Time clock is an unwelcome presence

LETTER — Posted July 4, 2011

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I recently did something I have not done since 1969: I punched in at the office time clock.

The problem of the time clock is symbolic of serious changes in medical practice.

A long time ago, I worked in a factory, so punching in was the norm. As a surgeon, for all of my career, the tasks of recording time and monitoring vacations were done by clerical staff to support my mission of patient care. That support has eroded.

The hospital says federal law requires computerized records about work attendance and uses this as a rationale for punching in, which means sliding my ID badge through an attendance station.

It is not an alien task, as we slide badges through a similar box for CME credit for grand rounds.

It is the message associated with punching in that upsets me. I am there at any hour, but I still need to document my presence. I submit billing slips, but I still need to document my presence. I generate computerized notes at all hours of the day, including from home on weeknights, and I still need to document my presence.

Many doctors are concerned about resident work-hour restrictions, but I need to slide my badge in that time clock to prove I was on the job.

How far are we from sliding in and sliding out, meaning that hours restrictions will apply to everyone? Would any administrator have had the audacity to ask the great physicians of the last century to punch in? Would Dr. William Osler have complied? How about Dr. Michael DeBakey? What does this say about the future of medicine?

Jeffrey L. Kaufman, MD, Longmeadow, Mass.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2011/07/04/edlt0704.htm.

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