Seven Habits for Reducing Work After Clinic

Sumana Reddy, MD; FAAFP, Peter Rippey, MD, CAQSM; Arnold Cuenca, DO, CAQSM, FAAFP; Sumi Sexton, MD; Troy Fiesinger, MD, FAAFP; Kenneth G. Adler, MD, MMM; Brandi White


Fam Pract Manag. 2019;26(3):10-16. 

In This Article

Abstract and Introduction


The administrative burden on family physicians is immense. Prior authorizations, quality reporting, formularies, refills, sign-offs, messages, documentation guidelines, and electronic health records (EHRs) can all frustrate physicians' efforts to focus on providing high-quality patient care. These administrative hassles undoubtedly contribute to the rise in "work after clinic" as well as physician dissatisfaction and burnout.

A recent study of four specialties, including family medicine, found that physicians in ambulatory practice spend one to two hours each night on EHR tasks or paperwork – not to mention all the time they spend on these tasks during the workday.[1] A separate study found that family physicians spend nearly 30 hours per month working on the EHR after hours, with activity peaking on weekends around 10 a.m. and again at 10 p.m.[2] This has been dubbed "date night with the EHR."[3]

But perhaps it doesn't have to be this way.

Changes are needed at the organizational and national levels to fix our broken system (see "What's being done to address administrative complexity?"). But in the meantime, physicians have to find ways to regain some control over their time and not burn out.

This article will share practical steps physicians can take to improve efficiency and reduce the amount of time they spend working after hours. These strategies are based on our collective experience and offer a variety of approaches to the problem depending on your personal work style, your practice workflow, your priorities, etc. It is our hope that, by focusing on what physicians can control and applying sound principles to our work, we can reduce the burden and restore the joy of practicing medicine.