The 5-8 Minute Change That Helped Me Stop Charting at Night as a Physician

Back when I was having multiple patient charts to complete at the end of my clinic day, I understood the concept of seeing one patient and completing the chart before moving on to the next patient. In theory, it made sense, but in reality, I was resistant. My brain offered many reasons for not completing the patient charts right away: you want to keep the patients as close to their scheduled times as possible. Finishing the patient chart will take too long before you see the next patient. The staff wants to get out of here, and you do not want to be the one causing them to do overtime. All these excuses seemed to be reasonable at the time. The end result was that I was not able to finish the patient charts until at least two hours, if not more, after seeing the last patient of the day.

What was holding me back? The simple answer is fear. Fear that I would be judged because the patients had a wait longer. Fear that the patients would not like me because of the long wait times. Fear that the staff would judge me because I kept them late.

I was living in this “comfort zone” of doing what I was familiar with, and almost accepted that it was my story – that was the way it had to be.

Why was I afraid to try something different? The unknown is frightening. You do not know if it is going to work, and by default, your brain is offering the vision that you cannot do it. This is normal. If you fully believe that you can do it – seeing one patient and completing the chart right away in this example – you would have done it already. The discomfort is your current self resisting to wear a new identity.

It is often uncomfortable to change what you are doing, because it is an uncharted area by you – even though other people have successfully done it. It is natural for you to think that this is for them and not for me. At the same time, you can allow your mind to entertain what is possible – if they can do it, then I can do it too. I can work toward achieving it.

Be intentional about what voices you are listening to. If you know that something is going to get you closer to your goal, even though it is scary, even though you have not done it, be open to doing it. You may feel like throwing up. For me, it was getting over the judgment of my patients. My belief was that if I allowed the patients to wait longer, patients would not like me, even though I was doing my best to take good care of them.

I was told on different occasions that what made you want to throw up was the thing that would get you where you wanted to be. Doing it scared, I tried. Oh my, it was really uncomfortable, disturbing, the fear (of judgment) was so real. Then I timed myself, how much longer did I have the next patient wait for? Usually an extra five to eight minutes. By the time I walked into the next patient’s room, I could give that patient 100% focus, because I finished everything on the previous patient. If the patient waited for twenty, or even thirty minutes, would an extra five minutes make a big difference? By seeing the patient and completing the chart right away, I freed up mental space to focus fully on one patient at a time. Even if a patient mentioned something about the wait, I would just thank them for their patience and explained that it was a really busy day.

The more I did the uncomfortable thing, the less uncomfortable it felt. I stopped wanting to throw up. I stopped thinking about being judged. I started seeing the results – it had become my routine in the office to see one patient and finish all the orders, review test results and the chart before going to the next patient. That helped me shed the burden of having a pile of charts to complete at the end of the day. That helped me leave the office with all my work done by 5 pm – without decreasing the number of patients I see.

If I were a caterpillar, the complete metamorphosis of becoming a pupa to an adult butterfly would be frightening. I actually had to stay put in the form of a chrysalis, stuck in tight quarters, before becoming an adult. The caterpillars do it anyway – they become beautiful flying creatures. If we can do the thing that will bring us closer to our goal, even though it makes us want to throw up, we will eventually adopt a new identity, one that is closer to your goal, if not already at your goal. When I look back at my journey – now, if I were to go home with undone charts, that would make me want to throw up.