For many healthcare providers, the workday doesn't end when the last patient leaves. Tebra surveyed 163 licensed healthcare professionals and 850 US adults to examine how after-hours documentation demands are affecting providers personally and professionally, and whether patients are noticing the difference in the exam room.

The findings reveal a documentation burden that has grown heavier over time. And it's costing providers thousands of dollars in unpaid time, contributing to widespread burnout, and eroding the patient-provider relationship.

For healthcare providers, documentation has become a job that follows them home,  into evenings, weekends, and the hours most people reserve for rest and personal life.

On average, healthcare providers spend 4.8 hours per week completing clinical notes or charting outside of their scheduled work hours. Overall, 70% of providers said they chart outside of work hours at least some point during the week. Nearly 2 in 3 (64%) chart into the evenings, and 45% chart on weekends to keep up with documentation.

The financial toll of that time adds up quickly. Based on the mean reported salaries among survey respondents, the estimated annual value of unpaid after-hours charting time came to approximately $10,200 per provider.

The burden also appears to be growing: 40% of providers said the volume of after-hours charting has increased compared to 2 years ago. When asked which step in the charting process consumed the most time, 55% pointed to writing narrative or free-text notes, followed by reviewing or reconciling records from prior visits (16%) and entering structured data fields (13%).

The hours providers spend charting outside of work also carry significant personal and professional weight.

More than 3 in 4 doctors and providers (77%) agreed or strongly agreed that after-hours charting is a significant contributor to provider burnout, highlighting a critical need for reducing administrative burnout. Nearly as many said after-hours charting left them feeling mentally drained (72%), and 45% said the time they spend charting at home affected the quality of their work the next day.

A majority (64%) felt that documentation requirements have passed what's clinically necessary, and over a quarter (26%) have considered leaving their job because of charting demands.

The documentation burden doesn't stay at home. As providers sit in the exam room tethered to their screens, patients are beginning to feel the distance.

Providers being on screens during a visit has resulted in interrupted conversations (28%) and patients forgetting to mention a concern they had (17%). Over a third of patients (36%) said they left a doctor's appointment in the past year feeling like the provider didn't fully address their concerns. Women were more likely than men to report this (43% vs. 28%).

For 1 in 6 patients (17%), a doctor being too distracted by a screen has led them to switch providers or seriously consider switching. This rose to 21% among Gen Z patients and 20% among millennials.

Patient attitudes about screen-heavy appointments reflected broader concerns about trust and connection:

When patients leave an appointment feeling unheard, the effects don't end at the door. They show up in the decisions patients make about their own care.

Patients were most likely to share their frustrations about feeling overlooked by a provider with friends or family (34%). A third (33%) looked up symptoms or sought medical advice online instead of returning to their provider, and 31% left a visit without asking a question they had prepared.

More than 1 in 4 (26%) avoided scheduling follow-up appointments as a result of feeling unheard, 22% delayed following up on a health concern, and 19% sought a second opinion from another provider.

When asked what would most improve the quality of face-to-face time with their provider, 42% of patients said they want their provider to review their records before entering the room. Other things that would help included better eye contact and communication habits (33%), longer appointment slots (25%), and less time on the computer during the appointment itself (19%). More than 1 in 10 (13%) believe AI healthcare software—providing AI-powered tools for clinical and practice efficiency—could also help handle notes automatically.

Documentation demands are stretching providers thin, and patients are absorbing the cost of that pressure in the exam room. Private practices that find ways to reduce the after-hours charting burden, whether through smarter workflows, better technology, or tools that handle note-taking during the visit, stand to benefit on both sides of the relationship. That is where a platform built for independent practices makes the difference.

Tebra's electronic health record software pairs AI Note Assist with customizable charting tools to ease the documentation load while maintaining compliance with national standards for protecting sensitive patient health information. AI Note Assist turns a provider's voice or typed inputs into structured, HIPAA-compliant notes and drops them directly into the chart, while custom SOAP templates and smart shortcuts cut the clicks and free-text writing that providers named as their biggest time sink. The result is less charting after hours and more presence with the patient in the room. When providers can be more present, trust builds, care improves, and patients stay.

Tebra commissioned two online surveys conducted in May 2026. The provider survey was fielded May 20–28, 2026, and collected responses from 163 licensed healthcare professionals in the United States, including registered nurses, mental health clinicians, physicians, physical and occupational therapists, pharmacists, physician assistants, nurse practitioners, and licensed practical nurses.

The patient survey was fielded May 25–28, 2026, and collected responses from 850 US adults who had seen a primary care provider or specialist in person within the past 2 years.

The estimated annual value of unpaid charting time was calculated by converting the mean reported annual salary to an hourly rate (salary ÷ 2,080 hours) and multiplying by the mean after-hours charting hours per week across 52 weeks. 

Tebra, headquartered in Southern California, empowers independent healthcare practices with cutting-edge AI and automation to drive growth, streamline care, and boost efficiency. Our all-in-one EHR and billing platform delivers everything you need to attract and engage your patients, including online scheduling, reputation management, and digital communications.

Inspired by "vertebrae," our name embodies our mission to be the backbone of healthcare success. With over 165,000 providers and 190 million patient records, Tebra is redefining healthcare through innovation and a commitment to customer success. We're not just optimizing operations — we're ensuring private practices thrive.

The data and findings in this article may be used for noncommercial purposes only. If you choose to share or reference this research, please provide a link and proper attribution to Tebra.