Charting is neutral.
It’s because we can each have different thoughts about it.
It restores a certain amount of urgency and empowerment so that you can choose how you want to take that next step in your life. Join me in this episode as we take a moment and think about how you can finish your charting at work.
Finishing that charting at work involves achieving a level of charting mastery. It’s not about getting to a level where you say, “I am a super user.” It’s about getting to a point where you can finish work at work, go home to be present with family and friends, and pursue other interests outside work. All those priorities are intentional and have the margin of what matters to you. Learn more in this episode.
During this episode, you will learn about;
[00:00] Episode intro
[03:09] Today’s focus; Why Charting in medicine may not feel neutral, but it really is
[03:18] My journey in clinical residency and experiences in charting
[05:50] Circumstances in medicine that can lead to stress
[08:10] Feel overwhelmed, and don’t run away
[08:57] A case scenario- how a perspective of two doctors with pending chats
[12:40] It comes down to choices
[14:40] Do you want to make a change?
[16:30] How to start considering the charting as neutral
[18:35] Wrap up and calls to action
Do you want to get home sooner from the clinic or hospital? With all your notes and charting done, too? Get your FREE PDF guide with 10 tips to maximize your clinical efficiency! https://www.mededwell.com/efficiencyguide/
Dr. Ryan Stegink(Host)
Get Coaching with Dr. Stegink: https://www.mededwell.com/coaching
Above are the episode show notes and below is the transcript via www.temi.com. Some episode transcripts have been edited more than others, but they are up in the meantime to help those who would rather read and for searchability on the web. Extensive editing has not been prioritized as I seek to both produce regular content and maintain my own wellness. See the website disclaimer if you have questions, since this is all for your education and entertainment only. Enjoy!
Dr. Ryan Stegink (00:01):
Does charting in medicine seem overwhelming the queue of messages, labs, patient calls that never seems to get smaller. The pile of preauthorizations awaiting your input, the tens or hundreds of charts that you still have to finish and sign it’s exhausting, right? And still all you want is to be able to go home with your work done, to be able to spend time with family, hang out with friends, practice, self care. I want to invite you to join me for a six week long coaching program, charting mastery, where you will get equipped with the skills and approach that you need to get home sooner and leave that work at work, to check out more info and to join the wait list, head over to charting mastery.net. You will be among the first to hear when the door is open so that you can join me on this journey.
Dr. Ryan Stegink (01:12):
There will be opportunities to reflect and earn CME after the different sessions as well. And now onto today’s show. Welcome to the MedEd well podcast, empowering physicians to get work done at work, then be able to reflect and choose what is important for both their life and medical practice. I’m your host, Dr. Ryan Stegen general pediatrician and life coach for physicians. Hello, and welcome to another episode of the med well podcast. I’m your host, Dr. Ryan Stegen. And I want physicians to come here and be encouraged and equipped to take the next step in their own wellness journey. Thanks so much for subscribing for sharing these episodes and for engaging with these concepts. I’m super excited to share about today’s episode, because it has really had a lot of personal impact on me and was part of why I have put together a six week group coaching program called charting mastery, because I want other physicians to be able to finish their work at work.
Dr. Ryan Stegink (02:33):
That wasn’t the case for me for so long. And having figured out a few things myself, I want to walk other physicians through that process and to be able to get the transformation, those skills and the mindset that you need to be able to get everything done. That hasn’t been your experience. If you wanna get on the wait list to hear about the next time that I’m opening up another cohort of the program, you can head over to charting mastery.net. So today we’re talking about why charting in medicine may not feel neutral, but it actually is. So when I was first out of residency, as many of you may know, I was full time in a clinic setting, outpatient pediatrics, and I was doing a lot of free texting in our EMR. There wasn’t really the opportunity for templates. And so there was a lot of typing, a lot of clicking back and forth.
Dr. Ryan Stegink (03:42):
And about three months in, we actually switched medical record systems and this new one had a lot of bells and whistles and worked quite well, but it still had to be customized. I had a training session with some other physicians where I was told, just sit there, just watch and don’t do anything. And I knew that was not gonna work for my learning style. I wanted to get in there and try and customize things. And yet I didn’t have any guidance. And then they said, here you go and go see some patients. So I jumped in for a couple days and then took a couple weeks off to study and take my boards. And then I came back and just hit the ground running. It took a long time to get to a place where I had the tools that I needed. But even more than that, it was more about how I experienced that overwhelm those extra charts that I’d have to stay late to finish that I’d have to do in the evenings.
