Learning a new EHR(electronic health record)

Learning a New EHR (electronic health record)

I haven’t posted for awhile because my brainspace has been occupied by a new life situation that I love, but it requires every doctor’s least favorite thing: learning a new EHR.

Oh, you’re used to documenting in this esoteric way, hopping from tab A to tab B to write your note and place orders? Now you must adjust and mix the blue and yellow to make green then remember that you have to dig six levels in to check a box to prove you did something.

My new colleagues warned me about this EHR before I started. “It’s annoying” and “It’s one step above the VA.” (The VA’s system is supposed to be the worst dinosaur of them all.)

People who know me know I have a motto of sorts:

”My goals are to bring value to the community and to hone my skills as a physician.” Period.

Can I still bring value to the community when I spend 50% of my worklife navigating through a maze of obscure software just to take care of patients and do my job? Yes, I can.

Does it make my day more “challenging” than it needs to be? Yes. But I never forget the privilege I have of being invited into peoples’ lives every time I enter a new exam room with patients waiting to see me.

The privilege of the doctor-patient relationship and the right to continuity of care

You may be interested to learn I have what might be considered a strange or quirky habit. At the end of every shift I take stock of my schedule. How many visits today were with a repeat patient? I make a little hash mark/note (for example “2nd III” for three patients whom I saw for the second time, and “3rd I” if I saw one patient for their third face-to-face visit with me, and after four lines it gets the diagonal line to make five.) Continuity of care, which in human speak means seeing the same doctor every time, makes a huge difference in the quality of care I can provide and the care patients receive.

I think we can all agree that I can provide better value to the community when the patients and I aren’t re-inventing the wheel every time they come to the clinic.

Plus, it’s a great compliment when people come back to you again. Last week a patient gave me a big hug when I told her that seeing her here at my new office (I’d seen her twice at my old office) was my warm fuzzy of the day. What an honor to have folks follow you to a new clinic!

Rural medicine and being a country doctor

This is a medically-underserved community, so I understand that people need a competent doctor that is local and not an hour+ (Mammoth Lakes), or 3+ hours (Reno) or 5+ (Los Angeles or Las Vegas) or 8+ hour (San Francisco) drive away. I won’t flatter myself that folks follow me solely for my grace and charm (tee hee). They also follow me because they know somewhere deep down that they are safer when they have a primary care physician.

If I can provide safety to people, it is worth hunting through an outdated EHR as part of my duties. My office is set up for good music through speakers or headphones so at least the music is soothing the savage beast sitting there for an hour or two or three after the last patient has left for the day. Point, click, wait for the spinning circle, type; point, click, wait for the spinning circle, type; wash, rinse, repeat.

But…it’s important for me to document not only what happened during office visits in the EHR. I want to provide value and document/blog the real life process of embracing rural medicine that I sought out. Also, there are other videos on the internet I’ve made about this transition to medically-underserved California, health topics, my horse, and life in general.

Documenting my transition from city medicine to country doctor medicine…more to come!

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