Doctors in the U.S. work long hours. In 2024, pediatricians worked about 52.8 hours per week, which is a bit less than 54.3 hours in 2023. Out of this time, they spent about 27.2 hours caring directly for patients. The rest of the time is used for indirect patient care tasks such as writing notes, checking test results, and handling insurance paperwork. Pediatricians spend about 13 hours each week on these indirect care duties. These tasks still take a lot of time even though there have been attempts to make them easier.
One big problem is the time spent on Electronic Health Record (EHR) tasks outside of normal work hours. In 2024, more than 22% of doctors spent over eight hours a week doing EHR work after their normal schedule. This after-hours work is sometimes called “pajama time” because doctors do it from home at night. It takes away from their personal time and makes them tired and unhappy with their jobs. Although doctor burnout has gone down slightly from 53% in 2022 to 43.2% in 2024, the amount of documentation still causes stress.
Pediatric healthcare faces extra challenges because pediatricians must keep detailed and accurate records for children who need special care. Bad documentation habits like too much copying and pasting or using autopopulated text can cause “note bloat.” Note bloat means notes become very long and cluttered. These long notes do not always make care safer and make it harder to review patient records and make good decisions.
Note bloat is a bigger problem in pediatric and other healthcare notes. Copying and pasting too much or using autopopulated text can fill notes with extra or unimportant information. This makes it hard for doctors to find the main details quickly and can cause mistakes. Sometimes notes wrongly include information from other patients or miss important new facts, which can lead to unsafe care.
Though the Centers for Medicare & Medicaid Services (CMS) changed rules to focus documentation on assessments and medical decisions rather than lots of details, notes still keep getting longer. The new rules support time-based billing, which pays for the time spent on care instead of how much is written. However, not everyone uses this billing method yet. Many doctors still write long notes to support billing, which keeps note bloat going.
Note bloat also makes communication between care teams harder. Research shows that more than 16% of nursing notes are never read by other clinicians. Too many notes slow down teamwork and stop care from improving through better data sharing.
Many health systems in the U.S. are using artificial intelligence (AI) to make their work easier and reduce the time spent on paperwork. AI tools include things like ambient scribes, natural language processing (NLP), and automated message handling. These tools save time and reduce mistakes.
Besides AI, hospitals and clinics have tried other ways to reduce too much documentation and note bloat.
Using AI and automation helps fix problems with paperwork in pediatric healthcare. These tools make routine jobs easier so doctors can focus on patient care.
Using AI and time-based billing helps pediatric doctors and administrators. When paperwork is lower, doctors spend less time working after hours, feel less burned out, and have better job satisfaction. Groups like Texas Children’s Pediatrics and The Permanente Medical Group show AI saves about one hour a day per doctor. That adds up to a lot of saved time at big clinics.
For administrators and IT teams, AI and new billing methods improve operations. When doctors spend less time on paperwork, clinics can see more patients and staff work better. Automation also helps with staff shortages in healthcare.
Making AI work well means aligning it with current EHR systems, training staff, and watching for AI mistakes, like wrong information. Working with clinicians to find small workflow problems can help place AI tools in the best way for each clinic.
AI tools combined with new billing methods like time-based billing offer ways to fix documentation problems in pediatric healthcare in the U.S. Many health systems have shown good results using AI scribes, live transcription, message tools, and team workflows. While there are challenges such as managing AI accuracy and changing documentation habits, these tools provide ways to reduce pediatric doctor burnout and improve clinic work.
Clinic leaders and IT managers who adopt these tools and workflow changes can improve doctor well-being, make clinics more efficient, and improve patient care quality. Methods that reduce long notes, automate boring tasks, and improve billing processes can change how pediatric healthcare documentation works in a busy healthcare system.
AI streamlines documentation by automating note-taking, summarizing patient interactions, and assisting in drafting responses. This reduces the hours physicians spend on electronic health records (EHR), especially outside of clinical hours, thus decreasing burnout and enhancing time for patient care.
Geisinger uses AI to optimize workflows and reclaim physician time. Texas Children’s Pediatrics implemented AI-supported documentation to reduce rote note-taking. The Permanente Medical Group employs ambient AI scribes for real-time transcription, improving physician satisfaction and patient interaction.
Physicians, including pediatricians, spend extensive hours on indirect patient care and administrative tasks such as documentation, insurance forms, and order entry. This administrative burden extends beyond work hours, contributing to burnout and reducing time available for direct patient care.
Pediatricians reported an average of 52.8-hour workweeks in 2024, with significant time devoted to documentation and indirect patient care, slightly lower than previous years but still substantial enough to impact work-life balance.
Health systems employ team-based care, embed clinical pharmacists, train medical assistants as scribes, and educate physicians on efficient billing methods. Tools like AMA STEPS Forward® provide playbooks for workflow optimization and reducing redundant tasks.
Ambient AI documentation allows physicians to focus on the patient during visits instead of typing notes. This real-time transcription ensures detailed, accurate medical records while enhancing physician-patient interaction and personalized care quality.
AI assists physicians by managing inboxes, filtering messages, drafting responses, and automating documentation tasks outside clinical hours. This helps physicians avoid ‘pajama time’ — work done after hours — improving their well-being.
Health systems educate physicians on alternatives to note-heavy documentation, such as time-based billing, and integrate scribes and AI tools to reduce excessive or redundant notes, making documentation more concise and efficient.
AI-supported documentation reduces the time spent on administrative tasks, thereby decreasing burnout and enhancing job satisfaction by allowing more time for meaningful patient interactions and reducing after-hours work.
AMA’s ‘Saving Time Playbook’ and ‘Taming the EHR Playbook’ offer evidence-based strategies to streamline workflows, reduce redundant EHR tasks, and enhance physician well-being. These resources guide healthcare leaders in implementing systemic changes for sustainable improvements.
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