National survey of pediatric care providers: 70% of trainees experience stress due to documentation

Results from a national survey of pediatric care providers recently published in Clinical Pediatrics highlight the increasing burden of documentation and the need to include coding and billing skills as part of the medical curriculum.

To assess the amount of time spent on documentation in pediatric practice and providers’ understanding and comfort level regarding billing and coding, survey data was collected from 601 members of the American Academy of Pediatrics Section of Pediatric Trainees practicing in the U.S.

The survey was sent to participants via email and consisted of 24 multiple-choice questions designed by the researchers to:

• Gather demographic data from respondents (i.e. gender, age, practice details, subspecialty, and level of training)
• Assess the amount of time providers spend on direct care and documentation in inpatient and outpatient settings
• Evaluate respondents’ perceptions about the utility and accuracy of their documentation
• Subjectively assess the impact of coding and billing in physician practices

The results showed that one third of respondents reported spending more than half of patient encounter time in the outpatient setting on documentation. This number was significantly higher at 62% for encounters in the inpatient setting.

Documentation was a major source of stress for physicians in inpatient and outpatient settings. Over 70% of respondents either agreed or strongly agreed that documentation and billing add stress in practice.

Additionally, 59% of respondents either agreed or strongly agreed that they are apprehensive about medicolegal issues regarding charting. There was a significant positive correlation between reported feelings of apprehension about documentation including potential medicolegal issues and reported feelings of stress due to documentation.

The results also suggested a need for physician education on medical coding and billing. Sixty-two percent of respondents reported having no prior coding and billing training yet over 70% of respondents felt coding and billing education should be included in the medical curriculum.

The survey results have implications for hospitals and physician practices, which may benefit from taking measures to reduce documentation burden and increase providers’ knowledge of professional billing and coding.