Yes, very interesting. But it is non-patient administrative work, so I'm not sure if it applies to the submitted article. That does, however, support the argument that in general, the US system requires more administrative work, yet (I believe), the US and Canadian systems achieve about the same health outcomes. And I also believe the Canadian system is cheaper. It's then reasonable to conclude that the many layers of the US healthcare system are the cause.

It would be reasonable for patient-related notes to be correlated with other administrative work, but it's not necessarily so.

The article points out that most of these notes are not related to patent care.

A seasoned supervisor told me that, when he was a resident working in the psychiatric emergency room, he used to see more than three times as many patients as we residents see now.

“How?” I asked him, with an incredulous lilt in my voice that could barely be masked.

“Our notes could be shorter back then,” was his reply. (Insurance, regulations and electronic health records weren’t issues back then.)

Correct, and I understood that, so I was not clear. My question was on whether or not patient notes are also associated with more-bureaucracy-for-the-same-health-outcome. At higher cost. Maybe more patient notes actually lead to better health outcomes, even though they're an annoyance for doctors and cause them to see less patients.

Got it, it's a good point and worth looking at. Doctors taking lot's of notes while in with a patent could also lead to worse outcomes as they are distracted.

However, ~50% increase in healthcare costs would need to have a huge impact on patent outcomes or drastic fraud reduction to be worth it.