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Do You Know How To Chart?

. . . or do you just know how to write a SOAP note?

Don’t take this the wrong way, but . . . do you know how to chart? Or do you know how to write a SOAP note?

Many, many, MANY clinicians fall into the second camp.

If that’s you, know that it’s not your fault. School doesn’t teach us how to chart - whether you went to nurse practitioner school, physician assistant school, medical school, dentistry school, veterinary school, you get the drift.

This stuff is simply not taught to us as students.

I get it - sort of; there is a LOT of other important information that we have to master during those years. Some of it will be information that we use all the time, maybe daily, regardless of our setting - I’m looking at you, CMP.

But one of the most compelling things (if you ask me) that unites us all as clinicians is charting.

We all do it; no one is exempt. Multiple times a day, maybe dozens of times a day.

When I say charting, I mean more than writing a note. I mean pulling up previous records. I mean ordering labs. I mean responding to messages from staff. I mean sending referrals. I mean resulting labwork. I mean processing refills. All of that, and more.

School generally teaches us to write a SOAP note. Yes, this is the backbone of a progress note with a cute little name that helps us to organize what we are going to put where. You could just as easily learn to write an OLDCARTS note, though, and tack on a diagnosis and plan at the end. SOAP is a framework, not a method.

Knowing how to write a SOAP note isn’t going to make you good at charting, it’s not going to make you an efficient user of your EHR. It’s just going to help you document.

You may or may not know this, but one of my hats is as an Investigator for my Board of Nursing. In that role I have literally read tens of thousands of notes. I know what I am looking for when I have to read your notes . . . and I know what is so not necessary and gets skipped over. I can tell who knows how to chart and who simply knows how to write a SOAP note.

When I was in NP school, we had to write formal SOAP notes and turn them in as assignments weekly; the rubric had a minimum page count of 6 or 7 pages if I recall, and probably 5 or more scholarly references. Knowing how common this is in NP school, it makes sense that we get into “the real world” and still write our notes like this. That’s what we were taught, that’s ALL we were taught on the subject. And then if the patient wants to cover 10 different concerns in a visit . . . that’s going to be one long note.

Those are the notes that keep you at the office after hours.

Those are the notes that keep you charting at home.

Those are the notes that keep you charting on the weekend.

I’m really hung up on the fact that for the average NP, just 5 hours of extra work per week (staying late, coming in early, charting at home) comes to $15,000 in uncompensated time in a year.


There is so much chatter about how we have to “know our worth” but what about hidden dents in our worth? If you make $100,000 a year but have to stay late just 5 hours each week, you’re diluting your worth. You’re giving your employer $15,000 worth of your time for free.

So what do we do?

We learn to chart. We get some Chart Magic.

I’ll be straight with you: I’m selling a course that is going to help a lot of people learn to chart > manage their time more effectively > leave the office on time regularly > get their free time back. You should check it out, and if you are interested, you should get in now while the price is lower than it will be the next time I open it (like hundreds of dollars less). There is info at the end of this message.

But what I want for you more than anything is to get your time back in your control.

We both know that things are wild in healthcare right now, and they are not going to get better. We need to unify and raise our voices and advocate for ourselves - but that is not going to happen if we are busy closing charts at 10:00 at night all the time.

So whether you let me show you how to chart and get your time back, or you find another method - FIND SOMETHING. It’s so imperative to your professional success, to burnout / moral injury prevention, to being able to advocate for ourselves and take care of our patients.

Whew. That was a lot.

Details on Chart Magic (enrollment ends on April 7): click here.

Take care,

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