If we think about what physicians do, the physician-patient interaction is what springs to mind first.
But … we do other things too … how much else?
We've had our home-grown messaging system in place for about 18 months now, and I just did a little analysis of some of the data in the system. We use the system for phone messages and patient – initiated e-mails. When a patient calls with a question, a message is generated to the nurse or physician. It's much better than paper messages – which we outlawed in the summer of 2002. An average of 71 messages were generated in the system per day. We have 2.5 physicians (2.0 until 11/03) and 2 nurses. The 2.5 physicians received an average of 42 messages a day — so about 15 messages per physician.
Some messages are just FYI: patient calls and nurse gives advice, sends FYI to physician.
Other messages represent work to be done — either calling a patient or calling a physicians or (ugh) calling an insurance company. This varies, but I find that when I call home with my ETA for dinner, if I have more than 10 items in my "in" box, It'll be more than 40 minutes to get home (I live about 90 seconds from the office).
The other work we do is review labs and make calls or send messages based on the lab results. Our labs are scanned in to our "in" box as well. In the same timeframe, we have scanned 42,562 pages — about 170 per day (about 70 per physician per day). Reviewing these takes time too.
When we did this work in the paper world, it was all represented by a pile of paper on the desk. Now we can quantify how much work this represents, and perhaps we can figure out how much time to expect this to take — which would ultimately determine how we budget our time and human resources.
.. no wonder I'm up so late …