We teach wrong when we teach residents to write elaborate notes. 1/many
Doctoring is not performed in front of a computer in a work room. 2/I’m going off
Every extra minute spent writing pretty notes is a minute not spent

- solving the sick person’s problem
- learning about the disease, it’s diagnosis and treatment
- discussing complex medical decisions with colleagues

And most importantly

- talking to your patient 3/
How many times do I hear “he is noncompliant” and “she has no understanding of what’s wrong with her”!

Well, non of those things is going to change while you stare into the monitor in the “work room.” 4/ stay with me
Notes need not be perfect. 5/this is the thesis
Write that down. 5/srsly
Notes are a quick and dirty representation of the ACTUAL WORK YOU HAVE DONE THAT DAY.

Of which zero is done on the note, itself. 6/
The note is not your patient. 7/man
Just jam down some words that represent the actual doctoring you have performed. Explain in haiku efficiency what the hell you are thinking. One sentence about what you think is going on and what you intend to do about it. 8/
Then log off, step into the hallway of the hospital, and walk around to see what’s going on in each of your patient’s rooms. 9/don’t be scared!
Believe me, they don’t know what you are doing when you aren’t in their room and they don’t care. 10/#facts
Your patients view you as a Mechanic of Health, not a Court Reporter of Disease.

Work they don’t see you doing is not getting done. 11/
Some among you may start your rebuttal “CMS documentation requirements state...”

You are the exact medical educators turning medical doctors into hopeless depressed spiritually void bureaucrats. Go get an MBA and leave doctors to practice medicine. 12/12

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Cut your losses.
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1. The mRNA is injected into your arm.
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I recently had a house staff teaching team and as an experiment we added a “problem” onto the end of each patient’s problem list called:

Bias.

[A thread]
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😂😂😂
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