theophylline

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May 7, 2009
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How many of you spend more time filling out charts and paperwork than actually seeing patients? Do your interns or senior residents typically sign-off on your notes.

It seems to me that, for the sake of didactics, despite the utility of contributing to the intern workload, that a lot of the documentation should not be left to the medical student. Writing a H&P and learning how to properly document is critical, but that is different from filling out discharge summaries all night on patients you don't know.

My feeling is that there is great variability on this across hospitals within a single institution as well as across institutions in this country. Still, medical school is an experience that we pay for, and the degree to which instruction exists in some settings is truly in need of independent, outside review and reform.
 

rock_climber

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i'd say right now it's probably about 50/50 as far as time spent. i haven't had to write notes on pt that i don't know, but my intern/residents expect me to write the note if i see the patient, which I am fine with. it seems like a 50/50 ratio is very generous in fact when I look at the amount of time the residents/attendings spend on notes, dictations, etc. i think it is good practice, but if i was writing d/c summaries for pt's that i'd never seen that would be a different story for sure
 

SoCuteMD

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We didn't do that stuff for patients we weren't carrying for the most part. I would say my paperwork/time spent with patient ratio was probably 1:2 (so 2/3 of my time spent on paperwork) as a medical student. Now I've become more efficient at both. So it's still the same.
 
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BigRedBeta

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If youre being forced to do paperwork on patients that aren't yours, you're getting scutted, and you should let your clerkship/rotation directors know.

Doing paperwork is an important skill to have, because it's going to be what you do with a lot of the time you spend in residency and in your working life. Plus, it's the one thing you can do as an M3 early on in the year. You may not know the steps to take when a potassium level comes back at 7.8, but you can ask questions and write a good note.

Further, a lot of the discrepancy between time spent with patients and time spent writing notes is due to the fact that it takes so much longer to write things down. Even efficient residents may spend 5 minutes with a patient in the morning during pre-rounds, and take 10 minutes to write their note, and it seems out of whack.

If you want to cut down on your paperwork, practice dictating whenever you can. Especially helpful for longer documents like admission H&P's and discharge summaries.
 

plainolerichie

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I spend very little time seeing the patient, but much more time writing, etc... Maybe 3/4 or 2/3 time writing notes and paper work.
 

Random

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Speaking only for myself, my experience as a student doing paperwork has made me more efficient as an intern. And now that I'm an intern, while I won't have my students do all of the paperwork, I will have them write orders, scripts, etc. to get used to doing so. And at my program, I'm not responsible for d/c summaries as an intern and we dictate next to nothing.