What is scutwork?

From Wiktionary: tasks that are tedious and monotonous or trivial and menial, usually inherent in the operations of a larger project

Physicians in training complain about scutwork.  They use the term to describe anything that they would rather not do.  Scutwork changes over the years.  Back in the day, we complained of starting IVs, drawing blood and wheeling patients to radiology.  Most hospitals no longer have houseofficers perform these tasks.  We considered those tasks scutwork because one need not go to medical school to perform them.  I think the definition of scut has changed.  I received this comment this morning.

I am an intern. I would say 20-80% of my time day by day is spent doing paperwork and assorted scutwork. Some of it is medically useful (pt notes, informed consent, advanced directive stuff). Notes take up the majority of my time. We are not allowed to dictate inpatient notes (I have been told) at the main hospital, as it would overwhelm the transcription services, and a second training hospital offers no transcription services at all. There is plenty of room to train physicians in less hours without sacrificing medical competency.

Can anyone but a physician write progress notes or write orders?  If those tasks are scutwork, then you will be plagued by scut your entire career.  Notes are an essential part of medical care.  We must document what we plan and why.  Rarely are we the only physician caring for a patient. 

I have worked in university hospitals, VA hospitals and community hospitals.  None of the hospitals provide dictation services for daily notes.  Some provide dictation for admission notes, and almost all provide dictation for discharge notes.

Writing patient notes helps me provide better care.  As I write my note, I review all the available data and organize my thoughts.

Our intern probably spends more time writing notes because as an intern one has less experience.  Thus, notes take longer to write.  These tasks are essential in one’s development as a physician.

Now I do understand the frustration of being a December intern.  It is a difficult year.  But when July comes and you are a 2nd year resident, observe the new interns.  Then we will start to understand how much you learn during that stressful year.

As I said last week, you cannot develop expertise without enough experience – We we should not shortchange medical training

Expertise includes writing notes, talking with consultants, and even walking to radiology to review films with the radiologists.  I would not want an intern caring for me unless that intern had a resident and attending supervising them.  Few interns have enough experience.  Internship is a necessary step in the acquisition of expertise.  Most of the tasks that you label scutwork are tasks you wil perform your entire career.