Mandating computer physician orders entry is one of the most destructive policies in healthcare. It’s the biggest factor that tethered the physician to the computer. If a patient needs a CT scan, the doctor can’t just put it in the note or tell a nurse. The doctor has to take the time to click through the cumbersome order entry. It creates a culture where doctors are admonished and pestered about orders, even when the intent is perfectly clear and documented in the record. Patient decided they want their CT scan at another location? “Doctor, you need to re order the scan.” Patient wants to change their surgery date? “Doctor, you need to put in a new order.” “You ordered this lab wrong. You need to fix it.” “There is a new order set for this medication. You need to use that.” “Speech therapy says the patient can eat. You need to put the order in.” This adds up to a huge burden on doctors. Every little thing requires many clicks in the computer. It all adds up. We researched this at ucsf and found the neurosurgeons were spending 2 hours a day just on order entry. Not notes, imaging review, or in the OR. Just orders. And that doesn’t count the time it takes to find an open (and working) computer, log in, and find the chart. Other studies have estimated between 15-30 full workdays are consumed annually just in order entry. That’s an entire month of doctor time gone just to click through the computer. I’m not saying we go back to chicken scratch on a pad of paper. But if the doctor note says “patient needs CT of the head” why do we require another 40 clicks? If a doctor is running to the OR, why cant a verbal order suffice? If a surgery was already booked correctly once, why does the doctor need to re enter it completely? Imagine how much more time doctors would have to treat patients if we simply reversed that rule.