The 3 Mistakes That Triple Physician Charting Time

by | Aug 6, 2021 | Physician Charting

Let’s face it, what’s getting most physicians down is not their patients. No, ask any group of physicians what the hardest part of the job is and you’ll like to get a pretty consistent response: it’s the EMR! With studies showing that we spend, on average, two hours on “paperwork” for every hour in the room with a patient, there’s no question that it is a massive time suck for most. Yet, the EMR is definitely here to stay, so what can you do?

You may have met with IT, gotten smart sets, templates, and other hacks. You may have shadowed an uber-efficient colleague in your practice. You may have even been lucky enough to get a scribe.

Even with all these fixes, many physicians are still struggling to get the job done, spending hours upon hours at the computer, charting in the evenings, weekends – in what often seems like every waking hour. Charting saps precious time and energy that could be spent with family, on personal projects and hobbies, or simply unwinding.

It’s one of the prime contributors to career dissatisfaction and burnout.

In the hundreds of physicians, I’ve coached over the past decade, I’ve seen three consistent patterns that dramatically worsen charting inefficiency.

1. Expecting Perfection in Physician Charting

The first common mistake that physicians make with charting is expecting perfection. 

Perfectionism is something most physicians have in common, and it served us well in getting the grades and MCAT scores we needed to get a foot in our career door. But perfectionism around charting becomes something that can drive us into the ground.

We can obsess over charts, ruminating over-diagnoses or tests ordered. We go over every note twice, check for spelling, and make sure every sentence has perfect construction.

More than the enemy of the good, perfect is the enemy of done! We simply don’t have the time to sit around and make every note-perfect, and focusing on perfection prevents us from finishing notes and moving on. 

Perfect is actually the enemy of much more: it is the enemy of career enjoyment, satisfaction, resilience, and well-being. 

The antidote for perfectionistic charting involves getting better at just accepting “good enough” charts. There’s an acronym that can be a lifeline here: OHIO. When you Only Handle It Once, you commit to finishing a note without looking back and agonizing over imperfection. This way, you can make more time for activities that will fulfill and sustain you, allowing balance and satisfaction outside of your practice.

2. Focusing on Your Flaws

The second major stumbling block physicians face with charting is self-defeating thoughts. In the hundreds of physicians I’ve coached, I’ve heard variations of these coming into their mind when they sit down to chart:

“I’ll never get these done.”

“I’ve never been very good at all this.”

“Everyone else is so much more efficient than me.”

 “I’m not sure I’m even cut out for being a doctor.”

A lot of times, we can think that beating ourselves up is the best way to motivate ourselves to accomplish more. But, in reality, the opposite is true – all these negative thoughts simply erode your motivation and energy. 

The more you focus on what you’re doing wrong, have yet to do, and believe you aren’t capable of – the less you’re able to accomplish. The more you focus on your strengths and what you have accomplished, the more energy you have to accomplish more. This is what modern motivational science makes abundantly clear.

Nowhere is this more true than around physician charting.

While it takes practice to move from self-criticism to self-praise, physicians who learn to be more supportive and affirming with themselves are the ones who become more capable and efficient charters. 

Pay attention to self-critical messages and try flipping them:

 Go from:

“I’ll never get these done.”TO “I can get these done.”

“I’ve never been very good at all this.” TO “I’m perfectly good at this.”

“Everyone else is so much more efficient than me.” TO“I may not be the best, but I am efficient enough.”

 “I’m not sure I’m even cut out for being a doctor.” TO  “I’m definitely cut out for being a doctor.”

Make these flips and I suspect you’ll find that your charting efficiency increases dramatically.

3. Confusing Your Identity With Your Charting 

Oftentimes, charting spirals into a huge, identity-forming, make or break part of the career. It can become a measure of our worth as physicians. Sadly, this can turn charting into our nemesis. 

When we view charting through this lens, it’s no surprise that it becomes this momentous beast we have to deal with every day – and something that we agonize over and procrastinate.

But the truth is, charting is just something that needs to get done. 

Nothing more, nothing less – it’s simply part of the job. An annoying, time-consuming part of the job – but just another task to be completed. Your ability to chart doesn’t have any bearing on your value or skill as a physician. 

