hours are you guys actually working on an average admin day? I was talking to one of our local private guys and he said he regularly works for ~12 hours (at home) on his admin day. Is that standard?

It depends on if it's patient care related admin work (like catching up on charts, results calls, etc) or practice/hospital business related admin.

If it's the latter, or a mix of the two, I can see it happening sometimes, but not every single week. When I had a 50/50 admin/clinical job, there were certainly a handful of days over the course of a year that I would have a full 8h day of admin work to do. But it wasn't ever 12 hours.

If I was seeing 30-40 patients a day on the other 4 days, and was super inefficient in my work, yeah, I might have that much work to do on my admin day. But I generally see 16-20 a day and it's rare that I have more than one or two charts unfinished, or more than a few results to follow up on when I leave for the day.

I can't tell you if it's "the norm" but I can't imagine that kind of work to be done an admin day.

 

[Plutarch02]

How many hours are you guys actually working on an average admin day? I was talking to one of our local private guys and he said he regularly works for ~12 hours (at home) on his admin day. Is that standard?

About 15 minutes, I check my inbox at 11 am and again at 3 pm.
I see 15-20 patients a day on my other days and I dictate while other pts are being roomed. If you're seeing 30+ a day I could see having a backlog to take care of.

Other time I'm working out, walking, being with family etc.

 

[HemeOncHopeful19]

About 15 minutes, I check my inbox at 11 am and again at 3 pm.
I see 15-20 patients a day on my other days and I dictate while other pts are being roomed. If you're seeing 30+ a day I could see having a backlog to take care of.

Other time I'm working out, walking, being with family etc.

When do you take care of clinic prep for the 15-20 patients? Or do you just go in blind every day (not knocking it just curious what people's process is)

 

[gutonc]

When do you take care of clinic prep for the 15-20 patients? Or do you just go in blind every day (not knocking it just curious what people's process is)

You didn’t ask me, but at this point I usually take about 20 minutes the night before and then however long it takes to eat my breakfast the morning of. The night before is just to look over and make sure all the follow up patients are lined up. And the morning is for going over the new patients for the day.

 

[Plutarch02]

When do you take care of clinic prep for the 15-20 patients? Or do you just go in blind every day (not knocking it just curious what people's process is)

I'm still in early career so a lot of those 15 or so pts are iron deficiency anemia, anemia of CKD, DVT/PE on DOAC. I mainly spend twenty minutes the night before looking at new patients but again a lot of the new pts are going to be wbc of 12, or plts of 120 pretty straightforward benign heme.

For the complicated new onc or transfer onc case I spend a lot more time prepping for them but not on admin day still the night before.