Dr. Ryan Stegink (04:54):
I’d have to do on the weekends. It got to be so much that one evening sitting next to my wife, she said something has to change. I was so stressed. So overwhelmed just was like, this charting is stressing me out. But as we’ve been talking about, and as I’ve learned more in my own life lately, charting is just a circumstance. If I didn’t have any thoughts about the charting, I wouldn’t feel anxious or overwhelmed because circumstances are things that any two people like in a court of law could sit down and say, yep, that’s what it is. It’s just a thing. There’s not different perspectives you can have about it. And so that’s where I wanna lead us today. Some of the circumstances in medicine, particularly in an outpatient setting could be the number of patients on the schedule. The number of charts left to close the number of papers to sign notes from outside specialists to review the amount of messages or results coming into one’s inbox.
Dr. Ryan Stegink (06:18):
And we think it’s easy to think that the feelings of stress of overwhelm are because of the amount of work left, but really it’s our thoughts that cause these feelings and many times they’re unconscious, we think they’re just automatic. And we just make that connection between the circumstance of, I have four patients left to see, and it’s currently four o’clock. And we think that circumstance causes us to feel stressed, but really it’s a thought of, I don’t know if I can do this. I really wanna be home for dinner by five 30. I’ve been in these situations before and everyone leaves and then I feel all alone, but there might be someone who says, I can do this. I’ve got this, my team’s gonna have my back. We’re gonna go for it.
Dr. Ryan Stegink (07:24):
And many times it’s uncovering those unconscious thoughts that maybe as we reflect on it, they don’t service us. It’s not helpful when you get to those feelings of overwhelmed because many times in at least when I feel overwhelmed, it often leads to a little bit more of in action that maybe I want to escape or buffer where I wanna do something else. Maybe I wanna check my email or go do an Inba message that I can check something off really easily. Or I want to go talk to somebody or I just, I just need a moment and taking an opportunity to pause and to just be, can be really helpful, but it’s not that you are just trying to resist or run away from those feelings. Sometimes it’s a matter of allowing yourself to feel that overwhelm, to take that deep breath and to say rather than buffer or try and escape this situation, or allow myself to think more thoughts that lead me to more overwhelm saying, okay, where do I want to intentionally go from here?
Dr. Ryan Stegink (08:54):
So I wanna give you you an example of how this could play out. Say we have two physicians, one doctor number one has 100 charts left to sign from the past few weeks. We see a lot of patients. And even that is a thought of a lot of patients. So doctor number one has 100 charts left, doctor number two has only 20 charts left. They’re having a conversation. And doctor number two says, I have a lot of charts left to complete. So we’ve talked about how those thoughts may lead to feelings of stress or overwhelm, but it’s only the perspective on the situation, those thoughts, because then doctor number one comes back and says, you have so few charts left to do compared to me since I have a hundred. And so like we talked about, there are circumstances that we can have thoughts about.
Dr. Ryan Stegink (10:01):
And as we think those thoughts, and maybe we want to, some of them don’t necessarily service, but again, some of them are kind of unconscious automatic thoughts, but as we continue to think them, we often make them into stories. Maybe it’s, I can’t get whatever it is done in that period of time. And sometimes there’s expectations that we have of ourselves or what we’re gonna be able to get done that may not be realistic. That’s also the case for administrators and others that think every patient can fit into a 15 minute slot, but maybe it’s, maybe it’s true. Maybe it’s not, but it’s how we respond to that. Those thoughts. We have stories. We tell ourselves that lead to the feelings that give those actions that cause us to take those actions that give us those results. If we don’t do ’em, they give us the results.
Dr. Ryan Stegink (11:11):
If we do do them actually. And it’s really about taking the time to look at these things, cuz it’s so easy to just go through a day to say, oh, this is what it is. I can’t change anything I can’t do. This is unreasonable. And yet those are thoughts. Those are stories that we tell ourselves. And ultimately a lot of this comes back to what you wanna say is important. So for me, when I see a teenager, I wanna give them a chance to talk together with a parent or guardian. If they brought them, I want to be able to do an appropriate physical exam. And then typically I want to talk to them confidentially, as long as they’re not gonna hurt themselves, someone else or some of the other things for which we’re mandatory reporters. And so many times that doesn’t fit into a 15 or 20 minute slot.
