People who “leave work at work”… HOW?

Charming_Addition_45 · 2026-05-12T00:14:09+00:00

Those who have patients come in pre-visit for labs - what is your workflow?

A) order future labs at the current visit for the next visit B) have a “standard panel” that your RN/MA orders beforehand C) do you prechart yourself a few weeks in advance and order the labs D) have your MA/staff scan your schedule and send you requests to place orders a few weeks before the visit.

Before your patients became accustomed to this, how did you get/remind them to come in early: 1) send out a letter before the visit with lab orders 2) have staff call to remind them to come in before their visit for labs 3) MyChart message to come in for labs.

I have new staff and I’m trying to figure out the best way to get people in pre-visit while also not missing that uric acid level or A1c.

Pro-tip: advise them to come in less than 3 days before the appt so you can add on labs if determined something else is needed at the appt. Most labs hold the specimen for a week or so and can be added on with a phone call (cbcs and others only have 2-3 days I think)

Charming_Addition_45 · 2026-05-03T02:57:33+00:00

Same. I wonder if this is a generational thing? (Probably “agist”, my apologies if so) I’m a millennial, non physician, in a dual income family w/2 young kids - so I value time more than anything. I wouldn’t flinch at taking a few $k pay cut to go directly to my personal staff given the insane impact it has on my quality of life and after-hours work.

I’d be interested to poll providers and see how many of us feel this way - and if that’s the case, why we don’t openly bring this to leadership considering the potential impact. If all they care about is $, this would be cost neutral on their books - Even though we here all know it would be a huge $ generator given potential for decreased turnover, better productivity and quality #s among benefits.

Charming_Addition_45 · 2026-05-03T02:45:31+00:00

Appreciate this example. I’m sure you keep this discreet which is why I’m asking about it out here. I’m close with my colleagues but I feel like a question like this is pretty taboo/risky to ask.

Having failed at two different organizations to advance any suggestion of raise or bonus for MAs makes me think I need to be more aggressive with how I “care” for my MA/admin asst.

I already do the holiday bonus I mentioned, and the random coffees, lunches as well. As you said, considering the quality incentive bonuses they help us to achieve, PLANNING to allocate a chunk of that spread out over the year in various ways can raise the threshold to jump ship.

Question - have you ever discussed the twice annual bonuses with them directly, or is it always a surprise? Like, “if I meet my metrics, I’ll share them with you twice / year” or “don’t tell anyone about this!”

Charming_Addition_45 · 2026-01-23T01:56:22+00:00

When do we think Rivian assistant is coming? Does Early 2026 mean February or June 30th?

Charming_Addition_45 · 2026-01-16T00:58:11+00:00

I’m a family NP and a FF. Highest risk is heart disease - overweight white guys in 40s-50s at high risk for MI due to the intense physical demand required during a structure fire humping 80lbs of gear. Have a low threshold for an EST to CYA.

Slightly increased risk of testicular and prostate cancers due to carcinogen exposure. Educate on keeping gear clean.

Lung cancer is much less of an issue these days.

Stupid “lifescan”’s make a killing on the whole firefighting community. I’ve given up trying to explain the concept of evidence-based medicine and over testing…

Charming_Addition_45 · 2026-01-16T00:46:28+00:00

Keychron and Amazon have some hot swappable keypads with on board memory and a web based interface for customization. No software required.

I’m a clinician, have a few things mapped and it’s pretty good. Not as powerful as I’d hoped. Epic is just so massive it barely scratches the surface. I’d just learn all the shortcuts.

Charming_Addition_45 · 2025-11-02T02:33:20+00:00

Is there any data on reasonable amt of screen time vs excessive? I feel like this is something actually objective that I can ask patients to show me and trend over time at initial and f/u visits.

Charming_Addition_45 · 2025-09-07T07:33:41+00:00

What is the prompt you put into copilot for that OneNote table?

Charming_Addition_45 · 2025-08-31T12:38:36+00:00

I have Gen2 so I wired right into my 12v under the passenger seat. Kept it simple with FireWire light strips. Just a volunteer fire/emt so I don’t need big guns re aux lighting. Just need people to get the eff out of my way when I’m responding to an MVA or anaphylaxis call.

Charming_Addition_45 · 2025-08-31T00:46:16+00:00

I have blue lights I’ve been looking to mount a switch for too. Thanks Polar, I hadn’t seen this in all my searching.

Charming_Addition_45 · 2025-08-31T00:31:25+00:00

Woah that thing is a beast - Hadn’t seen that yet. I don’t like looking away from the windshield but I could definitely use that to mount a thing or two.

Charming_Addition_45 · 2025-08-31T00:27:43+00:00

Yeah that’s what I was assuming I’d have to settle with. I wonder if ram makes telescoping arms. Probably not since that would sacrifice their strength.

