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Using the Fourth Exam Room (Part 5 of 12)

Many physicians bog down their workflow by batching a lot of work for the end of the day. When it's finally time to go home, there are charts to dictate, calls to make, and so on. It's frustrating — and inefficient. At the end of the day, a physician will need to spend a minute or so remembering his or her thoughts about a patient visit before dictating a note. Those minutes add up: it takes a minimum of 15 minutes to rebuild your memory for 30 charts. Why not dictate, instead, while you are with the patient? Like all of us, patients retain less than a third of what they hear. Dictating in front of them, in a conversational way, will increase retention of information and demystify their care. Tell the patient what you are about to do.

Did you know it takes at least 15 minutes to remember the notes you need to take for 30 charts? Dictate during your exams to avoid wasting time.

Alternatively, we've seen a scribe attend each exam, often a medical assistant who can also serve as an escort during internal exams. The scribe takes all the notes and stays on after the physician leaves the room to answer additional patient questions and provide instructions. Meanwhile, the physician already is in the next exam room with another scribe.

If that seems too odd or too expensive, consider setting up a virtual — or real — fourth exam room. After every third patient visit, duck into the nurse's station, dictation station, or some other semi-private space. Return whatever calls have come in during those exams, review test results, do your dictation, and complete any forms that are pending. In short, do the work throughout the day instead of holding it for the end.

Our essay next month will be "Using Nonphysician Providers."

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Physicians Practice

Disclaimer: The material above has been prepared by Physicians Practice. It has not been reviewed by the DermQuest Editorial Board for its accuracy or reliability. Reference to any products, service, or other information does not constitute or imply endorsement, sponsorship, or recommendation by members of the Editorial Board.