“Too many cooks in the kitchen” is a well-known idiom. It implies that more input is not always better when it comes to cooking a meal.
We can think similarly about the number of providers who are actively involved in a single hospitalization. As medicine is not formulaic, each provider brings his/her own experiences, training, practice habits, etc., to the case. Each may order procedures, tests or medicines that are of interest from their own perspective. As medicine becomes more hyper-specialized, the fragmentation even in the inpatient setting may foster inefficiencies and thus contribute to waste. Moreover, with today’s electronic notes being a copy/paste/data pulldown exercise of ”note bloat,” a multitude of providers on a case means an imperfect information exchange among the care team.
Given these effects, one would hypothesize that it would be better to have fewer providers on a case, even when risk adjusting by severity of illness. This eReport examines that hypothesis and finds a close correlation between length of stay (LOS) and the number of providers who have written a med/lab/rad order. More or less, for every additional doc, patients will stay an extra day in the hospital. We also find that not all generalists are alike in the frequency of consulting other providers, giving us an opportunity to reduce this excess length of stay.