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Early Careers, Family Medicine: How to Manage Charting & Labs

Your early years in practice can feel overwhelming for different reasons: diving into your practice, keeping a schedule, and practising without supervision to name a few. This article aims to tackle some of those overwhelming aspects you might experience, and suggest strategies for mitigating them.

One potentially blindsiding aspect can be Charting & Lab Follow-up. Maybe you’re feeling successful after completing a full day in clinic, but then realize that even though it’s 5 pm you have all the charts left to finish! Maybe at 5 pm that “Critical Lab Results” rolls into your inbox or across your desk… 

In your early career, you can set the stage for good habits in practice. The truth of the matter is every person practises a bit differently, therefore Charting and Lab Management strategies will also be unique. But here are some things that have helped me:

Setting priorities will be important: Do you want to be done charting in the clinic every day? Do you not mind doing things after hours? Who will cover your labs if you aren’t around?

I tackle two main areas to help with these goals: 

Charting:

  1. Most EMRs have macros capabilities. They can be huge time-savers. Common procedures (eg. an IUD insertion) can use templates. Personally, I have found macros the most time-saving charting tool. Be sure to customize them for every patient by adding additional details when needed.
  2. Scheduling time for charting directly into your appointments, or blocking chunks of time for charting during the day: this allows real-time catching up which is important to ensure your memory of the visit is still fresh.
  3. Dictation can help if typing is not your forte: software can be expensive, but if it allows you to be more efficient then over time, it can be a financially effective solution. Connect Care has excellent dictation software built in. 
  4. Saving medications in your EMR: similar to macros, saving your favorite medications in your charts will save time and clicking.
  5. Ditto saving common lab req’s. Prenatal Appointments are a great example as Standard of Care is uniform. Having pre-saved requisitions will save you time and ensure nothing is overlooked. 

Labs:

  1. Again, you need to allow some time in your day. Follow-up of these is important, and if you let them pile up, it will seem overwhelming and insurmountable. A good time is prior to your clinic day. If you have restrictions with childcare or commute, book your first patient of the day 15 minutes after your arrival. Remember, lab follow-up is part of patient care. 
  2. Join a call group or ensure that your clinic has a policy for helping to cover after-hours lab results and personal vacations. Taking a vacation means you need a break from labs too!
  3. Batch them. If your inbox is full to the brim, work in 10-15-minute slots. Before you know it, it will be empty, and the accomplished feeling is priceless!

Establishing healthy habits early in your practice will make your life more enjoyable in the long run. Best luck, and happy practising!

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My name is Smitha Yaltho and I feel privileged to work as a family physician. Why? I believe that being a family physician has been the best job any physician can hope to have. I have personally grown in my own abilities and skill-sets with diverse opportunities in ambulatory practice, acute care and work in Facility Living.  Working in primary care has been exciting and has also afforded me tremendous opportunities for growth while still remaining stimulating in its complexity.  I believe that Family physicians are trusted partners in patient care –  every step of the way. 

Why are you volunteering to serve on this committee?
I currently have an interest in Physician Leadership and  trauma informed care.  I have served as a director with the Board of Directors with the Edmonton North PCN, Edmonton’s largest PCN. Thereafter, I have worked as the Director of Medical Services with CapitalCare (also based in Edmonton) for almost 6 years. It is my express wish that my contribution on the ACFP board of directors will highlight the excellence of family medicine that exists right here and now within the Alberta health care system. 

What about the ACFP’s work do you find most valuable?
Ability to highlight and further support the excellence of primary care right here in Alberta.