The following editorial, published in the Annals of Internal Medicine stated that electronic health record upkeep and maintenance absorb two hours of physician time for every hour of direct clinical time with patients. It also states that physicians who utilize EHRs are at a higher risk for burnout than their peers, as well as reporting decreased satisfaction from patients. Documentation support services, through dictation or documentation assistance, enable more face-to-face time with patients and physicians report greater satisfaction when these assistance is available to them.