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We have physicians on our medical staff who do not complete their medical records on time. What suggestions do you have to address this problem?

Medical Staff Legal Advisor, December 16, 2004

You are definitely in good company in struggling with getting physicians to complete their medical records in a timely manner. Here are some examples of approaches that have proven successful in other organizations:

 1. Set and communicate clear expectations:  Both in initial orientation, at periodic meetings, and at reappointment, be sure to clearly identify expectations for physicians to complete their records in a timely, legible, and adequately thorough manner.
2. Provide feedback. Develop a periodic report, by physician, of incomplete charts. Share the report with the physicians and the department chair. You may need to "unblind" the data to get real movement, but most physicians don't like to be shown to be an outlier, even on medical records completion.

3. Establish a carrot. Some medical staffs have utilized quarterly and annual drawings for prizes to motivate physicians to complete their records. The names of all physicians who have not been on the suspension list in the previous quarter (or year) get placed into a bowl and one or more are drawn to receive significant prizes. I've seen a medical staff give awards of $500, $750, and $1,000 to their prize winners.  Others have given an all expenses paid weekend at the Ritz-Carlton. These types of prizes have an amazing effect on getting medical records done in a timely fashion.
4. Establish a stick. You should have a clear policy that simply states that whenever a physician goes on the suspension list five times in a 12-month period, it is deemed a voluntary withdrawal from the medical staff. You usually only have to use this stick once, and the rest of the medical staff will get the message. 

Remember, it is usually only a small number (on average about five) physicians who are responsible for the bulk of your incomplete records.  Showing them they are different, sometimes even publicly, is a powerful tool for motivating change.