Clinic is for clinic. Not for forms.

Physician paperwork management is one of those problems we solve the wrong way by default: we do the form right now, in the room, because it just gets it done and off the mental to do list.

But this realistically isn’t easier in the big picture. It just feels that way in the moment.

The Cost of “I’ll Just Do It Now”

How many times have you been wrapping up a visit, rising out of the chair when the patient reaches into their bag and pulls out a novel of insurance forms? Heart instantly skinks. Energy immediately changes. Frustration (likely) jumps. You are now running four more minutes behind and clinic has barely started.

Or you’re between OR cases, in the middle of marking the next patient and someone needs a work note right now.

These are legitimate tasks. They are part of the job. But, great news, the job does not specify that they need to happen at that exact moment.

If we do one extra form per patient and see ten patients in a half-day, that is ten minutes of clinic time gone. Do that across a full week and it is easily an hour of unplanned administrative work squeezed into time that was already booked to the max. The lateness compounds. The stress compounds.

What a System Actually Looks Like

A colleague (a Canadian physician who runs a busy subspecialty practice) handles it like this: if a patient needs a work note or third-party insurance forms, they are directed to call her admin. Admin collects the paperwork, gets it into her EMR as a task and notifies her when it is ready to complete. Once she signs off, admin handles the return to the patient.

The patient knows what to expect. Admin knows what to expect. She knows what the expect and it’s not on her mental ticker tape in her head. Win-win-win.

That is not a complicated system. It is just a system. (This is another business-principle-applied-to-medicine, inspo from The E-Myth Revisited.)

Another approach: block dedicated time weekly for work notes, insurance forms, etc. Example: thirty minutes every Thursday morning. Patients who need paperwork are told it will be ready by end of day Thursday. They stop calling to follow up. Your admin stops fielding those calls. The forms get done in a focused window, not as an afterthought wedged between two consults.

The key in both cases is the same. The expectation is set upfront, you know there is a system so it’s not on your mind (or eating your clinic minutes) and everyone knows how it runs.

The Short Version

Does physician paperwork management actually reduce stress or does it just move the problem around? Personally, it reduces it. A lot.

When forms have a dedicated time and a clear process, they stop accumulating in the back of your clinic brain. You are not half-thinking about that insurance form while calculating where you are in the schedule and trying to listen to your next patient.

Should patients be told about this policy in advance? 100p, and early. Most patients are fine with it once they know what to expect and when they will get their paperwork back.

Will some patients still complain? Probably. But likely fewer than you think, and far fewer than when there is no system and things sit in some cracks.

Clinic is for clinic. Physician paperwork management works best when it lives somewhere else on the schedule with a process your whole office understands.

Dr. Kate Boehm, MD, MEd, FRCSC is a reconstructive plastic surgeon and the founder of DuplicateMeMD. She stubbornly believes that practice management is the key for female physicians to have better health, wealth and lives and to feel like it was all worth it.