Oh, he didn't mean it in a "racial slur" at all. He's just a funny older man trying to identify someone. It was just hilarious because he was in the waiting room on his cell phone and he is very hard of hearing. It was loud and watching this 84 yo yell into a cell phone about the black doctor in front of other patients cracked me up.
Well, I've made some adjustments in the office and the workflow is markedly improved. I had every f/u and post-op patient charted and referring doc letters sent before the end of clinic. I finished morning clinic (8-12) and all the history was on the new patients. I sat down and ate some lunch and finished the new patients' charts, sent the consult letters, and sent the H&Ps to the hospital. Done by 1pm and off to the O.R. without having to come back to the office to finish up. Perfect. No, I'm not finished with the patients before they leave but that really wasn't my ultimate goal. My ultimate goal is to be done with office charts/responsibilities before 5pm each day. So really that is a marked move in efficiency from my old paper chart days.
I would dictate in between patients, or at the end of clinic, pay a transcriptionist, read through the transcriptions a couple days later, send off the referring docs letters, fax a copy of the H&P to the hospital. So instead of a 2-3 day turnaround, it's done within a few hours.
I have to type a lot more than usual but fortunately I'm a fairly good typist. It's very difficult to template things that you are used to just commenting on when dictating. I used to do this a lot to better identify the patient when I reviewed the chart later. A lot of people have GERD that may need an EGD and Lap Nissen. I can template those symptoms. I can't template the fact that the patient is the wife of one of the ICU nurses and she finds it odd that lettuce really bothers her stomach and not the normal "spicy/caffeine/etc". Or that she was seen at Mayo clinic for an odd persistent leukocytosis, had 2 bone marrow biopsies that were inconclusive, and still doesn't know what's wrong with her. So I can template the basics signs and symptoms, but these types of facts that I like to include for thoroughness are time consuming to put in a chart. I've tried Dragon9 and thought it was more difficult to use than simply typing.
O.K. Having my front office "staff" put in the weight of the patients and send me the chart to my inbox works great. I love that. Plus, it forces us to get weights on patients and in many operations, weight loss/gain is a significant vital.
So I'm using many of your suggestions and improving my workflow exponentially.
Thanks again.
