91. Is this the end of note bloat? | Breaking down the 2023 documentation guidelines
11/07/22 • 66 min
28 years ago, the die was cast for how emergency department encounters were documented. Since then, we've had note bloat, click fatigue, and too much attention placed on things that really didn’t matter. All of that is slated to change in 2023 with dramatic new documentation guidelines (that today’s guest calls ‘refreshing’) are implemented. When was the last time you heard the word ‘refreshing’ used when it came to charting? And a massive thank you and hat tip to my friend Matt DeLaney who now runs ERcast - he was the first to alert us to these guidelines and interviewed Jason when they were first announced.
Guest bio: Jason Adler, MD is a clinical assistant professor of emergency medicine at the University of Maryland where he is also the director of compliance and reimbursement. He is also the vice president of acute care solutions at LogixHealth.
Episode Sponsor: Ivy Clinicians. Curious if there’s a better clinical opportunity out there? Ivy is the simplest way for physicians, PAs, and nurse practitioners to match with jobs they love. With Ivy, you can find all 5,549 emergency departments, filter by your preferences, and connect securely with the right employers. All for free.
For full show notes of this episode and all sorts of other goodies, visit our podcast website
Awake + Aware | Our 2025 Live Event
⭐ Join us at Awake and Aware 2025, a game-changing 3-day workshop from May 5-7 in Bend, Oregon. Learn how to stay cool when the pressure’s on and lock in the mindset you need to flourish. Space is limited.
🖱️ Website: Awakeandawarebend.com
🎓 P.S. Yes, this is a CME event!
The Flameproof Course
The hidden anti-burnout curriculum we all should have learned in training. Cohort 3 begins Sept 10, 2024. Get the deets
We Discuss:
- History and physical documentation are now at your discretion;
- Heavy value is placed on cognitive work and medical decision making;
- History from a non-patient source is valued in these guidelines;
- Ordering a test is equally valued as not ordering a test;
- Consideration of escalation or deescalation of care;
- In addition to documenting your shared-decision making conversations, your MDM should include;
- Population health - Stable means something different when it comes to documentation;
- Social determinants of health;
- There is a heightened emphasis of independent interpretations of separately billable procedures (EKGs, X-ray, CT, U/S);
- Jason’s take home points;
- And More.
28 years ago, the die was cast for how emergency department encounters were documented. Since then, we've had note bloat, click fatigue, and too much attention placed on things that really didn’t matter. All of that is slated to change in 2023 with dramatic new documentation guidelines (that today’s guest calls ‘refreshing’) are implemented. When was the last time you heard the word ‘refreshing’ used when it came to charting? And a massive thank you and hat tip to my friend Matt DeLaney who now runs ERcast - he was the first to alert us to these guidelines and interviewed Jason when they were first announced.
Guest bio: Jason Adler, MD is a clinical assistant professor of emergency medicine at the University of Maryland where he is also the director of compliance and reimbursement. He is also the vice president of acute care solutions at LogixHealth.
Episode Sponsor: Ivy Clinicians. Curious if there’s a better clinical opportunity out there? Ivy is the simplest way for physicians, PAs, and nurse practitioners to match with jobs they love. With Ivy, you can find all 5,549 emergency departments, filter by your preferences, and connect securely with the right employers. All for free.
For full show notes of this episode and all sorts of other goodies, visit our podcast website
Awake + Aware | Our 2025 Live Event
⭐ Join us at Awake and Aware 2025, a game-changing 3-day workshop from May 5-7 in Bend, Oregon. Learn how to stay cool when the pressure’s on and lock in the mindset you need to flourish. Space is limited.
🖱️ Website: Awakeandawarebend.com
🎓 P.S. Yes, this is a CME event!
