I have always found that dictation makes the most accurate note. It may not give all the reminders and fields so you code and get MIPS, etc. but while there are macros most of the time the dictation describes exactly what happened. I would much rather get a dictated note from a consultant, and I would much rather get it in SOAP format instead of APSO. I was using DNS and loved it, but I didn't feel comfortable doing it in front of the patient, therefore, I would need to wait until the end of the day. I suppose I could ask walk the patient to the door, then go back and dictate.
The huge frustration of dictating in AC is that there is no way to use the dictation to jump between fields. That's the whole idea, to never have to use the mouse. But, I do find that when I dictated the note was much more thorough.
There was one person on here, I forget whom, he will comment if he sees this, but he would type in short sentences that would remind him of the note, then come in early when fresh and do them. I do think that dictation fits better with FP as you generally have to address the different problems at the end.
The other thing is I tend to not get behind when typing a note in the room. Since you have to dictate after it is easy to save it for later. I suppose this is out of place, but the other advantage of dictating at the end of the day is the ability to be organized and look things up as you finished you A/P.
The thing that is catching on more and more are scribes. But, I see them mostly in the ED and specialists. It just seems like it has to add to the cost. More money going to the specialists and less for the lowly PCPs. Jon may want to comment on that.
