depends on the situation.
My previous jobs have been: 100% chart review (new grad for first 3 mos, outpatient FP), but very quickly dropped to 10% after the doc knew me and the board of medicine approved the request; but never less than 10%. Even 10% can be quite a lot of work for the supervising doc when the PA is seeing 25 pts/day in clinic...my last job the chart room would randomly pull 10% of charts and set on the doc's desk to review once a week. He usually had a tall stack to review. It took some time if he was actually paying attention. Once in a blue moon he would call me on something, usually a teaching moment, like suggesting this antibiotic in this situation instead of what I chose and the rationale, or this antihypertensive, etc. Was very rarely on something really big.
Now in my current situation we aren't mandated to have more than 10% chart review but the way it works in our ED we have every single chart reviewed by and cosigned by the attending. This is entirely for billing purposes and it states that "the patient was seen personally by me, the H&P was done by the physician extender, and I reviewed key portions of the H&P myself", yada yada. If the docs do this they can bill 100% of the visit instead of the 85% incident-to for PAs. It is a real pain in the butt to have every patient with otitis and eczema reexamined by a doc. It is stupid but it is the way we do it. I have no problem with getting the attending's stamp on belly pain and chest pain, and in fact I welcome it, but come on, URIs? Vaginitis? Remember I've been a PA for 7 years, I'm pretty sure of myself on the bread and butter stuff.
I think you were asking how much of a burden is the chart review on the supervising physician--really, I think it depends on how well you know your PA/NP and how closely you work with them. It gets easier over time when you know one another well and how you practice. I imagine there's a learning curve for the reviewer as well as for the PA/NP.
Hope this helps....
