McPherson Elizabeth, Zaleski Christina, Benishek Katrina, McCarty Catherine A, Giampietro Philip F, Reynolds Kara, Rasmussen Kristen
Department of Medical Genetic Services, Marshfield Clinic, Marshfield, Wisconsin 54449, USA.
Genet Med. 2008 Sep;10(9):699-706. doi: 10.1097/gim.0b013e318182206f.
Our work is the first documentation, in real time, of workflow in a general genetics department including data on patient care, research, and other activities for both clinical geneticists and genetic counselors.
All physician geneticists and genetic counselors in the medical genetics department used an electronic tool to record their activities in 15 minute increments during clinic hours, evenings, and weekends over a 10-week period.
The average work week was 54.1 hours for physicians and 43.5 hours for genetic counselors. During clinic hours physicians spent about one-fourth of their time on direct patient care, one-fourth on other patient-related activities, one-fourth on research unrelated to individual patient care, and the remaining fourth on all other activities. However, after hours and on weekends they spent most of their time on research. Genetic counselors spent half of their time on patient-related activities, one-fourth on direct patient care, and the remainder on all other activities. The total professional time averaged 7 hours per new patient and 3.5 hours per follow-up with nearly 60% of this time devoted to patient-related activities.
The labor intensive nature of clinical genetics, the large amount of time devoted to patient-related activities, and continuing limitations on billing by genetic counselors all contribute to the financial challenges faced by genetics departments.
我们的工作首次实时记录了普通遗传学部门的工作流程，包括临床遗传学家和遗传咨询师在患者护理、研究及其他活动方面的数据。
医学遗传学部门的所有医生遗传学家和遗传咨询师使用一种电子工具，在为期10周的时间内，按15分钟的增量记录他们在门诊时间、晚上和周末的活动。
医生的平均工作周时长为54.1小时，遗传咨询师为43.5小时。在门诊时间，医生将约四分之一的时间用于直接患者护理，四分之一用于其他与患者相关的活动，四分之一用于与个体患者护理无关的研究，其余四分之一用于所有其他活动。然而，在工作时间之外和周末，他们大部分时间用于研究。遗传咨询师将一半的时间用于与患者相关的活动，四分之一用于直接患者护理，其余时间用于所有其他活动。每位新患者的专业总时间平均为7小时，每次随访为3.5小时，其中近60%的时间用于与患者相关的活动。
临床遗传学的劳动密集性质、用于与患者相关活动的大量时间以及遗传咨询师计费方面的持续限制，都导致了遗传学部门面临的财务挑战。
