Docs, tell me about your paperwork.

"Code Black" is a fascinating just-released documentary that follows several residents at LA County General Hospital emergency room, described as the busiest in the country and the originator of modern emergency medicine, over a period of years from their first days as first-year residents to becoming the seniors. During the filming they move from an old, antiquated facility to a new building. In the old space many federal and state regulations had been waived because they were impossible to comply with, but in the new space they are fully enforced, and for the docs it's a big adjustment. One doctor spent two minutes dealing with a trivial problem and then spent half-an-hour filling out the paperwork. Another doctor said that examining, admitting, treating and discharging a patient can generate as many as 50 to 60 separate forms, and since most of these people are uninsured, insurance forms aren't even part of the picture. Doctors are required to sign off computers if they step away for a minute, and they spend a lot of time logging back into the system. Patients wait as along as 15 hours to see a doctor, and some give up and leave. We see the doctors redesigning the waiting area and procedures to try to speed things up, but they are always overwhelmed.



Question: How much time do doctors spend on paperwork? How many separate forms could be combined? Are electronic records an advance, or a problem? How much more time would doctors have for patients if the paperwork load could be reduced? Etc., etc. (There could be a another discussion about how creating community clinics for small problems would allow ERs to focus on the serious stuff, but that would be a different thread.)

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