Do we really need more doctors?

Ask ten people in the hospital how to improve patient care and nine people will more than likely tell you: more staff, more nurses and definitely: more doctors.

I’m not sure whether this is true.

The following statement is true:

Doctors do not have enough time for their main tasks. But what are their main tasks?

In my opinion these should go in category 1:
  • talking to the patient
  • talking to their relatives
  • examining the patient
  • procedures that have to be performed by doctors
  • review exam results and
  • discuss the patient with other doctors and consults.

If we could focus our time solely on these tasks, we’d be fine. I don’t think anybody would demand more doctors.

But when I look at my day at work I notice that the tasks above probably only add up to 60% of my day. The rest is filled with tasks that could easily be performed by physician’s assistants, nurses (I’m gonna pay for writing this, big time…), secretaries   or non-medical staff.

Let’s call these tasks category 2:

  • writing ECGs
  • writing down orders in the computer/chart of the patient
  • drawing blood
  • preparation before procedures (e.g. central venous line: desinfection, preparing the table, booting the ultrasound, ordering the chest X-ray)
  • ordering radiologic exams (CTs, angiograms etc.)
  • check blood products and other medications for their expiration date. (I’m serious, that’s what have to do!)
So our main goal should be to exclude category 2 tasks from our task list. Nobody profits from doctors fulfilling these tasks. It raises hospital costs and it harms the patient.
Which counterarguments do we have to expect?
  1. “Doctors get so much money, they shouldn’t complain.”
  2. “Nurses already have no time for taking care of the patient, don’t give them anymore tasks!”
  3. “It’s good that doctors have to draw the blood, that way they have more contact to the patient.”
  4. “It has always been this way.”

While 1 and 3 can be easily argued against, the 2nd objection will cause emotions in any ward, which is why this discussion is avoided. But with a little bit of courage, we  can have this discussion and rethink whether the current to-do-list of a nurse makes any more sense than the doctor’s.

  • Putting a new patient in the computer system?
  • Preparing meals for patients?
  • Re-filling carts?

These are all tasks that can be don’t require a certified, highly qualified nurse. These tasks can be performed by assistants without medical knowledge.

We have to rethink how we are working in the hospital. The sentence „It has always been this way.“ should not be part of this process.