What Filed Have the Most/Least Amount of Paperwork?

[mgso4]

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What about the more competitive fields (e.g. ortho, derm, rads)?

Edit: Title should read What Fields***

 

[evilbooyaa]

Every field is going to say they have the most paperwork. And to some extent, it's true. I would say surgical specialties have a little less, especially if they're constantly in the OR. Rads is generally dictating their reports nowadays, so IDK if you count dictations.

 

[45408]

I thought the cardiac surgeons probably had the least paperwork. Most of their patients had been worked up by cardiology, so most clinic visits resulted in an operation. Ten minutes of "hihowareya, sign the consent here" could result in a 3-6 hour operation. The PAs wrote most/all of the notes, orders and D/C summaries. The surgeon usually dictated the op notes and not much more.

 

[Guero]

I thought the cardiac surgeons probably had the least paperwork. Most of their patients had been worked up by cardiology, so most clinic visits resulted in an operation. Ten minutes of "hihowareya, sign the consent here" could result in a 3-6 hour operation. The PAs wrote most/all of the notes, orders and D/C summaries. The surgeon usually dictated the op notes and not much more.

Every singe note I see by any surgical specialty (aside from consults) are tiny. That said, I imagine consults feed a large proportion of surgical cases. EM notes are pretty darn skimpy, too.

Prowler, how would you compare your GS paperwork load to those in medical specialties?

(I'd say neurology and psychiatry have the longest notes, followed by IM.)

 

[Anastomoses]

whoa. good question. I'm glad someone is keeping an eye on practical matters. I hadn't even thought of this.

 

[survivordo]

I'd say EM would be a contender. Seems like most of their paperwork is simply pull up a template and change a few things here and there. Correct me if I'm wrong but it doesn't seem like they have to do any billing either?

Survivor DO

 

[KinasePro]

Ophtho wins hands down. Their notes are mostly acronyms, diagrams, and drawings. That being said, ophtho clinic is pretty brutal and the patient volume is higher than most, so that may balance things out to some extent.

Psych & neuro notes are long, but their volumes are relatively low so the burden seems lighter to me. In-patient psych has an assload of paperwork to deal with, but their census is relatively low compared to the other services so again, it didn't seem so oppressive to me.

The apex of paperwork misery is primary care, IMO. They get shafted with many of the absurd government forms like SSDI, which can take ~90 mins to fill out if done correctly. On top of that, their chart notes need to capture a lot of petty detail which may become important later.

 

[Guero]

Ophtho wins hands down. Their notes are mostly acronyms, diagrams, and drawings. That being said, ophtho clinic is pretty brutal and the patient volume is higher than most, so that may balance things out to some extent.

Psych & neuro notes are long, but their volumes are relatively low so the burden seems lighter to me. In-patient psych has an assload of paperwork to deal with, but their census is relatively low compared to the other services so again, it didn't seem so oppressive to me.

The apex of paperwork misery is primary care, IMO. They get shafted with many of the absurd government forms like SSDI, which can take ~90 mins to fill out if done correctly. On top of that, their chart notes need to capture a lot of petty detail which may become important later.

Great distinctions!

 

[45408]

Every singe note I see by any surgical specialty (aside from consults) are tiny. That said, I imagine consults feed a large proportion of surgical cases. EM notes are pretty darn skimpy, too.

Prowler, how would you compare your GS paperwork load to those in medical specialties?

(I'd say neurology and psychiatry have the longest notes, followed by IM.)

SICU notes and the cardiac surgery notes (written by PAs) are fairly sizeable. They're certainly longer than some hospitalist notes.

There's still plenty of paperwork in general surgery. Office consults, follow-up visits, re-admissions, etc. all contribute to paperwork. Op notes, d/c summaries, etc. I'm not sure I will want a mid-level provider, because I don't know if the amount of work they would save me would warrant the salary they usually command. It kind of depends on your practice environment.

