Why Your Family Physician is Doing More Paperwork

Physician Culture Inside and Outside the System

As a board-certified family physician who’s practiced medicine for 11 years in the Fishers area, I’ve delivered health care in a typical family practice office, as part of a hospital network and through an employee-based clinic. Now, as a direct primary care physician who runs my own practice at Fishers Direct Family Care, I believe I’ve found the best way to deliver high-quality patient care.

I was born and raised in Fishers and went to New York for medical schooling. In my first job as a practicing family physician, I worked in a hospital network in Indianapolis. While the culture in the hospital network was positive for physicians, the system placed so many burdens on physicians as they saw patients. The network tended to focus on asking physicians to see as many patients as possible and completing administrative work, from quality reporting to Electronic Health Record (EHR) work to seeking prior authorizations for payment.

That focus on patient volume and massive amounts of paperwork really puts a strain on physicians, many of whom only want to deliver the best health care.

Quantity vs. Quality: How Physician Culture Changed Over Time

This type of physician culture, where patient volume and paperwork outweigh best healthcare, has gradually increased over time. I started practice in 2007, and the extra burdens placed on physicians were much less then.

Over time, the work involved in maintaining electronic medical records, as part of the EHR policies passed in 2009, has resulted in many changes for health insurance providers, Medicare and other government payers. It also increased the workload of physicians. Our hospital network increased the nursing and administrative staffs to try and ease those burdens on physicians, but ultimately a lot of the responsibilities fell on the physicians.

In my opinion, these additional burdens on physicians provide no clinical value. Physicians want to take the best care of their patients, but many like me found ourselves doing more work that didn’t involve caring for the patient’s health. Instead, the work was related to payment, EHR, and other things that didn’t affect the outcome of the patient’s care.

Why Did You Choose Direct Primary Care?

I wasn’t surprised or shocked by the physician culture in the hospital network, but I soon realized I couldn’t care for my patients in the best way possible by staying within that system.

While physicians want to take good care of all patients, there are always trade-offs. Either we’re going to rush through visits to get all of our work done or spend more time with patients and take work home at the end of the day, which takes away from our family and personal life. So, it’s a constant struggle for physicians interested in delivering quality care to stay in that system.

Working as a physician in a direct primary care practice is completely different. The only person I am responsible to is the patient themselves, as there’s no interference with insurance companies, governmental payers or hospital networks. It’s just myself and the patient in the exam room and we take the time we need. That’s really a refreshing change to the way it was in my prior experience.

My job satisfaction has improved tremendously since starting my own DPC practice. I have the time to care for my patients in a comprehensive manner and I’m not getting interference from outside parties, whether it’s a hospital system, government payer or whatnot telling me what to do with the patient. I can do what I feel is best for them.

There are differences between being an employee versus running your own DPC practice, which brings its own challenges; however, the rewards far outweigh the hassle and headache you get when treating patients in a traditional setting.

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