By Emily Rappleye

As healthcare becomes increasingly corporatized, administrators lean on the good faith of clinicians to get the job done — and they may be leaning too hard, according to an op-ed by Danielle Ofri, MD, PhD, an attending physician at Bellevue Hospital in New York City.

Physicians and nurses almost always do what's right for patients, even if that means working extra shifts or putting in hours at home to log EHR data.

"I've come to the uncomfortable realization that this ethic that I hold so dear is being cynically manipulated," writes Dr. Ofri. With productivity maxed out, administrative creep sets in, and going above and beyond has become the norm for most clinicians, according to Dr. Ofri.

"If doctors and nurses clocked out when their paid hours were finished, the effect on patients would be calamitous. Doctors and nurses know this, which is why they don't shirk. The system knows it, too, and takes advantage," Dr. Ofri writes.

This workload is unsustainable. Dr. Ofri points to high and rising levels of burnout among physicians and nurses. She believes the solution is to cut administrative positions — which outnumber physicians 10-to-1—and use those salaries to hire more clinicians.