 

[Guero]

SICU notes and the cardiac surgery notes (written by PAs) are fairly sizeable. They're certainly longer than some hospitalist notes.

There's still plenty of paperwork in general surgery. Office consults, follow-up visits, re-admissions, etc. all contribute to paperwork. Op notes, d/c summaries, etc. I'm not sure I will want a mid-level provider, because I don't know if the amount of work they would save me would warrant the salary they usually command. It kind of depends on your practice environment.

Huh, I never would've expected that. And great point regarding NPs/PAs. That's certainly a hot topic these days. They're a huge plus for academic surgeons, though, as they lighten the load without affecting their (comparatively lower than private practice) salaries. Thanks for elaborating!

 

[Smurfette]

Gen surg has plenty of paperwork, but the number of refill requests, routine labs, and other similar tests is much, much less than primary care. However, precerts for tests and surgeries (done by my office staff) and FMLA, insurance and other paperwork (started by my staff but signed off and restrictions completed by me) are pretty common. Overall, GS is less administrative stuff, but since I am not in primary care, I have no experience with which I can compare it.

And there are some things NP/PAs cannot fill out. Some things must be by the attending physician. My PA handles a lot of hospital-related paperwork, but the routine stuff that streams into the office from pharmacies, employers and insurance companies generally gets sent to me.

 

[Guero]

Gen surg has plenty of paperwork, but the number of refill requests, routine labs, and other similar tests is much, much less than primary care. However, precerts for tests and surgeries (done by my office staff) and FMLA, insurance and other paperwork (started by my staff but signed off and restrictions completed by me) are pretty common. Overall, GS is less administrative stuff, but since I am not in primary care, I have no experience with which I can compare it.

And there are some things NP/PAs cannot fill out. Some things must be by the attending physician. My PA handles a lot of hospital-related paperwork, but the routine stuff that streams into the office from pharmacies, employers and insurance companies generally gets sent to me.

Awesome contribution! Thanks for taking the time to stop by, Smurfette!

 

[Winged Scapula]

As a surgeon in private practice here is the paperwork I had to do today ( a rather typical day):

Computerized order entry for all my operative patients

Updated history and physical for all Operative patients

Consent forms for all operative patients

Signed and completed the computerized Pathology requests for all operative patients

Postoperative orders for all operative patients

Dictate and write a post operative note for all operative patients

Tumor staging forms on all operative patients

Progress notes on all hospitalized patients

Consult note on a new patient

Sign FMLA and short-term disability forms

Electronic notes on all patient phone calls

Scripts for all postoperative patients and hospitalized patients

Tomorrow I am in the office and I will complete around 40 electronic notes for all the patients I see, progress notes on any hospitalized patients, and any other administrative duties such as refill prescriptions, disability paperwork etc.

Honestly all specialties have a lot of paperwork and it's a fallacy to assume that surgeons have left simply because they are in the operating room. With the advent of electronic medical records the requirement for paperwork has increased for all of us.

 

[Smurfette]

I put documentation of patient encounters into a different category than "paperwork" (which I consider to be more mindless stuff like med refills, pre-certs, FMLA forms, disability forms, signing off on test/path results, etc.). That's just my way of compartmentalizing it, I guess.

Just to add to what WS said, every physician (surgeon or not) should be charting notes for all in- and outpatient encounters, phone calls, etc. If you don't document it, you can't prove it happened. The more patients that a provider interacts with in a day, the more documenting they need to do.

 

[Siggy]

Anesthesiology. Their "notes" are templates. While, yes, there's a lot of documenting during the case (VS trends every 5 minutes, vent/gas stats every 15), it's not like you're doing a lot of other things during the vast majority of cases. It's definitely not the same as writing surgery progress notes.

 

[MilkmanAl]

Anesthesia with electronic records, sure. That's got to at least be better than average. Paper records, no way. There are a ton of forms to fill out.