Dr. Ryan Stegink (12:19):
And so that’s the circumstance. The patient is scheduled. This is the timeframe. And so I could say, I don’t have enough time to see these patients and to do the type of job to provide the level of care, the level of professionalism that I want to bring, but I can still choose. We talked about in a prior episode, how there are always choices. And so it may mean that if my patient needs this, I’m choosing to run a little bit behind schedule because it allows me to practice how I want. It may mean that I choose to appropriately make things briefer for a patient that doesn’t have very many concerns. We cover the things that we need to, and we try and make up time there.
Dr. Ryan Stegink (13:19):
And by realizing that you have choices, you have these choices in these situations can then allow you to tell yourself different stories, to have different thoughts to say, I can do this or to tell your team let’s do this. Because some of those thoughts, those stories can lead to feelings of empowerment, of confidence out of which then you’ll take actions of going for it. How can we speed things up and maybe get the vaccines before I come in to see them, if we’ve decided on what they need in advance and you can move towards some of those goals, those desired results, or at least get a lot closer to them. So sometimes it’s just a matter of slowing down to see what are those stories that you’re telling yourself in the midst of the day about charting those thoughts and those stories that may not be serving you to say, Hmm, maybe where those stories are getting me now in terms of the feelings, actions, and results.
Dr. Ryan Stegink (14:39):
Maybe I wanna make a change. You don’t have to, but by bringing some of those things to the surface, then you can look at it. It might be stories like I’m, I’m just slow with my charts. I can’t chart in the room and have good rapport. I can’t finish all my charts the same day or within 30 minutes of my last patient leaving. I’ve been there struggling with charting, even as someone who likes the technology is an early adopter, a high achiever in my medical record because these things, electronic medical records have been shown to contribute, to be correlated with burnout, regardless of whether you even like the EMR. So even those who do like it, it’s still an increased risk. So what now, so what do you do now that you said charting is a neutral thing? It’s just a thing you might be wanting to bite me on that right now, but I want you to see that it’s the thoughts that you’re having many times these thoughts lead to feelings where yeah, sometimes it feels good to complain.
Dr. Ryan Stegink (16:07):
Sometimes those are things that we think are helping us, but maybe those are having other unintended consequences that we didn’t realize or really we don’t want. So if they have a long term negative effect, these stories that we tell ourselves, aren’t serving us. So what to do now, if we consider that charting is neutral and that it’s the thoughts that we have about it can actually restores a certain amount of agency, certain amount of empowerment to you so that you can choose of how you wanna take that next step. I want you to take a moment and think about how it would be if you were in that future state, that ideal future state of being someone who has a level of charting mastery, it’s not about getting to a level where you can say, I am the super user. It’s about getting to the point where you are able to finish your work at work and to be able to go home and be present with family, with friends, to be able to pursue other interests outside of work.
Dr. Ryan Stegink (17:34):
It’s about those priorities that intentionality having the margin for what matters to you. And if you knew that you would be able to get there, how would you be able to look back at challenges that you faced these bumps in the road, these things that you really had to work through that right now seem like this insurmountable obstacle. But if you looked back from having already made it through, how would you see that as part of your growth journey of how it’s helped you move to that new place, that new person that you’re becoming, that’s able to both provide great patient care to be able to lead your team? Well, the care for yourself, your staff and your patience. Thank you so much for joining me here on this. Another episode of the MedEd, well podcast, if you haven’t left us a review already, I want you to encourage you to do that, subscribe and share this episode with a colleague that you think would really benefit from it.
Dr. Ryan Stegink (18:56):
If you know that you want to take the next step and really work on this as part of a group, wanting to just make a difference to take those next steps forward in a really intentional way through group coaching. I want to encourage you to get on the wait list, to hear about the next time that we’re starting up a cohort. You can get on the wait list by going to charting mastery.net, regardless of where you are on your journey, look at where you are, where you want to go. And those intentional thoughts that you can take to help yourself on this journey. Thanks so much for all you do and have a great day. And now for our important disclaimer, Dr. Ryan Stegen is a practicing general pediatrician, but the MedEd well podcast is not reflective views, opinions or belief of his employer nor his affiliated university. Additionally, the MedEd well podcast is for educational and entertainment purposes only, and should not be considered advice regarding financial legal student loan, medical, or any other specific topic. In such a case you should see consultation with certified professional in that particular area. Again, thanks for joining us on the MedEd well podcast and have a great day.