Pajama time severance: How to leave work at work

The Apple TV+ series "Severance" follows Mark Scout, a man grieving the loss of his wife outside of the office and who is unaware he has a wife inside the office. The protagonist submits himself to a "severance" procedure, splitting himself into two people. When severed people enter the office, they have no memory of their life outside of work. However, when they are out of office, they have no memory of their 9-5 day.

It is difficult for physicians to leave work at the end of the day and not take it home. We have coined a term for this called pajama time. Pajama time is a term used to describe doctors working outside of regular hours, often at home. Pajama time includes completing EMR records, billing, and creating prior authorizations to obtain permission for patients' medications, tests, or procedures. These pajama-time tasks are uncompensated and may require 1-2 hours of work each evening.

The causes of pajama time include:

• Administrative tasks may require doctors to complete these tasks outside of work hours.
• Completing electronic health records (EHRs) at the end of the day.
• Responding to emails and phone calls that can't done during office hours is done outside of work hours.
• Staying current on reading journals and publications cannot be accomplished during work hours; it must be done outside of work hours.

Consequences of pajama time?

• Pajama time can affect doctors' job satisfaction and impact patient care.
• Pajama time contributes to physician burnout at epidemic proportions, impacting nearly 50% of all physicians.
• Deterioration in patient satisfaction impacts our online reputation.
• Pajama time can lead to doctors sacrificing personal and family time and deteriorating relationships with family and friends.

To successfully have severance and leave work at work and avoid bringing it home, focus on creating clear boundaries, establishing routines, and practicing self-care techniques.

1. Set clear boundaries:

• Define work hours and stick to them, or at least make a commitment that when you leave the office, you will not work at home and will take only emergency calls or emails.
• Try to start and end your workday at designated times and resist the urge to check emails or work outside these hours.
• Communicate your boundaries: Let your colleagues know you're unavailable after work hours, and avoid taking work-related calls or responding to emails outside your designated work time.

2. Establish routines:

• Create a closing ritual: Develop a routine to signal the end of your workday, such as tidying up your workspace, reviewing your to-do list, or planning for the next day.
• Use your commute to transition: Utilize your commute time to mentally detach from work and shift your focus to personal activities or relaxation.
• Schedule after-work activities: Plan enjoyable activities to look forward to after work, such as exercise, hobbies, or spending time with family and friends.

3. Practice Self-Care:

• Prioritize exercise and relaxation: Incorporate physical activity and mindfulness techniques like meditation or yoga to manage stress and improve mental well-being.

4. Limit work-related discussions:Try to avoid work-related conversations at home.

5. Manage your stress:Practice mindfulness: 

• Engage in mindfulness exercises to help you manage stress, reduce overthinking, and promote mental clarity.
• Seek professional support: If you're struggling with work-related stress, consider seeking support from a therapist or life coach.

6. Consider an unplugged hour or, better yet, a day where you do not respond to cell phone\internet. Most of us are tethered to the Internet and iPhone seven days a week and even on vacation. We have become slaves of social media, Email, texting, and apps.

A solution to this enslavement is getting unplugged or having an "electronic" Sabbatical" when you are totally unplugged from the Internet, mobile phone, computer, iPad, and other electronic devices for just a few hours in the evening. After going without the computer umbilical cord in the evening, when you are free from the digital world, you will notice dramatic changes within yourself. You will think differently, act differently, and see things from a new perspective.

Bottom Line: It is not easy to be severed from our work when we go home at the end of the day. However, by implementing a few of these recommendations, you can effectively separate work from personal life, reduce stress, create a healthier work-life balance, and maybe use your pajama time for family and friends and have time to pour yourself a glass of wine and watch an episode of "Severance."

Medical Office Supplies

15% Off All Products

Manual Prescription Pad (Large - White) Memo Pad








Manual Prescription Pads (Light Blue) Notepads








Manual Prescription Pads (Light Yellow) Notepad








Manual Prescription Pads (Light Pink) Notepad








 Billing and Collection Supplies





 Business Cards and Stationary





 Chart Labels





 Medical and Rx Pads

Ambient clinical intelligence: Better than a scribe and less expensive

COVID-19 has brought telemedicine and virtual appointments to many medical practices. This increases efficiency and productivity and improves access to care. I have observed that middle-aged and older physicians are averse to technology. They are comfortable with the status quo. But even technophobes can't ignore the AI revolution in healthcare, particularly regarding medical documentation. Virtual appointments and telemedicine aren't the only advancements in healthcare. Ambient clinical intelligence (ACI) is an answer to data entry, which is the bane for most physicians and may even be why many physicians decide to leave the practice of medicine.

