Hospital doctors spend three hours a day on bureaucracy

Doctors in hospitals in Berlin, Germany, spend an average of almost three hours per working day on documentation work. This was the result of a survey conducted German Hospital Institute (DKI).

This figure (2.9 hours) applies to doctors working in general hospitals. Similar times arise for doctors working in psychiatric hospitals.

Nursing staff are therefore busy with bureaucracy for around 2.7 hours per working day; in psychiatry, this figure is lower for nurses. A total of 98 psychiatric hospitals and 225 general hospitals with 50 beds or more took part in the survey between 24 and 29 July.

Considering an average of about 40 hours per week, a hospital doctor would be busy with bureaucracy for 36 percent of his or her working time. For psychiatric doctors it would be the equivalent of 33 percent.

Calculating the total number of doctors working in hospitals (165,000 in 2022), more than 59,000 doctors would be busy with documentation tasks alone, explained DKG CEO Gerald Ga today when presenting the results.

According to the calculation, more than 116,000 full-time nursing workers (a total of almost 343,000 in 2022) would be completely blocked by bureaucratic tasks.

If bureaucratic tasks could be reduced by one hour a day, 21,600 full-time medical professionals would be laid off, added Henriette Neumeyer, vice president of the German Hospital Association (DKG).

The President of the Berlin Medical AssociationPeter Bobbert, declared bureaucracy, was a danger to us all. You can’t afford it anymore. It costs money and joy in our medical profession and it costs manpower, says Bobbert.

Today, every doctor is needed and if they can get rid of one hour of bureaucracy every day, more than 21,000 doctors could be created overnight. We are looking for new doctors and we will find them by cutting red tape, he said of the shortage of skilled workers.

Don’t lower quality standards

Bureaucracy not only burdens patient care, but is also extremely costly, Ga explained. Hospitals are in an extremely tight financial situation, so clinics and staff need to be freed from unnecessary regulations.

These measures would not cost health insurers any money, Ga stressed. For him, it is not about lowering quality standards, but rather about reducing bureaucratic requirements that have no impact on patient care or could even harm it.

The DKG has developed corresponding proposals to reduce bureaucracy and made them available to the Federal Ministry of Health (BMG), Neumeyer explained. She complained that a law to ease bureaucracy in the health sector is still missing.

At the beginning of November last year, Federal Health Minister Karl Lauterbach (SPD) announced that a draft… Law to debureaucratize the health system before Christmas 2023placed should be. However, this has not yet happened and there are still no key points for such a project.

One example of how to reduce bureaucracy would be to avoid redundancies in Medical Service (MD) tests, Neumeyer suggested. Hospitals often need to document similar requirements across different procedures. Here, specifications could be shortened and the validity of test cycles extended to equalize the time of testing procedures.

Collective applications and longer intervals between exams

In addition, a more practical procedure for requesting new tests and treatment methods is needed, Neumeyer explained. By 2024, hospitals would have to submit individual requests for 982 different procedures in order to be able to use the corresponding methods.

The clinics submitted more than 120,000 individual applications. In 2019, around 60,000 applications were registered for 709 procedures. This development can also be seen as positive, as more new methods are becoming available, says Neumeyer.

However, individual requests have created a significant bureaucratic burden. Instead, there should be collection procedures that hospitals can adhere to, Neumeyer suggests. In addition, requests should not be repeated annually.

Bobbert also emphasized that structural tests of the MD are necessary. But the important question is how to do this. He criticized the double tests that the clinics had to carry out in a short space of time. He called on Lauterbach to keep his word and courageously review the structures of the health system. For every new bureaucracy, the old ones have to give way, Bobbert emphasized.

Central registry required

It would make sense to have some sort of central registry where data such as doctor numbers could be stored. Bobbert also suggested that hospitals should communicate changes in the future, rather than having to transmit the same data regularly.

The hospital reform envisages the introduction of a database that the Federal Medical Service will have to operate. Test results and notifications are to be grouped there. Furthermore, according to the current state of the hospital reform, random checks should be carried out in future instead of individual case checks.

A survey carried out by the Rhineland-Palatinate State Chamber of Nursing last year also showed very similar results to the DKI survey, explained Andrea Bergstrer, vice president of the Rhineland-Palatinate State Chamber of Nursing and director of nursing at the West Palatinate Hospital.

Along these lines, the second most cited reason for nursing workload is high administrative costs. Seventy-three percent of respondents said this was a particular burden, Bergstrer said. According to Bergstrer, 39 percent of respondents see the burden of documentation as a reason for changing jobs or even abandoning their career. Given the current shortage of care, this is a major problem for our society, Bergströmer explained.

The Marburger Bund also asked its members about the burden of bureaucracy in 2022. The survey showed at the time that… About a third of doctors are busy with more than four hours of paperwork every day. In 2013, according to an older MB survey, 8% said it took them more than three hours to do this. © cmk/aerzteblatt.de