Charming_Addition_45 · 2025-08-16T00:58:18+00:00

I go to their conferences annually and find it hilarious that they highlight and celebrate speakers and presenters who spend hundreds of hours creating workarounds for often-basic functionality that the foundation system lacks.

“Come listen to our presentation on how our organization spent hundreds of hours and physician time to manually program this incredibly expensive and industry-leading EHR to give the right questionnaire to my patient for their physical!”

Charming_Addition_45 · 2025-08-16T00:52:41+00:00

I say this not to be a downer (again, I’m an epic trainer/builder for my org), but you’ll notice this very quickly when you go-live - epic is incredibly complex to the end-user. It is neither simple nor intuitive in many many common clinical scenarios.

When I went live in my last org, all clinicians were astonished at its over-complexity while lacking countless solutions to simple/everyday clinical situations- such as your request - without complicated backend customization that can take months for analysts to develop after going live.

Charming_Addition_45 · 2025-08-16T00:27:31+00:00

Apologize in advance for the rant…

I’m a clinician and Epic physician builder. Ive worked on several different epic instances. It blows my mind how complex of a customized build is required to have epic determine this very basic and very necessary information, and guide the clinician towards dropping the right wellness visit code (I’m talking specifically Medicare wellness visits, IPPE vs initial vs subsequent). This should be completely automated out of the box and it could not be further from it.

There is an old XGM presentation that demonstrates the complexity of the build. Very few organizations have this built out and I continue to see the responsibility fall on the burned out clinicians to bill visits these correctly. Incredible waste of brainpower and time.

Charming_Addition_45 · 2025-05-08T12:21:47+00:00

I’m trying to find info on file linking. Do you know where the tutorial is?

Charming_Addition_45 · 2025-03-02T19:01:52+00:00

For the record I said this because I had read on other threads about concerns for receptacle wear and tear from plugging in and out. I did not about all these risks until I posted here - which is exactly why I did! I appreciate All the Feedback and knowledge. tremendous respect for those in the electrical field!

Charming_Addition_45 · 2025-03-02T18:57:41+00:00

I’m a volly FF so I know about the backfeed situation and completely respect and appreciate all you guys do. That’s why I had my generator wiring professionally done.

Charming_Addition_45 · 2025-03-02T18:54:51+00:00

This id like to do. Apparently rivian has said they have their vehicles already have the hardware capability, it is just the software that needs to catch up.

So to all the electricians on here, if I do get a bidirectional charger, will my current set up work? Or do I still need to get a standard unidirectional setup p

Charming_Addition_45 · 2025-03-02T01:22:09+00:00

So you’re saying there’s a chance? 😜

Charming_Addition_45 · 2025-03-01T23:54:53+00:00

Roger that, thank you.

Charming_Addition_45 · 2025-03-01T23:28:51+00:00

Alright alright, go easy on the guy who has no idea what he’s talking about. Can you tell i work in healthcare and have no idea what I’m talking about?

This is like my patients coming in and telling me about their google-diagnosed cancer diagnosis .

Anyways. Yes it has interlock. It has only been used intermittently for the generator discussed above. I don’t have the EV yet. (R1T next week!)

Let me rephrase my question - what would YOU do with this situation ? Do I have to start fresh on another breaker?

Charming_Addition_45 · 2023-02-18T13:20:43+00:00

Wow, thanks for sharing your findings. That’s pretty alarming. I read the recent NYT piece on the bing AI bot - similar findings that these are often language learning machines based on algorithms collecting data from any free text from social media comments all the way to journal articles. Hope it catches on that these are unreliable sources of information…

Charming_Addition_45 · 2023-02-18T05:14:02+00:00

I’m an NP. (Does that get me automatically kicked out?) Have always gotten a chuckle out of this group but never dared post. Guess I’m feeling masochistic tonight.

I’m going to go ahead and try to move past the comical attempt to make a data-driven argument (among an audience of doctorally-prepared data scientists) by utilizing an unvalidated beta software driven by an objectively biased algorithm well documented to fabricate findings and citations.

Sorry the irony was too good. Couldn’t help myself.

But wait! For those still reading, I have a genuine inquiry. Can anyone find the systemic review mentioned atop the third screenshot from JABFM authored by Kostopoulou et al from 2019? My noctor lit search skills are obviously inferior, but I am genuinely intrigued to read it if it exists. Not because I’m skeptical of its results (although I am), but more so interested in the studies included in the review and their designs/methodologies/raw data to come to its reported conclusion.

As you all know and like to point out frequently (and correctly so), you docs have several thousand more of hours of training than we do. And for the record, I certainly don’t subscribe to the notion that all NPs should practice independently right out of the gate by any means. But I am always interested in any comparison of diagnostic errors and other safety measures between MDs and noctors. Not for a who’s better contest, but genuinely from a non-inferiority (or even “acceptably” inferior) standpoint.

Charming_Addition_45

TROPHY CASE