Designing and Regulating Wisely: Removing Barriers to Joy in Practice
Authors: Christine A. Sinsky
Journal: Annals of Internal Medicine (2017)

Editorials2 May 2017Designing and Regulating Wisely: Removing Barriers to Joy in PracticeChristine A. Sinsky, MDChristine A. Sinsky, MDFrom American Medical Association, Chicago, Illinois.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-0524 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Policy, regulation, and information technology are 3 external levers that have been applied to clinical practice in an effort to create better value in health care. Yet, like clinical interventions, these initiatives may have adverse unintended consequences for patients and their care teams.In response to these outside forces, the daily work of physicians and their teams has increasingly been oriented around administrative tasks, such as prior authorizations, computerized order entry, billing-related documentation, compliance, and performance measurement. This orientation is associated with costs that only recently have been quantified. For example, administrative tasks associated with reporting performance measures alone are ...References1. Casalino LP, Gans D, Weber R, Cea M, Tuchovsky A, Bishop TF, et al. US physician practices spend more than $15.4 billion annually to report quality measures. Health Aff (Millwood). 2016;35:401-6. [PMID: 26953292] doi:10.1377/hlthaff.2015.1258 CrossrefMedlineGoogle Scholar2. Sinsky C, Colligan L, Li L, Prgomet M, Reynolds S, Goeders L, et al. Allocation of physician time in ambulatory practice: a time and motion study in 4 specialties. Ann Intern Med. 2016;165:753-760. [PMID: 27595430]. doi:10.7326/M16-0961 LinkGoogle Scholar3. Friedberg MW, Chen PG, Van Busum KR, Aunon F, Pham C, Caloyeras J, et al. Factors Affecting Physician Professional Satisfaction and Their Implications for Patient Care, Health Systems, and Health Policy. Santa Monica, CA: RAND Corporation; 2013. Google Scholar4. 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Ann Intern Med. 2017;166:659-61. doi:10.7326/M16-2697 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From American Medical Association, Chicago, Illinois.Disclosures: Author has disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-0524.Corresponding Author: Christine A. Sinsky, MD, American Medical Association, 330 North Wabash Avenue, Suite 39300, Chicago, IL 60611; e-mail, christine.[email protected]org.This article was published at Annals.org on 28 March 2017. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPutting Patients First by Reducing Administrative Tasks in Health Care: A Position Paper of the American College of Physicians Shari M. Erickson , Brooke Rockwern , Michelle Koltov , Robert M. McLean , and Annals On Call - Barriers to Joy in Medicine Robert M. Centor and Christine A. 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Moyer, MD, and Christine Laine, MD, MPH 2 May 2017Volume 166, Issue 9Page: 677-678KeywordsComputersHealth careInformation technologyMagnetic resonance imagingMedical educationMotivationPatientsPerformance measuresPopulation statisticsSafety ePublished: 28 March 2017 Issue Published: 2 May 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...