title: American Society of Clinical Oncology 2001 Presidential Initiative: impact of regulatory burdens on quality cancer care.
abstract: OBJECTIVE
  This study was conducted as part of the American Society of Clinical Oncology (ASCO) 2001 Presidential Initiative to assess the administrative burden of payer documentation requirements and their impact on oncology practice.
  
  
  METHODS
  The study consisted of a physician questionnaire and an activity log. Site visits were conducted to support survey data. Analysis included 2,493 questionnaires and 1,115 activity logs; data were also collected from site visits to 10 oncology practices.
  
  
  RESULTS
  Increased documentation was the greatest concern among respondents, greater even than the stress of dealing with death and dying. More than 97% of survey respondents reported an increase in documentation (averaging 1.4 h/d) and 77% reported an increase in work hours because of documentation in the past 5 years. As a result, more than 40% of respondents reported decreases in key aspects of patient care and decreases in teaching (48%) and research (39%). Site visit data demonstrate similar trends.
  
  
  CONCLUSIONS
  It is critical to find ways to decrease physician burden without decreasing the ability to prevent fraud and abuse. Reforms include provisions in a recently passed bill in the United States House of Representatives to streamline Medicare regulation and increase physician education. To address oncology-specific concerns, changes also should be made to supervision requirements for residents and fellows and evaluation and management documentation for oncology follow-up visits.
authors.affiliation: American Society of Clinical Oncology, Alexandria, VA, USA. leinhorn@iupui.edu
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Einhorn
authors.forename: Jenifer
authors.initials: J
authors.lastname: Levinson
authors.forename: Susan
authors.initials: S
authors.lastname: Li
authors.forename: Laurie
authors.initials: L
authors.lastname: Lamar
authors.forename: Deborah
authors.initials: D
authors.lastname: Kamin
authors.forename: Dan
authors.initials: D
authors.lastname: Mendelson
mesh_terms: D004282:Documentation / Q000706:statistics & numerical data*; D008495:Medical Oncology / Q000592:standards*; D006278:Medicare / Q000331:legislation & jurisprudence*; D011216:Practice Management, Medical / Q000639:trends*; D011996:Records; D011795:Surveys and Questionnaires; D014481:United States; D016526:Workload