Jump to content

How much work do you do at home?


Recommended Posts

I'm a relatively new grad and have been working in primary care for about 7 months now. I see about 15 patients/day and I am feeling overwhelmed by the amount of work I have. I write most of my notes write after seeing the patient, but usually by the end of the day I still have a couple things to finish on some notes. On top of that I have telephone encounters, labs, documents, and refill requests to review. I also like to prep my charts the day before so I know what I'm going to be seeing the next day. All of this amounts to being at work from about 7 AM (going in 1 hr early) to 5:30 PM and then doing about an hour of work at home. Lately I've been feeling like most of my life during the week is just work. I also don't think this situation is just because I'm new. The MD and PA I work with, both with 20 yrs of experience, do the same thing. It's making me feel burnt out from primary care and I've hardly just started. 

How much work do you do at home each day? What specialty are you in?

Link to comment
Share on other sites

37 minutes ago, mgriffiths said:

zero - work in FP and see on average ~20 patients...of course it varies some, like today I saw 28.  It was h3!!, but in the door at 7:55am (start at 8am) and out the door with my desk 100% clear at 5:30pm (last patient scheduled 4:40 or maybe 4:50).  Usually I'm out the door between 5-5:15pm.

Any tips for doing this? I feel like most of my day is spent just seeing patients and this leaves little time for labs, call back, documents, refills, etc. 

Link to comment
Share on other sites

Don't do any work at home.  Are you thinking "I'll just finish this at home"?  Because that might lead to you (maybe unconsciously) either working slower at work or actually putting it off until you get home- because you know you have a safety net, you slack off a bit and use your safety net as part or your work flow.

Aside from that, try tightening up your work flow.  Where are areas that are time wasters?

Are you using ancillary staff appropriately, to relay normal labs?  Do you have Ros check off sheets either in the waiting area or with the lpn?  

Do you dictate?  If you type, do you have a template you can use?  

Do you send out your own lab result letters?  

 

  • Upvote 2
Link to comment
Share on other sites

44 minutes ago, EMEDPA said:

zero. working from home is working for free unless you have X hrs of admin time/week built in to your schedule. If it is the last hr of my shift and I am behind on charts I only pick up people who are dying or very simple(UTI with + ua already done).

You mean we can get paid for doing this!?

Link to comment
Share on other sites

I used to take work home like 7-10 charts but have found that if I do I spend hella more time trying to finish at home than if I stay after work. Today I was swamped! Messages were crazy (been crazy all week) and I'm covering another provider while he basks in Disneyland with his family lol.

I had 11 charts to finish. If I took that home it would probably take me a good 3 hours to finish. I stayed after work and finished all those charts answered all my messages and the one I'm covering's inbox and resulted out all my results and his in under 2 hours.

Now I'm home chillin' watching the warriors game and just had a wonderful dinner and cheesecake for dessert [emoji39][emoji513][emoji106][emoji1690]

I refuse to take work home.

Sent from my SAMSUNG-SM-G891A using Tapatalk

  • Like 1
Link to comment
Share on other sites

Yes - taking work home all the time is a recipe for burnout 

At my institution there’s a big push for HCC coding for risk adjustment so we have the additional burden of “missed coding opportunities “ being monitored AND posted daily .

this is obviously causing even more documentation requirements / headaches 

yep - done with primary care and time to move on 

 

 

  • Like 1
Link to comment
Share on other sites

14 hours ago, Paigems said:

Any tips for doing this? I feel like most of my day is spent just seeing patients and this leaves little time for labs, call back, documents, refills, etc. 

Our EMR is terrible compared to some of the ones I used while in PA school, but it allows for templates - I have many, I think at least twice the amount of the next provider in the practice.  I even invested the time to make some that I don't use that often, but it keeps me from having to search for buttons in the ROS and PE portions of the EMR (I hate point and click medicine).  My second biggest time saver.