Ambient clinical intelligence (ACI) uses AI and voice recognition to automate clinical documentation, reducing administrative burden and decreasing physician burnout. ACI captures patient encounters during the doctor-patient encounter, generating detailed clinical notes. As a result, physician productivity increases.

ACI uses AI to write clinical notes during patient visits so doctors can focus on the patient, not the computer.

ACI reduces the documentation burden. ACI listens to the doctor-patient conversation and writes notes that you can easily transfer to the practice's EMR.

It's like having a scribe in the room with the patient who knows what goes in the medical record.

ACI, along with voice recognition technologies, is different from human transcription. It interprets the patient's conversation to include the necessary details to create a complete medical record.

ACI also automatically categorizes patient symptoms and treatment plans and can organize your care plans.

ACI means you can only remember part of the conversation. You can enact care plans and make decisions.

How ACI works

1. Turn on the ACI from your computer when your doctor-patient encounter begins. The program "listens" for up to three hours, whether it's a face-to-face or virtual visit.
2. At the end of the counter, you can select the edit mode on the computer. ACI will create a note in less than one minute. The edit mode also provides information to the program that helps ACI learn your voice, accent, style, and speed of interaction with the patient.
3. You can end the encounter with a single click and transfer the completed medical notes into your EHR.

When beginning to use ACI, it is essential to edit the encounter. You want to ensure that medical terms and prescription names are correctly transcribed. With repeated use, ACI will capture these terms and names accurately.

Of course, there are caveats with ACI that are common with all new technology. These include:

There may be technical difficulties. The technology may not always work correctly or may have caused incomplete or inaccurate notes and glitches. The glitches decrease with repeated use.

Automated notes may not capture the nuances of a patient's condition or the unique perspective of the healthcare provider.

A future problem is that relying too heavily on automated note-taking may lead to declining healthcare providers' documentation skills.

Bottom Line: Patient encounters are about connection and trust. ACI handles the administrative tasks that impede patient care. Ultimately, ACI creates a better experience for the physician and patient. ACI gives doctors their time and lives back; you can plan to be home for dinner.

15% Off Medical Practice Supplies

VIEW ALL

Manual Prescription Pad (Large - Grey)

Manual Prescription Pad (Large - Yellow)

Manual Prescription Pad (Large - Pink)

Manual Prescription Pads (Bright Orange)

Manual Prescription Pads (Light Pink)

Manual Prescription Pads (Light Yellow)

Manual Prescription Pad (Large - Blue)

Manual Prescription Pad (Large - White)

VIEW ALL

__________________________________________________

Appointment Reminder Cards

VIEW ALL PRODUCTS

Appointment Reminder Cards (100 pack-White)

$44.05

15% Off 

Appointment Reminder Cards (100 pack-White)

$56.30

15% Off 

Appointment Reminder Cards (100 pack-Light Pink)

$44.05

15% Off 

Appointment Reminder Cards (100 pack-Light Blue)

$44.05

15% Off 

Appointment Reminder Cards (100 pack-Light Pink)

$56.30

15% Off

VIEW ALL PRODUCTS

Payer Scorecard results: A wake-up call for insurers and a call to action for practices

For medical practices, payer relationships are often a source of frustration, inefficiency, and financial strain. For good reason, it's one of the major topics we cover at Physicians Practice.

Our 2024 Payer Scorecard survey confirms what many in the industry already suspect: payer performance is failing to meet the needs of physicians and their patients. With an overall score of2.02 out of 5, the results highlight a widening gap between payers and the practices (and patients) they are supposed to serve.

Take a moment to check out our full data, then I'd like to share some thoughts on where medical practices go from here.

4 Takeaways from the Payer Scorecard

1. Reimbursement rates remain the primary pain and conflict point

A staggering 66% of respondents identified low reimbursement ratesas their biggest challenge with their largest payer. This aligns with anecdotal complaints from physicians who say their contracts have stagnated for 15 years or more without fee increases. Small practices, in particular, feel ignored and under-compensated.

2. Customer service and communication are failing

Physicians rated their largest payer’s customer service at 1.84 out of 5 — the lowest score across all categories. Practice communication fared only slightly better at 2.03 out of 5, with many respondents citing difficulties in identifying the right contact person for claims issues and appeals.

One respondent put it bluntly: “We need a dedicated provider relations contact, not faceless representatives who don’t resolve anything.” Another added, "Insurance companies outsource customer service, and those representatives don’t understand the issues or refer us to experts.”