The Flameproof Course
The hidden anti-burnout curriculum we all should have learned in training. Cohort 3 begins Sept 10, 2024. Get the deets
We Discuss:
- History and physical documentation are now at your discretion;
- Heavy value is placed on cognitive work and medical decision making;
- History from a non-patient source is valued in these guidelines;
- Ordering a test is equally valued as not ordering a test;
- Consideration of escalation or deescalation of care;
- In addition to documenting your shared-decision making conversations, your MDM should include;
- Population health - Stable means something different when it comes to documentation;
- Social determinants of health;
- There is a heightened emphasis of independent interpretations of separately billable procedures (EKGs, X-ray, CT, U/S);
- Jason’s take home points;
- And More.
Previous Episode
90. The Dalai Lama’s Doctor Has a Prescription for You | The critical distinction between empathy and compassion
Barry Kerzin, MD, the Dalai Lama’s personal physician, is back to dive deeper into: the difference between empathy and compassion, why compassion (versus empathy) is a critical aspect of medical care, generating self compassion, and answers to listener email.
Guest Bio: Barry Kerzin, MD is a US born and trained family physician who for the past several decades has resided as a monk in Dharamshala, India — home of the Tibetan community in exile. In addition to serving as H.H. the Dalai Lama’s personal physician, Dr. Kerzin is the founder of the Altruism in Medicine Institute, whose mission is to increase compassion and resilience among healthcare professionals and extended professional groups, such as police officers, first responders, teachers and leaders.
Self described as “...a doctor, a monk, a teacher, a lazy man. All of these things, yet none of these things,” you can follow Dr. Kerzin on Facebook, Youtube, Instagram or learn more about his story here.
Episode Sponsor: Ivy Clinicians. Curious if there’s a better clinical opportunity out there? Ivy is the simplest way for physicians, PAs, and nurse practitioners to match with jobs they love. With Ivy, you can find all 5,549 emergency departments, filter by your preferences, and connect securely with the right employers. All for free.
For full show notes of this episode and all sorts of other goodies, visit our podcast website
Awake + Aware | Our 2025 Live Event
⭐ Join us at Awake and Aware 2025, a game-changing 3-day workshop from May 5-7 in Bend, Oregon. Learn how to stay cool when the pressure’s on and lock in the mindset you need to flourish. Space is limited.
🖱️ Website: Awakeandawarebend.com
🎓 P.S. Yes, this is a CME event!
The Flameproof Course
The hidden anti-burnout curriculum we all should have learned in training. Cohort 3 begins Sept 10, 2024. Get the deets
We Discuss:
- The difference between empathy and compassion;
- Can compassion be taught?
- Listener email about having a hard time switching between empathy and compassion;
- Barry’s response to the listener's email;
- Self compassion after a bad patient outcome;
- Exercises to help build compassion;
- The decision point between accepting people how they are and trying to change them;
- And More.
Next Episode
92. Strategies for Shift Endurance
It’s a tough time to practice medicine, which makes paying attention to self-care even more important. In this episode, we break down three specific strategies for improving mental and physical performance during a long shift, sustaining shift endurance, and building a scaffolding for joy at work.
For full show notes of this episode and all sorts of other goodies, visit our podcast website
Awake + Aware | Our 2025 Live Event
⭐ Join us at Awake and Aware 2025, a game-changing 3-day workshop from May 5-7 in Bend, Oregon. Learn how to stay cool when the pressure’s on and lock in the mindset you need to flourish. Space is limited.
🖱️ Website: Awakeandawarebend.com
🎓 P.S. Yes, this is a CME event!
The Flameproof Course
The hidden anti-burnout curriculum we all should have learned in training. Cohort 3 begins Sept 10, 2024. Get the deets
Episode Sponsor: Ivy Clinicians. Curious if there’s a better clinical opportunity out there? Ivy is the simplest way for physicians, PAs, and nurse practitioners to match with jobs they love. With Ivy, you can find all 5,549 emergency departments, filter by your preferences, and connect securely with the right employers. All for free.
We Discuss
- A perennial nocturnist shares his approach to career longevity;
- An unexpected thread in the origin story of medical training in the US;
- Three strategies to focus on self-care and improve endurance during shifts;
- Fuel like an Ironman triathlete;
- Does the patient always come first?
- Using the dynamic between tension and relaxation to conserve energy;
- Using intention as a tool for self-care.
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