I saw five patients this morning. I checked 35 boxes on various pieces of paper; wrote some type of diagnosis or classification 25 times; and printed or signed my name 20 times. I dictated nine letters, each of which will have to be corrected. And oh "by the way," none of the children had anything seriously wrong.
Imagine Frederic Taylor standing over me with a stopwatch doing one of his famous time-motion studies during my four-hour morning clinic. In that time, 148 minutes (2.5 hours) were consumed by the administrative tasks above, leaving 1.5 hours for the five patients. Per patient, that is 18 minutes to: take a history; do a physical exam; evaluate records; make a diagnosis; and discuss with the family. No time left...for the patient. Certainly no time to think.
There is a technique called value chain analysis that every successful manufacturer uses. You assess each step in the process, determine the relative value of each, and eliminate those steps that add no value. If you did value chain analysis on my morning, the study would show that over half of all my time (2.5h/4h = 62.5%) was spent on non-value-adding steps!
You say you have no sympathy for me? Because I get paid well? Think again. You should feel righteous anger. Smoke should be coming out of your ears. All that non-value-adding time was stolen from YOU. That is time the doctor couldn't spend with you, time you still had to pay for. Where do you think 30% of all your healthcare dollars go? Each year, you shell out $500 billion that does NOT go to providers, hospitals, pharmaceutical companies, wheelchair manufacturers, etc. It just disappears in the middle, but you still have to pay for it.
Lest you think this wastage is all insurance companies, red tape and redundancy, think again. A major part of that non-value-adding $500 billion per year is the cost of regulations, most of which are worthless. None (!) are proven to work.
Have you ever heard of the torture technique called death by thousand cuts? Any single cut is small but the sum total causes great pain and the person dies from blood loss. That is what is happening to healthcare: death by a myriad of little cuts. And if healthcare dies, whether by drowning or by a thousand cuts, it is YOU the patient who will suffer.