3. The prior authorization burden continues to grow

More than 74% of respondents reported that they are handling more prior authorizations than in the past year, yet payer scores in this category remain abysmal. Physicians rated prior authorization experiences, including clarity, response time, and ease of process, at just 2.25 out of 5.

It’s no surprise that 97% of respondents believe payers should be required to reimburse for prior authorization work via a dedicated Current Procedural Terminology (CPT) code. The time and administrative burden on practices are becoming unsustainable.

4. Payment processing and billing systems are a mess

With a score of 1.96 out of 5, payment and reimbursement processes ranked among the most frustrating aspects of working with payers. Delayed payments, inaccurate claims processing, and appeals processes lacking transparency remain major concerns.

One practice administrator shared: “Their systems don’t interact with ours, so we have to manually correct claims, which delays payments.” Another simply vented: “Reimbursement stinks. I quit!!!”

What needs to change? A call to action for payers

Medical practices aren’t just asking for better pay—they want functional, transparent, and fair systems. Here’s what payers need to do to improve relationships with providers:

• Pay fairly: Practices want reimbursement rates that allow them to sustain their business, invest in staff, and remain competitive. Physicians are being pushed out by unsustainable compensation models.
• Streamline administrative processes: Prior authorizations for generic or medically necessary medications must stop. Payers should also integrate billing systems with practice management software to reduce claim rejections.
• Improve communication: Practices need a dedicated provider relations contact instead of generic customer service hotlines.
• Reevaluate their provider relationships: As one physician noted, “Instead of looking at me as an expense, look at me as a tool to care for your beneficiaries.”

Where do practices go from here?

While practice administrators may feel powerless, they can take proactive steps:

• Negotiate aggressively: Despite 37% of practices not negotiating contracts, those who do — especially independent groups — can push for better reimbursement rates.
• Advocate for CPT codes for administrative tasks: Nearly all physicians agree that insurers should pay for the prior authorization workload. Advocacy through state and national medical societies can drive real change.
• Leverage public pressure: By sharing payer performance data with industry groups, policymakers, and patients, physicians can expose unfair practices and advocate for reform.

The bottom line

The Payer Scorecard reveals an industry in crisis: poor reimbursement, bureaucratic inefficiencies, and opaque communication are making it increasingly difficult for medical practices to operate. But with data in hand and a clear mandate for reform, practices can fight for a fairer system. It’s time for insurers to step up—or risk losing the very providers who keep their customers healthy.

 

Medical Office Supplies

15% Off All Products

Manual Prescription Pad (Large - White) Memo Pad








Manual Prescription Pads (Light Blue) Notepads








Manual Prescription Pads (Light Yellow) Notepad








Manual Prescription Pads (Light Pink) Notepad








 Billing and Collection Supplies





 Business Cards and Stationary





 Chart Labels





 Medical and Rx Pads

AI – “Everybody at the bar gettin’ tipsy”

If you’re familiar with Shaboozey’s hit song, you’re likely also familiar with the lyrics – “[o]ne, here comes the two to the three to the four.” Let’s consider generative artificial intelligence (AI) and what’s evolving in health care.

One, HL7 FHIR (Fast Healthcare Interoperability Resources) is a standard predicated on internet standards used by other industries, which “defines how healthcare information can be exchanged between different computer systems regardless of how it is stored in those systems.” Utilized for exchanging electronic health records (EHRs) between different systems, it is an application program interface (API) that enables the sharing of healthcare data to occur. Notably,

The CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) builds on CMS' previous rule by outlining requirements for additional information that certain payers must provide via the Patient Access API and new requirements for certain payers to implement three additional APIs: Provider Access API, Payer-to-Payer API, and Prior Authorization API. The APIs finalized in CMS-9115-F and CMS-0057-F must meet certain technical standards to drive interoperability and increase provider and patient access to health information.

The take-away is that covered entities should be keeping pace with CMS instructions because API and FHIR compliance tie into HIPAA compliance.

Now, recent proposed and actual legislation. Here comes the:

Two, proposed legislation (HR 238 – “Healthy Technology Act of 2025”) introduced in Congress by Congressman Schweiker, would amend the Federal Food, Drug, and Cosmetic act to establish that AI and machine learning technologies would qualify as a practitioner eligible to prescribe drugs involved if authorized by the state involved and “approved, cleared, or authorized under 510(k), 513, 515, or 564.” Given the infancy of AI, as well as the number of hallucinations and concerns for HIPAA violations, this legislation is unlikely to pass.

