How much administration does health care really need?

Originally posted on Common Sense Family Doctor on February 7, 2022.

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During my residency in family medicine, one of the faculty was tasked with the challenge of teaching all of us the "practice management" curriculum, trying earnestly to make us understand how much of our time and energy in clinical practice would be consumed by administrative tasks. Even then, it struck me as borderline crazy how non-procedural physicians are paid. At the time I graduated from residency (2004) and for many years afterward, the financial value of an outpatient "evaluation and management" (E/M) visit was determined not only by the complexity, acuity, and number of medical issues addressed, but also by the number of body "systems" discussed and physically examined. Why the latter should have any relationship to how much money a patient and/or her health insurance company pays for an office visit was, and remains, beyond my comprehension.