Letting go of all of the pressure and weight that we assign to charting helps us let go of all of the intense emotions many physicians experience around charting: anger, frustration, annoyance, bitterness, contempt, and more. 

This, of course, makes it easier to get charts done!

In Summary

You can recover from charting woes when you accept charting for the beast that it is, detach your sense of worth from it, and recognize that just getting charts done is 100 times better than spending time obsessing over them. 

In doing so, you’ll be reclaiming your life from the EMR. You’ll also make time for the people you love, be calmer and focused, and live the life you went into medicine to enjoy.

If you found this helpful, you’ll want to attend the Charting Your Life workshop. It’s available for individual clinicians and for hospitals and health systems as well. Learn more here.

  1. Embrace uncertainty

When you stop and think about it, uncertainty and change are the only things that are certain. Impermanence is one of the basic laws of our world.

After all, everything changes. Our relationships change. Our kids grow up and change. Our bodies age and change. Our environments change. Our planet changes.

All too often, however, we forget this basic truth. We somehow expect things to be predictable and stable.

The problem is that this expectation sets us up for difficulty. It leaves us struggling unnecessarily when something shifts. It adds a layer of suffering above and beyond that caused by all the VUCA around us.

What I’m getting at is that we have a choice. We can meet uncertainty with reactivity or we can meet it with mindful understanding.

More than meditating on a remote mountainside, mindfulness helps us have the calm, steadiness, and clarity we need to work constructively with all the change and uncertainty.

At the same time, while we can find ourselves resisting change, we can remind ourselves that it does not have to mean something bad! Just take a moment right now to think of all the difficulties you have faced in your life and work that are now resolved and far behind you. This can help you see how change has actually been quite the positive.

  1. Respond to complexity with compassion

Even knowing that change is the only thing that is certain, it can still be difficult to weather. Living in such a VUCA time is difficult. You deserve compassion for managing all the challenges.

With mindful awareness, we can bring ourselves compassion for what we’re going through. There is increasing evidence that self-compassion is a powerful antidote to stress and even burnout. From where I sit, I think that it is actually one of the most powerful medicinals available to us.

  1. Take purposeful pauses

With mindfulness, we are aware of what is going on within and around us. We tune in and pay attention to our experience. We learn to utilize our breath to take us out of the fears, worries, stories, and preoccupations our minds are so good at generating about what might come next, and bring us back to the present moment. Here in the present, we leave that overly activated limbic state and can experience a sense of calm.

A pause also serves to allow our prefrontal cortex to come online. It creates a critically important space between our emotional response and conscious, intentional action.

Once we have paused, we can then see more clearly that fear had taken hold. 

With a pause, we become the witness of our experience as opposed to the one trapped by it.

  1. View VUCA as opportunity

I don’t know about you, but I can find myself reacting to the VUCA environment with something of a fixed mindset. With a fixed mindset, I am telling myself things like ‘it shouldn’t be this way’ and ‘why is this happening?’

When I can utilize mindful awareness, I can see that I’ve boxed myself in with a fixed mindset. I can challenge myself to grow. By grow, I mean challenging myself to see whatever difficulty I’m experiencing as an opportunity to learn.

Here again, mindfulness again throws us a lifeline. Mindful awareness involves leaning into curiosity.

I can flip the script and ask myself:

What can I learn from this experience?

How can I use this to be a better version of myself?

How can I help others cope in this VUCA environment?

What do I want to look back and see about how I acted?

In summary, while VUCA is definitely the order of the day in healthcare and beyond, you don’t have to succumb. You don’t have to live in fear. There are constructive actions you can take to help you cope with uncertainty, build calm in chaos, and even thrive in chaos and VUCA. While we can’t control much that is contributing to the VUCA time, with mindfulness we can control how we respond to it.

I hope you’ll try out these 4 mindfulness strategies as I have seen them help countless people. I’d love to hear how it goes.

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To learn more about how mindfulness coaching can help you cope with this VUCA time, please reach out for a complimentary consult.

6 Free Resources To Help You During COVID19 And Beyond.

  1. 14-day meditation series 
  2. Imposter No More PDF
  3. Resilience Book Chapter
  4. Leading In Crisis PDF
  5. Balance To Burnout PDF
  6. 30-minute consult

Take advantage of one or more of these valuable resources created for clinicians and non-clinicians.