By: Dr. Avery Crocker
The holiday season is nearly upon us, and unless you want to find a Disability Tax Credit Form in your stocking, you will want to be efficient in completing your charting, forms, and administrative tasks this month.
Like many family physicians, our group often struggled with the seemingly relentless flood of paperwork generated by community practice. To support us, our PCN funded the Charting Champions Course (designed by Dr. Sarah Smith) for interested physicians. The course’s goal was to suggest methods for reducing the burden of administrative work. It was a hit—many in our group found its takeaways to be efficient, effective, and practical.
The Charting Champions method emphasizes the goal of completing the clinical encounter before starting another clinical encounter. This means finishing charting, requisitions, and referrals before seeing the next patient. The idea is that it takes significantly less effort to complete related administrative tasks during and immediately following the patient encounter. The method also reduces the amount of paperwork piling up, out of context, ready to overwhelm by the end of the day.
And while this leaves very little time between patients—and often can delay the start of the next patient visit—it frees you to go home at the end of your clinic day without charts to complete and rewards you with unencumbered downtime. Practically, the additional effort expended recalibrating clinical timing and dealing with tasks between patient visits reaps far greater rewards in the form of spending time with family, exercising, meal prepping, or binge-watching the latest Netflix hit, all without being haunted by the specter of paperwork.
That said, each family physician’s experience may differ, and there is no silver bullet for eliminating charting and administrative woes; so, I casted a wider net by asking my colleagues to share their insights for those of us in our First Five Years of Family Practice. Their tips include:
1. Write referral letters and complete forms while the patient is in the room.
This lets you ask questions and clarify symptoms in real time, and when you leave the room the paperwork for that encounter is completed. Book longer appointments if necessary!
2. Touch results once, and do not open your inbox until you have time to fully manage the results.
Glancing at each result multiple times and deferring recalling the patient, reviewing the result, writing a letter, or whatever the case may be, just takes up a great deal of time and adds stress without chipping away at the ever-growing to-do list.
3. Ideally, complete your work for the day before leaving for home.
It is much harder to reengage with the tasks after getting home. And you are often faced with other demands (be it from family, friends, or your own self-care needs), meaning that work ends up being deferred until ‘later’ and interferes with your time to relax.
4. Utilize smart phrases, templates and macros in your EMR.
If you find yourself typing something more than once per day, consider creating a smart phrase or macro to improve efficiency. For common complaints, create templates with clickable selections.
5. Have patients complete a PHQ9/GAD7 with all mental health ‘off work’ visits so you can attach the screener to the form that details all their symptoms.
This lets patients articulate their needs in their own words while reducing the time and effort required to complete the patient encounter.
Please share some of your practices that help you decrease the burden of paperwork in your practice in the comments!