Why dictate, instead of just taking notes?

[mskk]

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[DrYoda]

I shadowed a pathologist (or two) today, and it was an awesome experience. However, all of the residents/attendings/everybody's mother *dictated* everything. I observed an autopsy, and the forensic pathologist dictated into a recorder before, during, and afterward. I sat in on a brain cutting session, and the resident taking samples afterward dictated everything. I overheard a lot of people complaining about how they had to dictate such and such...etc etc.

My question is, why? Doesn't it take twice as long to dictate and transcribe, as it would to just write everything down in the first place? Is this practice common across multiple specialities, or just path? Is it hospital-specific?

...don't ask me why I didn't ask this while I was at the hospital today; i have no idea.

Would you want brain bits on your notes?

 

[NotAndrew]

I shadowed a pathologist (or two) today, and it was an awesome experience. However, all of the residents/attendings/everybody's mother *dictated* everything. I observed an autopsy, and the forensic pathologist dictated into a recorder before, during, and afterward. I sat in on a brain cutting session, and the resident taking samples afterward dictated everything. I overheard a lot of people complaining about how they had to dictate such and such...etc etc.

My question is, why? Doesn't it take twice as long to dictate and transcribe, as it would to just write everything down in the first place? Is this practice common across multiple specialities, or just path? Is it hospital-specific?

...don't ask me why I didn't ask this while I was at the hospital today; i have no idea.

You can dictate your notes and then send the dictations to a transcribing service. It ends up being faster.

 

[starfishprime]

Would you want brain bits on your notes?

Type on a keyboard covered in plastic.

 

[BigRedBeta]

Dictating makes things go MUCH faster when you've got a stack of charts to run through. Even as a third year medical student (which by definition means I wasn't very good at dictation) I could spit out SOAP notes for clinic visits in about 3 and half minutes. In the end the documentation doesn't get into the chart immediately because obviously it's got to be transcribed somewhere, but it saves time for the physician to be sure. And actually, a lot of big hospitals outsource their dictation services and they get done overnight so there's really not even that big of a delay. The one exception might be for radiology reports which may still be done in-house for faster turn around time.

 

[Signaq]

I shadowed a pathologist (or two) today, and it was an awesome experience. However, all of the residents/attendings/everybody's mother *dictated* everything. I observed an autopsy, and the forensic pathologist dictated into a recorder before, during, and afterward. I sat in on a brain cutting session, and the resident taking samples afterward dictated everything. I overheard a lot of people complaining about how they had to dictate such and such...etc etc.

My question is, why? Doesn't it take twice as long to dictate and transcribe, as it would to just write everything down in the first place? Is this practice common across multiple specialities, or just path? Is it hospital-specific?

...don't ask me why I didn't ask this while I was at the hospital today; i have no idea.

As someone who has both dictated and handwritten evals/notes in an emergency room and private practice, I'd say dictation is by far more efficient and easier. Poor handwriting is a terrible problem -- if you cannot read the notes of the provider ahead of you, the notes are worthless and a real liability. Dictation takes care of that problem, obviously. Also, with back-to-back patients, dictation becomes a quick way to document your findings, then move on to the next patient versus trying to format, spell check, go back and correct mistakes. Dictating immediately after a patient encounter allows for easier recall of details versus waiting until later in the shift when you try to handwrite out 20 evals from the past few hours and try to recall one patient complaint from another. Typing or even handwriting evals takes too long, too risky for spelling/formatting errors, and too hard to computerize and reproduce when compared to a dictated eval. Turn-around time in my hospital is less than 2 hours for STAT and less than 24 hours for routine reports -- a workable timeline for most dispositions in my experience.

 

[Kaustikos]

As someone who has both dictated and handwritten evals/notes in an emergency room and private practice, I'd say dictation is by far more efficient and easier. Poor handwriting is a terrible problem -- if you cannot read the notes of the provider ahead of you, the notes are worthless and a real liability. Dictation takes care of that problem, obviously. Also, with back-to-back patients, dictation becomes a quick way to document your findings, then move on to the next patient versus trying to format, spell check, go back and correct mistakes. Dictating immediately after a patient encounter allows for easier recall of details versus waiting until later in the shift when you try to handwrite out 20 evals from the past few hours and try to recall one patient complaint from another. Typing or even handwriting evals takes too long, too risky for spelling/formatting errors, and too hard to computerize and reproduce when compared to a dictated eval. Turn-around time in my hospital is less than 2 hours for STAT and less than 24 hours for routine reports -- a workable timeline for most dispositions in my experience.

That and you don't have to transcribe everything yourself. I would rather talk into a recorder about something than right it down/type it bit by bit. And not having to have to type it out wins, hands down.

 

[justdoit31]

A lot of physicians do this... the family physician I shadowed took brief notes when in exam with patients onto the chart in shorthand then would dictate the whole case which helps to cover bases more and saves her a lot of time!

She usually would see 2-3 patients then sit down with her voice recorder and dictate those patients. She would include stuff she calculated outside of the patient rm as well (like BMI) and also recommendations for future monitoring in case she is booked and that patient saw one of her partners for an emergency.

 

[Styria]

An internist I shadowed would write his notes down while he was with the patient. Though he spent more time per patient too, which I liked. It saved him overhead costs.

 

[tdittyx2x3]

An internist I shadowed would write his notes down while he was with the patient. Though he spent more time per patient too, which I liked. It saved him overhead costs.

According to the posts so far here, I would think he would be losing money in the long run being that dictation is more efficient. More time --> more patients --> more money.

But hey I'm all for more time with the patients.

 

[unsung]

Typing would be faster for me than dictating into a recorder. Anyway I type almost as fast as I talk, so it's not a big difference at all. I work at a hospital now and it's so much easier for me to type my notes vs giving oral report. I find with oral report I'm often forgetting something or giving my report in a haphazard fashion. My writing is far more concise, logically organized, thorough, etc. I guess I just write better than I talk.

Guess I'm in the minority, though? I guess things could be difference once I'm actually writing SOAP notes as a med student.

 

[Signaq]

Typing would be faster for me than dictating into a recorder. Anyway I type almost as fast as I talk, so it's not a big difference at all. I work at a hospital now and it's so much easier for me to type my notes vs giving oral report. I find with oral report I'm often forgetting something or giving my report in a haphazard fashion. My writing is far more concise, logically organized, thorough, etc. I guess I just write better than I talk.

Guess I'm in the minority, though? I guess things could be difference once I'm actually writing SOAP notes as a med student.

I hear you -- as a former secretary typing 90+ wpm, it felt so awkward at first to dictate. Believe me, dictation is so totally worth embracing. You will learn to be concise in your dictated speech, which can only help when you're talking with other health care professionals who expect your oral reports to them to be concise, logical, organized, thorough....👍