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Guest Blog: Should physical therapists leave their computers at their desks while treating patients?

by Kevin Prue, PT, DPT, CSCS, president and director of Prue Physical Therapy and Sports Performance in Cary, NC. Dr. Prue is also an editorial team member at New Grad Physical Therapy. You can find him at @DrKevinPrue

The number of practices that rely on paper notes, charts and traditional means of documentation is decreasing, regardless of the setting. As clinics try to improve efficiency and streamline the EMR process, physical therapists and other healthcare professionals are being encouraged to document on their computers during sessions with patients. While there are certainly benefits to documentation during appointments with patients, there are also hindrances.

Benefits of Documenting While With a Patient

Documenting while with a patient helps physical therapists eliminate the piles of notes that collect on our desks at the end of each day. Trying to remember what our 9:00 AM patient said or did at 6:00 PM can be extremely difficult, especially after we’ve seen 15 other patients that day.

By completing our documentation during each visit, we can help ensure that everything we are putting into the medical record is accurate, medically necessary, and completed on time. By having our computers in front of us during treatment sessions, we have quick and easy access to previous notes, a full medical history and contraindications that can help shape our treatment plans. This not only helps us provide high quality care, but it can keep our patients safe. Aside from improving the quality of care and increasing patient safety, in-session documentation can also save physical therapists time.

Let’s face it, we got into physical therapy because we enjoy helping people, not because we love paperwork. A typical 9-5 workday can turn into a nightmare when clinicians are faced with hours of patient documentation, billing and coding at the end of each day. By documenting during each patient visit, physical therapists can save themselves hours each day, which not only increases  clinics’ efficiency, but also allows us to leave work at a reasonable hour so we can get our daily workout in, or whatever else we need to get done during the day (yes, physical therapists do have lives outside the clinic). So, as electronic documentation becomes the norm, it’s only logical for physical therapists to jump on board with in session documentation in order to use their time efficiently.

How Computers Can Negatively Impact Patient Care

Being able to multitask is almost a necessity in physical therapy, so typing the subjective portion of a note as a patient talks almost comes as second nature. However, typing away at our computers can also become a distraction to our patients and be interpreted as rude or dismissive, even if we are listening intently.

Physical therapy is a unique profession where we get to spend a lot of time with our patients, and sometimes listening can be therapeutic in its own right. Thus arises the dilemma of documenting while we work with patients. If a patient perceives that we are not listening to them because we are working on our computers while they are sharing their story with us, then we are not doing a big part of our job as healthcare providers. Research has even indicated that patient centered communication and perceived listening by a healthcare provider leads to improvements in patient satisfaction and outcomes while also leading to a decrease in malpractice lawsuits.

Making eye contact, practicing good communication skills, and being attentive to our patients can also lead to increased trust between clinician and patient. Trust is essential in the clinician/patient relationship, especially in a field like physical therapy where we place our hands on patients. We need our patients to trust that we understand their concerns and trust us to make clinical decisions that are going to help them.

If we give off the impression that we are disengaged, uninterested or uncaring, then no matter how good a clinician we are, our patients won’t trust us. Trust is something that needs to be earned, and if a patient’s first impression of us is “another healthcare provider who is more worried about their paperwork than the patient right in front of them”, then it will be nearly impossible to earn that patients trust.

So what’s the Right Answer?

There is no right answer to whether or not we should bring our computers with us into a physical therapy session. No matter what method you choose, as a clinician, you need to remain attentive. Don’t undervalue the importance of listening and communicating with your patients in order to save yourself some time at the end of each day. If you can handle documenting during your sessions and your patients don’t mind, go for it.

However if in-session documentation leads to increased distractions or causes you to consistently ask a patient to repeat themselves, then maybe this tactic isn’t the best for you. If you are unsure of how your patients will respond to you documenting during a treatment session, don’t be afraid to ask. Fortunately as physical therapists, we get to know our patients on a personal level, and we can determine which patients may find a computer being in the treatment room as a big turn off to make this decision easier for us.

Ultimately it’s your decision as a clinician, but even if you think your patients are comfortable with you taking notes during an appointment, you should still make it clear what you are doing. Tell them beforehand that you will be taking notes and don’t forget to make some eye contact during the conversation to show that you really are engaging with them, not just pounding away at a keyboard. After all, being viewed as a caring, compassionate and effective physical therapist is much more important than being left with a few notes to complete at the end of the day.

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