0%
of every clinic hour goes to the EHR and desk work.
A direct observational study of internal medicine found 49% of physician time was spent on EHR and clerical tasks during clinic hours, vs. 27% on direct patient care.
Stats · primary sources
The cost of the chart, in numbers we can cite.
Each figure links to a primary source. We update them as new evidence appears, and we note when our priors are wrong.
0.0hrs/night
of “pajama time” documenting after clinic.
U.S. physicians spend roughly 1–2 additional hours each evening on documentation — “work after work” — a leading driver of burnout.
0clicks
per ten-hour ED shift, just to chart.
An analysis of an academic emergency department found physicians made approximately 4,000 mouse clicks during a typical shift — the majority for documentation.
0%
of physicians report at least one symptom of burnout.
EHR usability is among the strongest predictors. The lower a clinician rates their EHR, the higher their reported burnout.
0min/encounter
spent on the EHR per patient encounter.
Median EHR time per encounter — chart review, documentation, ordering — across primary care.
0%
of physicians say EHRs contribute “greatly” to burnout.
Across recent surveys, a clear majority name the electronic record itself — not patient volume, not pay — as a primary stressor.
Methodology
Where possible we cite peer-reviewed direct-observation studies. Where survey data is used we say so. Numbers are rounded for legibility; underlying citations preserve full precision. Disagreements welcome — send a better source and we will update.
From the federal record
Public-domain reports we lean on.
GAO audits, AHRQ primers, HHS OIG investigations, and ASTP/ONC strategy documents. Federal works carry no copyright (17 U.S.C. § 105); we cite freely and link to the original.
Jul 2023 · GAO
Electronic Health Records: VA Has Made Progress but Continues to Face Significant Risks
GAO's running audit of the VA's $50B+ Cerner deployment. The throughline: cost overruns, patient-safety incidents, and adoption resistance from clinicians who can demonstrate, in detail, what the new system breaks.
“Until VA addresses these risks, future deployments are likely to encounter similar problems.”
Sep 2024 · AHRQ
Physician Burnout — Patient Safety Network
AHRQ's primer on physician burnout. Frames burnout as a patient-safety problem (not just a wellness problem), and names EHR documentation burden among the top operational drivers.
Jun 2022 · GAO
Medicare Advantage: Beneficiary Disenrollments to Fee-for-Service in Last Year of Life Increased Medicare Spending
Indirect but useful: GAO documenting how administrative burden in Medicare Advantage — including prior-auth-driven care delays — pushes seriously ill patients out of MA back into fee-for-service near end of life.
2024 · AHRQ
Diagnostic Safety — AHRQ
AHRQ's diagnostic-safety hub. Repeatedly identifies EHR usability and information overload as systemic contributors to missed and delayed diagnoses.
Apr 2022 · HHS OIG
Some Medicare Advantage Organization Denials of Prior Authorization Requests Raise Concerns About Beneficiary Access to Medically Necessary Care
OIG's foundational study finding that 13% of MA prior-auth denials reviewed met Medicare coverage rules. The denial machine is not merely inconvenient; it is, demonstrably, getting it wrong.
Feb 2020 · ONC
Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs
The closest thing the federal government has produced to an admission that the EHR mandate did not deliver what was promised. Five years on, most of its recommendations remain unimplemented.