How AI is NOT helping those doctors left in the system

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This recent study in JAMA was eye-opening. The researchers wanted to see if AI scribes help with how much these doctors need to use their EHR. It also looked at how it affected visit volume. This is what they measured: “Total time spent on the EHR, time spent on documentation, and time spent on the EHR outside scheduled hours or on unscheduled days, all normalized to 8 scheduled patient hours; weekly visit volume.”

Awesome stuff. The admins really wanted to help these docs who were working in 5 academic centers.

Or did they?

The findings:

AI scribe adoption was associated with 13.4 (95% CI, 9.1-17.7) fewer minutes of EHR time, 16.0 (95% CI, 13.7-18.3) fewer minutes of documentation time, and 0.49 (95% CI, 0.17-0.81) additional weekly visits delivered. Electronic health record time outside work hours did not change significantly. Changes associated with AI scribe adoption were greatest for primary care specialists, advanced practice clinicians, female clinicians, and clinicians who used AI scribes in 50% or more of visits.

So, it cut on EHR and documentation time a little. Great. But add an extra visit every other week. So, that was a trade-off to do more work. More importantly, it didn’t cut down on EHR time OUTSIDE of work! They were still stuck doing pajama work.

Here is my issue with all this. First, bogus metrics and quality indicators, all proven to do nothing but make the system more money, fill much of these doctors’ time in the system. That never changes for those trapped in the industrialized medical model.

Second, the more time given back to these doctors will be allotted to seeing more patients. And that is the goal for those poor docs grinding away. Their time will never be given back to them to see patients longer or to actually take a breather.

It’s a zero sum game unless these doctors leave and do Direct Care. Then those physicians can use AI (as scribes or whatever) to do better care, be a better doctor, or take care of themselves.

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About Douglas Farrago, MD

Dr. Farrago is a retired family physician based in Forest, Virginia. Since 2021, he has run DPCnews.com, a leading resource for the Direct Primary Care (DPC) movement. He is the author of three best-selling books on Direct Primary Care: The Official Guide to Starting Your Own Direct Primary Care Practice The Direct Primary Care Doctor’s Daily Motivational Journal Slowing the Churn in Direct Primary Care (While Also Keeping Your Sanity) In 2016, Dr. Farrago conceived the idea for the Direct Primary Care Alliance and co-founded the organization alongside other pioneering DPC physicians. He is widely recognized as a leading expert in the DPC model and frequently lectures to medical students, residents, and practicing physicians on how to successfully start and run their own DPC practices.Dr. Farrago sold his Direct Primary Care practice in October 2020 but continues to receive care there as a patient.