Old School and New School
No matter where I am, I hear the old school/new school discussion. In simplest terms, it's a comparison of how we did something years ago compared with how we do it now. In more unkind terms, it can become a condemnation of those who went to school back in the day or new graduates. It came home to me how different the thinking is last Friday.
I made a comment about how being slow in writing evaluations results in lower productivity. This was meant with a stunned silence followed by a question. Why aren't you writing them during the evaluations? That way it is billable time.
Now I admit I'm seriously old school. The people I was speaking to were new school. Back in the day, we were taught to devote our attention to the patient for the duration of the treatment session. The patient, or rather his payer source, was paying for our time and expertise. You don't take time out for prolonged documentation. You write test results. You note prior functional and living levels. You discuss goals and therapy expectations at the time of evaluation.
My understanding of new school teaching is that it's acceptable to write evaluations during the evaluation period. The same is true of progress notes etc. The reasoning is improved efficiency and less downtime. In theory, this would mean more patients can be seen in the same amount of time.
This discussion is a minefield I'd rather avoid. I simply use this as an example of the differences between the two schools of thought. I often write parts of my evaluations when I perform them. It's hard to remember details. What I don't do is complete the document. After I complete the evaluation, I begin treatment.
My new school colleagues complete the evaluation, write the evaluation and then begin treatment. I think the time is about the same. The difference is they charge for the time spent writing. For as long as I can remember, I've been told not to charge for documentation time. Things have changed. We complete the same process but in different ways.
I'm not comfortable with this new definition of what is chargeable time. Unless you discuss the evaluation item by item, I don't see it. Sooner or later I'm going to hear about my productivity. My options appear to be get with the program, document off the clock, learn to write very quickly or something completely different. I guess I'll see what happens.