How role models can make you a better doctor

“If it’s not written, it didn’t happen.”

We have heard this before. And it’s so true. Good medical documentation is essential because it reflects your clinical thought process. Your notes are crucial for continuity of care, to ensure you’re billing compliant, and to protect you in the event of a lawsuit. Your notes are an expression of your digital identity as a physician.

When I first started using templates many years ago, the most obvious benefit I saw was that I became more efficient at creating charts. But quickly, I realized there was another impactful payoff: by using personalized patterns and dotted phrases, mapping allows me to improve my skills as a doctor and provide better care to my patients.

Orientation at the point of service

Most medical errors are human errors! By incorporating patterns into your practice, you can be sure nothing gets missed. With a patient with chronic diarrhea, there are many things to assess. You ask the patient if they have recently taken antibiotics or travelled, if they suspect food poisoning or if they have drunk untreated water. You make sure no other members of the household have similar symptoms and you can ask if the patient is a man who has sex with men. With today’s fast-paced medicine, if you don’t use a “diarrhea” model, you risk missing out on essentials. This could lead you to a misdiagnosis.

Here are more examples of how templates help you:

As a safety net: Never forget to order LMPs in a patient with abdominal pain, thus preventing you from missing an ectopic pregnancy.
As a suggestion: In a patient complaining of hip pain, use the model to suggest examining the lumbar spine in case the pain is referred.
As a reminder: have this clue in your pharyngitis model: “If the SGA test is negative, consider looking for STI (gonorrhea) risk factors.”
As a checklist: Include all red flags in your headache or low back pain models.

Proper use of templates ensures that your note and your patient’s assessment don’t miss important details.

second digital brain

Models become very handy when you store knowledge in them. Enrich your models with everything you might need to access during a patient visit. New guidelines, indications and contraindications of a new drug and links to online pages or videos are good examples. Therefore, templates act as a second brain for anything you learn and fear you might forget.

Over time, you constantly improve your models. When you learn something new, update your models on the go so the information doesn’t need to be stored elsewhere. This knowledge becomes instantly accessible when it is most valuable: during the patient encounter.

Some physicians even take their use of models to the next level: they move all of their notes, medical knowledge, and references to their models. Anything new they learn from CME, they store in templates. This knowledge becomes instantly accessible when it is most valuable: during the patient encounter.

Learn from models

Some may say that using templates can make our memory lazy (“no more remembering, everything is saved in templates”). But the fact is that our memory and our knowledge are not entirely reliable. In fact, templates have the opposite effect on our memory: the more you use templates, the more you assimilate their content, and the more you retain knowledge and improve your skills.

Models do not exist to substitute for your thought process. Think of them as a supplement to improve your differential and solidify your medical decision-making. You learn from models you have created and updated yourself while maintaining full control over the documentation.

The use of templates should not be optional. It is a must that all physicians should incorporate into their workflow to ensure quality of care. When the templates are personalized your way, they gradually improve your skills by acting as a safety net, giving you point-of-care reminders, and serving as a knowledge base. You continually assimilate their content, which improves the quality of the care you provide.

Charles Tanguay is a family physician and creator of Dilato, an app to help doctors quickly write their clinical notes using templates and shortcuts.

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