I also have a TON of "auto-replace text" - I type three letters and the computer automatically inputs several sentences of information.  This is a wonderful thing that so many of my co-workers do not take advantage of...BY FAR MY BIGGEST TIME SAVER!!!!!

Beyond those two items, I almost never leave the room or allow the patient to leave until the chart is completed and closed.  If I leave the chart open it is because I am reminding myself about something.

My MA is awesome, which is the #1 reason I am sad to leave my current job, also why I have given her a portion of my bonus each time I have earned it.  This has made her the highest paid MA in the practice BY FAR and kept her from looking around for other positions just for a raise.   But, I also require quite a bit.  She takes care of 100% of all paperwork for me and then I sign.  She does prior auths, finds diagnosis codes when insurance companies are stupid (ALL THE FREAKING TIME!!!!), etc.  She calls patients with results, I only call if it is something serious, but usually if it is serious enough for me to call it means they really need an appointment so I don't call.

Now for the kicker...I feel that I am a compassionate provider and am more than happy to sit and talk with patients.  I have a personal relationship with many of them, knowing about their families, interests, jobs, etc. and they know about my family.  It is truly wonderful, but I also DO NOT just sit and talk forever.  When needed I keep the appointment on topic and focus on the topic at hand.  When a patient brings in a list of topics to discuss I make it clear that we can only do a few.  When a patient just continues to bring up issues, after the first 2-3 I tell them that our appointment is over and if they have further concerns they need to make another appointment.  The vast majority understand, they may not like it, but they understand.  Those that don't understand don't come back...fine by me.

  • Like 2
Link to comment
Share on other sites

Zero.  No stress, default entries for the EMR and our limited SOP and their applicable PE’s.  No refills or patient calls since I’m not their PCP.  Last patient is thirty minutes before close and I’m usually done no later than 15” till, assuming there is that last slot patient.  37.5 hours/week full time.  I may check something from home with our cloud based EMR 1-2x/year, maybe.

Edited by GetMeOuttaThisMess
  • Upvote 1
Link to comment
Share on other sites

Our healthcare system has the option for using vpn entry into the emr system via home laptop or cell phone. I have neither as I refuse to do any work at home. 

I typically do spend 30 minutes to 1 hour after my last patient in the office to finish charting, responding to calls, looking at results and refills which is unpaid work time unfortunately. I am suppose to work 8 pm to 4:30 pm. 1-2 days out of the week I am able to head home on time though which is a plus.  Your hours don't sound like outliers for primary care though to tell your the truth. I wonder if you are overcharting since this is your first year? Do you have a charting efficiency officer in your system to help and analyze your workflow and documentation?  

Templates and dot phrases or short cuts for long paragraphs towards documentation and prescriptions also help. My nurse also is a tremendous help with prior auths and making calls. I only call personally if the results are life altering such as need for hospitalizations or diagnosis of cancer. 

Link to comment
Share on other sites

  • 2 months later...

At the UC I worked prn for in WA, our scheduler would pay me for charting at home, though usually this averaged 15-30 minutes per shift. i got this for being hourly, full timers were salaried and paid per shift so they tried not to. 15 patients per day sounds fantastic... I have seen many primary care positions expecting you to see 25-30 ppd, so you are likely 1. Inefficient with the EMR,  2. over charting, 3. Spending too much time with the patients. h&p for most standard primary care patients should be 5-10 minutes...your MA/lpn/scribe should have most of the history done for you before you walk in the room if they are good/well trained....whcih leaves you 10 minutes for your plan and 10 minutes to chart....total 30 minutes per patient X 15 ppd = 7.5 hours. There will always be complicated patients who take longer but they should be the exception not the norm unless your in internal med or at the VA. 1-2 complaints per patient other than med refills. If time allows because of and easy complaint that take a minute or 2, then 3 complaints tops.  

Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

×
×
  • Create New...

Important Information

Welcome to the Physician Assistant Forum! This website uses cookies to ensure you get the best experience on our website. Learn More