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Jump to Key Points Every doctor can get bogged down with an endless daily to-do list consisting of everything from pre-authorizations and prescription refill requests to handling in-box messages from the patient portal, and endless electronic health record tasks.
These critical (but often invisible) tasks done “behind the scenes” usually take place before patients arrive in the early hours of the morning or at home late into the night — and are drivers of both burnout and exhaustion, with much of this non-patient work spilling into weekend and weeknight hours.
About Medscape Insights
Medscape continually surveys physicians and other medical professionals about key practice challenges and current issues, creating high-impact analyses. For example, in Medscape’s State of the Medical Profession Index Report 2026:
- 7 in 10 doctors surveyed were dissatisfied with their ability to manage one-on-one time with patients.
- Physicians rated satisfaction with record-keeping and admin tasks very low, with little optimism for improvement in the next 5 years.
- Doctors surveyed also expressed low satisfaction with admin’s ability to support them effectively.
“Sadly, this ‘work after clinic,’ which some providers call ‘WAC,’ is the stuff from which burnout stems,” Katie Takayasu, MD, a family physician in Darien, Connecticut, said. “Patient care is what actually fuels our fire but paperwork, especially insurance-mandated prior authorizations and logins to different systems to get patients what they need, is where providers lose steam.”
Fact is, much of this important work can’t be accomplished during regular patient time or clinic hours because it’s too time-intensive — and with the American Medical Association estimating that documentation and administrative tasks comprise about 35% of a doctor’s working hours — each week, the question remains: exactly when will this work get done?
“This usually means these tasks get pushed to nights and weekends when most of us should be relaxing, enjoying our families, or in some form of recovery for our nervous systems,” Takayasu added.
This is an industry-wide problem, not just an individual one, said Gary Price, MD, president of The Physicians Foundation, a public charity seeking to advance the work of practicing physicians and help them deliver high-quality healthcare to patients.
“The most important thing we need to do is to convince those who manage healthcare that the well-being crisis we have is a really significant problem from a financial standpoint, too,” he said. “It costs $500,000 to $1 million to replace a physician, and doctors are leaving clinical practice at higher rates and at younger ages than they have before.”
A Day in a Doctor’s Life
Ask Cassidy Rose Hood, MD, practice chief at Greenville Family Medicine in Greenville, South Carolina, and she’ll tell you her days are busy and every minute is accounted for, especially from 7:30 AM to 4:30 PM, when patients are booked for scheduled appointments.
“You will commonly find me arriving at the office at 7 AM, working through lunch, and staying until 5:30 PM,” she said. “That’s when I answer patient calls, complete prior authorizations, address MyChart messages, complete medical documentation, sign and renew home health and physical therapy orders, review lab and imaging results, and send medication refills.”
That said, Hood said she has managed her workload by intentionally structuring her workday to ensure efficiency, all while making sure to keep her patients’ needs a top priority.
“This involves collaboration with my clinical and support staff, including my RNs [registered nurses], CMAs [certified medical assistants], PSRs [patient service representatives], office managers, and supervisors, to secure streamlined clinical workflows when patients contact the office,” she said. “In addition, the implementation of AI into clinical practice has improved the timeliness of medical documentation and MyChart messaging.”
For Hood, remaining committed to leaving the office at 6 PM to eat dinner with her family, including her golden retriever, is nonnegotiable. Over time, she has also learned to accept the fact that if she is unable to complete every task, she’ll have to roll those clinical responsibilities over to the next day’s to-do list.
“It’s tempting to take my computer home and work through the evening to finally say ‘I’m done,’” she said. “I strive for my home life to be a place of peace and rejuvenation, and I’d rather accept the outcome of being behind than have a brief sigh of relief of, ‘I’m done,’ while missing priceless moments at the dinner table.”
Finding a Pathway to Balance
Given all of this, the goal of achieving some semblance of work-life balance is more elusive than ever. This is also reflected in another recent report, where nearly 6 in 10 doctors said they’d take a pay cut to improve their work-life balance.
Nadia K. Sirdar, MD, MPH, who spent a decade working as a hospitalist before opening Bethesda Modern Primary Care, her own private practice in Bethesda, Maryland, changed the entire way she practices medicine and said she has only achieved some sort of work-life balance since she went out on her own.
“Now that I’m in private practice, everything is on my own terms,” said this third-generation physician and mom of three kids aged 13, 11, and 6 years. “And when I do work at home, it’s because I want to and I am investing in my patients’ well-being long-term, which if you think about it, if they’re better cared for, there are fewer after-hours emergencies.”
Douglas Monasebian, MD, a plastic and reconstructive surgeon in New York City, believes that what’s worked best for him over the course of his 30 years in private practice has been to build a team he can rely on, from nurses to office managers, and delegate tasks to them, while always staying in close communication about daily tasks.
“Ultimately, everything comes down to me, but it truly helps to surround yourself with good people who think and act like you,” he said.
For Takayasu, there’s a way to reframe work-life balance, adding that many doctors have it backward when it comes to finding ways to balance the stresses of the job with a life that’s happy, fulfilling — and less stressful.
“The only way to create life-work balance is to decide what you want from your life first and then build your work around it,” she said. “Most physicians do the reverse.”
The experts cited in this article had no relevant disclosures.
Lambeth Hochwald is a New York City-based journalist who covers health, relationships, trends, and issues of importance to women. She’s also a longtime professor at New York University’s Arthur L. Carter Journalism Institute.
