To the Editor: Recent articles in the Journal describing endeavours to measure and classify the tasks of doctors are indicative of the re-emergence of work analysis and time and motion studies.1,2

While commending the authors on their endeavours, it is concerning that the articles state almost contradictory findings. Westbrook and colleagues reported that professional communication, social activities and meal breaks represented the greatest proportion of observed time.1 Zhu and colleagues reported that direct patient-related tasks accounted for 86% of intern time.2 Acknowledging the different contexts of the individual studies, the collective picture is one of confusion and may lead to misrepresentation of the work of doctors.

We have also analysed the work of doctors using observational techniques.3 We built on work done in the United States4 that is underpinned by functional job analysis (FJA)5 to produce a list of tasks (task taxonomy) that describe the work in the acute-care setting, and coordination of roles between hospitals and the community.3,6 The task is the fundamental unit of work, and FJA describes each task in terms of behaviours and interdependencies between people, data and things for the achievement of the task. The method seeks to achieve quality information through adopting precise language descriptions and benchmarks for levels of tasks required for jobs.5 Data are recorded by means of a simple electronic tool.6

Our method captures contextual information about the service (eg, location of work) and rigid details about the observed tasks. We have presented our findings at the 5th Health Services and Policy Research Conference of the Health Services Research Association of Australia and New Zealand,6 and the Change Champions Skill Mix and Workforce Development conference, both in 2007. We found that doctors in the units studied spent about 11% of time on education and training, between 50% and 60% on direct clinical activities (depending on context and role), and less than 10% of time on non-clinical administration. We suggest that if observations are recorded according to the purpose of the output, what may appear to be “socialising” may, in fact, be waiting for something or someone. It is far more important to measure what the impediment to getting on with the job is, rather than inferring that socialising is the main activity.

There is a need for a consistent task classification system that can be used across units and across professions to describe the work that is being performed. A common unit of measure would provide a strong foundation for collaboration and learning in work redesign projects across the nation. Without such a system, planning for the future and evaluation of new roles will continue to be hindered. To this end, we are happy to share the task taxonomy that we have developed, and welcome contact via email.