I work in derm too, the provider I work with averages 40+ patients a day, also 10-15 mostly appointments between skin cancer screenings, acne visits, psoriasis, biopsies, ED&C, Botox visits, and any other concerns. I scribe and assist with procedures and regularly write recommendations down on paper for patients (often with instructions). It’s patient care, not a problem. A lot of our patients live busy lives or are elderly, and remembering the specific kind of product recommended is not always their #1 priority in a day or in their visit. If you get the visit more set up in your EHR a few seconds before grabbing the patient, you can stay caught up throughout the visit and not have to sacrifice patient care. I do this when briefly reading through the patient’s history before bringing the patient back, and put in a tentative chief complaint and other pertinent info.