Over at KevinMD, Ed Volpintesta, MD, wrote a great post titled “What’s a typical day of a primary care doctor like?”
In the post, Dr. Volpintesta, an internal medicine physician who has practiced medicine for 35 years, describes his typical day. He admits “there is no such thing as a “typical” day. Each day is different. But the administrative demands and coordination of the human drama are matters with which all doctors are familiar.”
Even before arriving at his office, Dr. Volpintesta is doing administrative work: typing up a complicated case. Once at the office, he “fills out and faxes four fax requests from pharmacies for refills.”
Reading the post, you’ll note the doctor spends most of his day performing administrative work and coordinating patient care. He juggles patients that come into his office while responding to faxes, calling patients, following up with other doctors, filling out forms, filling out more faxes for pharmacy refills, and having his nurse fax forms.
I re-read the blog post and counted ten patients seen during the course of the day (8 a.m. to 4:30 p.m.). Dr. Volpinesta also worked with twelve patients, either by speaking with them directly or following up with specialists, clinics, other appointments and insurance.
So, during the course of one very full day, he treated twenty patients. Notes Dr. Volpinesta:
Much of the time that I spent with my patients was administrative. It was time-consuming and tiring. Most primary care doctors, have similar “typical” days. Some are much busier and see a wider range of diseases and patients. Some still make hospital and nursing home rounds as I once did. Some have weekend hours and night-time hours. Their practice styles depend on their skills and their financial goals and their ages…the time and energy consumed represents a dimension of health care that goes beyond technical competence. Insurers do not acknowledge the value of these services and rarely compensate primary care doctors for them.
Reading the blog post as entrepreneurs looking for ways to help doctors spend more time with their patients, we see there are multiple opportunities to free up the doctor’s time and eliminate administrative duties. A physician with a tablet-based practice would be able to handle most of the administrative duties with iPad/iPhone apps or optimized web sites taking advantage of HTML 5 technology. That would mean no need to sign a document, no need to fill out separate faxes to other doctors, clinics, or insurance providers. In addition, the applications should have sample ordering capabilities built in to remind the doctor, when appropriate, that samples are a click away.
Seth Godin recently wrote a blog post called Pest Control in which he states, “Your doctor now spends more of her time doing more non-medical tasks than ever before. Dealing with insurance companies, lawsuits, other doctors, partners and yes, marketing.”
Seth concludes that post by saying: “A big part of doing your work is defending your time and your attention so you can do your work.”
Today’s HCP faces big problems administratively. Fortunately, with a bit of smarts, many of the time-consuming tasks could be eliminated or reduced, leaving from time for physicians to focus on what they need to focus on — their patients.


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