Physicians chose health care as a profession to treat, diagnose, and care for patients. However, with the increasing amount of administrative burdens facing medical professionals, they have found themselves spending more time at the computer for billing issues than actually practicing medicine. This shift occurs with great frustration to the physician and as a major catalyst complicating patient access, quality of care, and overall health care experience.
Currently, for every one hour a primary care physician spends treating a patient, they spend nearly two hours on administrative responsibilities. This increases even further with after-hours documentation as physicians spend evenings and weekends attending to the non-clinical responsibilities that someone else must address but which now fall squarely on the shoulders of the average medical professional.
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A Documented History of Challenges
One component of modern medicine that has required an unbearable amount of time for physicians is documentation. While electronic health records are in place to digitize information that would otherwise bog down a paper-intensive experience, they’ve been implemented in such a way that create impressive administrative burdens that require time – billable time from a perspective of insurance coverage – for a vast majority of physicians.
A physician’s office can move seamlessly if everyone is on the same page; however, with so much data entry, insurance mandated data fields, forms and applications required by legal obligations for the fields in which health care providers work or quality reviews they supervise, the forms and paperwork can replace in-office time that should have been devoted to patient interactions.
There are many components of compliance that include elements which go beyond medically necessary accounting. For every quality review marker or statistical measure compiled on an annual basis, there are daily metrics needed to align to make sense of the annual review – which takes time – time that reduces access to patients.
Furthermore, insurance reimbursement creates levels of complexity and requirements. For every claim there is a systematic appeal; for every denial, a follow-up. All the while, physician interaction is limited because while a doctor might know what a patient needs based on their specific needs, the insurance company has other criteria set in place that the physician must appeal to. This diverts doctor’s responsibilities away from the patient and onto unnecessary discussions with insurers.
Administrative Requirements Galore
In addition to following insurance mandates, there is an increasing amount of quality reviews that encourage buy-in but create even bigger workloads. Quality of care metrics reduce daily treatment efficacy for quarterly and annual applications. Many aspects of reporting are de novo, where the same information is needed by different agencies in different formats.
With such extensive reliance on reviewing quality assessments, it becomes more important than actually presenting quality assessments face-to-face.
Medically necessary paperwork and requests only contribute to access-related restraints when payment parameters imply otherwise or no one appeals to medical integrity beyond billing – this shows how medical billing has transformed into something administrative overload separate from helping patients.
Nobody Went to Med School to Be a Bill Collector
Finally, billing has complicated the lives of many average professionals. The coding involved and billing specificities require additional knowledge outside of basic treatment implementation and epidemiology. It’s not enough for a doctor to treat; they also need to involve themselves with approval levels that turn doctors into financial managers when they should be administering diagnoses.
The amount of time it takes to connect with insurers based on their mandating timelines means that doctors now find themselves spending additional hours investigating what they should have gotten paid for instead of connecting with other patients.
Complications from Overhead Communications
In addition to extensive on-the-ground communications with patients who attempt to reach doctors via portals and voicemail systems, there are also innumerable communications from third parties. While it’s important for various parts of the medical industries to connect post-appointment or post-creation of a workup form, each entry bumps a new opportunity down the line because there’s no urgency unless it’s face-to-face.
Responding to insurance inquiries, lab results, forms from specialists and recommendations from family practitioners take up valuable time (and often overlap with other professionals who could’ve taken on the task themselves) but need the physician stamp of approval.
As such, communication bog down any hope of thriving in practice unless the doctor becomes privy to something that’ll compromise timely diagnosis or treatment.
If There’s Too Much Crossing an Administrative Bridge…
All these administrative burdens create a downstream negative impact on access and quality of care that sometimes suggest medical professionals would be better off without these restrictions in place as external professionals could do it better on their behalf.
For example, if there’s documentation that needs to happen anyway – the IRIS program suggests tracking referrals; however, if portals exist for this purpose, why intrude on doctor/patient time? As such, administrative professionals are experts in these matters specifically. Out-of-practice virtual medical billing help creates more opportunity for professional development with their services so practitioners can enjoy relative peace in clinician settings.
Complications That Reduce Quality Care In Practice
Ultimately, when medical professionals push through all these burdens or delegate them inappropriately anyway, it complicates access and quality of care. When patients feel like they can’t get their points across, it compromises diagnosis. When too much time is spent elsewhere beyond direct treatment, it reduces quality response.
Physician burnout levels are critical when they’ve shifted so far away from patient compassion and connection they fail to want to succeed as mediators once again. This reduces retention and available options for patients.
Creating Peace (When Possible)
There’s little sympathy for those people who have all this paperwork to fill out – they want insurance compensation as much as anyone else. There’s red tape everywhere but if practitioners can focus on what’s best for their outcomes instead of commercial ones for others – for their costs are sometimes financial burdens as well – it would make more sense.
As such, decisions should protect clinical time absent expectations based on bureaucracy that’s simply out of their realm. The safe space needed should deem medical professional expectations limited based on excess professional applications unrelated to helping patients.
Final Thoughts
Access would be stabilized and benefits would surround prevention if doctors didn’t have to worry about whether they were getting paid or how much time was being wasted just waiting around. However, any burden that redirects responsibility away from cash-strapped physicians fighting through this battle just isn’t worth it.
Therefore, there’s never justification for limiting access and quality of care for anyone; all decisions should empower clinical time instead of stripping it all down to what’s financially viable for people who didn’t even enter this field expecting such adjustments anyway.