Thomas Savides, MD, Brian Kwan, MD, Marshall Frieden, MD, Graham Ross, BA, Courtney Barbato, BA, Amanda Walker, BA, Mary Lee Krinsky, DO, Abbas Fehmi, MD, Wilson Kwong, MD, Gobind Anand, MD, Michael Chang, MD, Fady Youssef, MD, Ming Tai-Seale, PhD University of California San Diego, San Diego, CA Introduction: Triaging interventional gastroenterology (GI) referrals improves care efficiency but is associated with large amount of uncompensated work done outside of normal work hours. The purpose of this study was to assess the physician time spent triaging interventional GI procedure and clinic referrals. Methods: Prospective observational study from March 2024 to March 2025 involving an academic medical center with seven interventional GI endoscopists who share triage referral responsibilities each week they are on call. Physicians performed additional daily triage of referrals directly referred to them. To systematically capture triage work performed by interventional endoscopists, an electronic medical record “smart phrase” was created to track the following variables: Diagnosis/Reason for Triage, Triaging Physician, Triage Disposition, Procedure Ordered, Type of Anesthesia, Time Frame, Requested Provider, Triage Comments. Time spent performing triage work was calculated from the EMR’s user access log. Results: 3009 triages were captured, averaging 57 triages per week (range 14-87). Physicians spent an average of 4.2 minutes in each triage note. The physicians varied in time spent per triage from 2.5 minutes to 5.3 minutes. The on-call attending of the week performed 44% triages. 69% of referrals were triaged directly to procedures, 23% to clinic, and 8% to other (e.g. oncology or surgery or to get more information). 38% of patients were triaged to have urgent (< 4 weeks) procedures/visits (5% within 1 week, 12% within 2 weeks, 21% within 4 weeks). The mean amount of time per week spent by the on-call physician doing triage was 98 minutes. The mean amount of time per week spent by the other six non-on-call physicians doing triage was 29 minutes. 48% of triages were done after hours (5 pm to 7 am) or on weekends/holidays. Discussion: Half of all referrals triaging by interventional GI endoscopy physicians takes place on night/weekends/holidays. There were 57 triages per week which took an average of 4.2 minutes per triage. The on-call physician spent 98 minutes per week doing triages, while the not on-call physicians each spent 29 minutes doing triages. Although physician triaging referrals improves clinical operations efficiency and patient care by getting the right patient to the right care at the right time, it may decrease physician wellness and compensation.
Disclosures: Thomas Savides indicated no relevant financial relationships. Brian Kwan indicated no relevant financial relationships. Marshall Frieden indicated no relevant financial relationships. Graham Ross indicated no relevant financial relationships. Courtney Barbato indicated no relevant financial relationships. Amanda Walker indicated no relevant financial relationships. Mary Lee Krinsky indicated no relevant financial relationships. Abbas Fehmi indicated no relevant financial relationships. Wilson Kwong indicated no relevant financial relationships. Gobind Anand indicated no relevant financial relationships. Michael Chang indicated no relevant financial relationships. Fady Youssef indicated no relevant financial relationships. Ming Tai-Seale indicated no relevant financial relationships.
Thomas Savides, MD, Brian Kwan, MD, Marshall Frieden, MD, Graham Ross, BA, Courtney Barbato, BA, Amanda Walker, BA, Mary Lee Krinsky, DO, Abbas Fehmi, MD, Wilson Kwong, MD, Gobind Anand, MD, Michael Chang, MD, Fady Youssef, MD, Ming Tai-Seale, PhD. P6202 - Physician Time Spent Triaging Interventional GI Patient Referrals, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
