Documentation

One thing about being at the Valley is that daily notes are handwritten. This creates an interesting phenomenon; we write less because it takes more effort and time. But because we are constrained by time and physical writing effort, the notes we produce are more direct. When I write computerized medicine notes, I might expound on the theoretical aspects of a specific problem. "Anemia may be categorized into microcytic, normocytic, and macrocytic. This patient's anemia is microcytic and our differential diagnosis therefore is iron deficiency anemia, anemia of chronic disease, thalassemia, and lead poisoning." But when I am at the Valley, I instead write, "Anemia - MCV 75. FOBT. Iron 325 BID."

Whether this is good or not, I am not sure. As a medical student, notes are of paramount importance, but as a resident, they are a nuisance and necessity. Notes have an important documentation and legal value. Good notes also convey thought processes and communicate. But in the overall scheme of things, my priorities are focused on patient time and orders, not documentation. I found that having to write less at the Valley gave me more time to think about the "doctory" stuff - thinking about a patient and deciding what to do rather than writing about it.