To the three, on Jan. 22 the New York Assembly passed the New York Health Information Privacy Act (New York HIPA) and was sent to the Governor for her signature. New York HIPA seeks to impose strict requirements on entities that handle health or wellness-related consumer data. It is substantially akin to Washington State’s My Health My Data Act (MHMDA). Significantly, while New York HIPA exempts HIPAA-covered entities, it is limited only to the extent that covered entities are processing HIPAA PHI. Stated another way, while patient medical records may be excluded from New York HIPA’s application, other personal information medical providers and their business associates collect that has historically not been treated as PHI is likely to be subject to the provisions.

To the four, California’s Governor issued the Legal Advisory on the Application of Existing California Law to Artificial Intelligence in Healthcare (HC Advisory). In addition to the fact that the California Attorney General has the authority to take enforcement action against creators, marketers and users of AI systems if those AI systems result in a violation of California Law. Violations under the Unfair Competition Law may include: (a) falsely advertise the accuracy or utility of AI systems, or (b) create, market or disseminate an AI system that does not comply with federal or state laws, including civil rights and privacy laws. Notably, the corporate practice of medicine law can also be triggered.

In closing, “someone pour me a double shot of whiskey” because appreciating where state and federal laws have overlap can reduce compliance anxiety, understanding what other laws may be implicated can be daunting but also required, and treating any sensitive personally identifiable information (PII), including individually identifiable health information (IIHI) with the same care that HIPAA requires can mitigate not only the risk of an attack but also the risk of a government enforcement action – whether from a state or a federal government agency.

 

Medical Office Supplies

15% Off All Products

Manual Prescription Pad (Large - White) Memo Pad








Manual Prescription Pads (Light Blue) Notepads








Manual Prescription Pads (Light Yellow) Notepad








Manual Prescription Pads (Light Pink) Notepad








 Billing and Collection Supplies





 Business Cards and Stationary





 Chart Labels





 Medical and Rx Pads

This AI-powered stethoscope can detect pulmonary hypertension

A new study highlights the potential of AI for early detectiA new artificial intelligence (AI) algorithm integrated into a digital stethoscope by Eko Health shows promise in detecting pulmonary hypertension (PH), according to a study published in the Journal of the American Heart Association (JAHA).

The study, led by researchers from Brown University alongside the team at Eko Health, evaluated the AI’s ability to detect elevated pulmonary systolic pressures (PASP), a key indicator of PH. The model was trained on approximately 6,000 heart sound recordings paired with echocardiographic pressure estimates.

The study highlighted the model’s capabilities, using phonocardiograms (PCGs) recorded with a standard handheld stethoscope to screen for PASP. The algorithm performed well, achieving an average area under the receiver operating characteristic (AUROC) curve of 0.79, with a sensitivity of 71% and a specificity of 73%.

“This innovative approach demonstrates how combining digital stethoscopes with advanced AI can lead to a low-cost, non-invasive, point-of-care screening tool for the early detection of pulmonary hypertension,” Gaurav Choudhary, MD, lead principal investigator of the study, professor and director of Cardiovascular Research at Brown University, said in an organizational release. “Our findings represent a significant advancement in clinical practice that can ultimately enhance patient care.”

PH, a condition characterized by elevated blood pressure in the arteries of the lungs, is often underdiagnosed due to the reliance on echocardiography, which is not always accessible in primary care settings.

Left untreated, PH can lead to heart failure, early disability or early mortality. Eko Health’s AI-enhanced stethoscope offers primary care physicians a noninvasive, rapid screening tool to aid in earlier detection of PH.

The study also highlighted the algorithm’s ability to pinpoint key acoustic markers associated with PH — including an altered duration between the two components of the second heart sound and a tricuspid valve regurgitation murmur. By mapping these abnormalities, the AI tool provides physicians with a transparent and easily interpretable assessment.

According to the news release from Eko Health, across the world, as many as 10% of people aged 65 and older are impacted by PH, with millions more affected under the age of 65. Eko Health’s AI approach to PH diagnosis has the potential to transform early detection, diagnosis and management of PH, leading to better patient care in primary care practices.

Medical Office Supplies

15% Off All Products

Manual Prescription Pad (Large - White) Memo Pad








Manual Prescription Pads (Light Blue) Notepads








Manual Prescription Pads (Light Yellow) Notepad








Manual Prescription Pads (Light Pink) Notepad








 Billing and Collection Supplies





 Business Cards and Stationary





 Chart Labels





 Medical and Rx Pads