28 years ago, the die was cast for how emergency department encounters were documented. Since then, we've had note bloat, click fatigue, and too much attention placed on things that really didn’t matter. All of that is slated to change in 2023 with dramatic new documentation guidelines (that today’s guest calls ‘refreshing’) are implemented. When was the last time you heard the word ‘refreshing’ used when it came to charting? And a massive thank you and hat tip to my friend Matt DeLaney who now runs ERcast - he was the first to alert us to these guidelines and interviewed Jason when they were first announced.

Guest bio: Jason Adler, MD is a clinical assistant professor of emergency medicine at the University of Maryland where he is also the director of compliance and reimbursement. He is also the vice president of acute care solutions at LogixHealth.

Episode Sponsor: Ivy Clinicians. Curious if there’s a better clinical opportunity out there? Ivy is the simplest way for physicians, PAs, and nurse practitioners to match with jobs they love. With Ivy, you can find all 5,549 emergency departments, filter by your preferences, and connect securely with the right employers. All for free.

For full show notes of this episode and all sorts of other goodies, visit our podcast website

Awake + Aware | Our 2026 Retreat

Join us at Awake and Aware, our 3-day retreat in Scottsdale, AZ. March 1-4, 2026. Space is limited.

Learn More Here

🎓 P.S. This is a CME event.

The Flameproof Course

The hidden anti-burnout curriculum we all should have learned in training. Cohort 3 begins Sept 10, 2024. Get the deets

We Discuss:

History and physical documentation are now at your discretion;
Heavy value is placed on cognitive work and medical decision making;
History from a non-patient source is valued in these guidelines;
Ordering a test is equally valued as not ordering a test;
Consideration of escalation or deescalation of care;
In addition to documenting your shared-decision making conversations, your MDM should include;
Population health - Stable means something different when it comes to documentation;
Social determinants of health;
There is a heightened emphasis of independent interpretations of separately billable procedures (EKGs, X-ray, CT, U/S);
Jason’s take home points;
And More.

91. Is this the end of note bloat? | Breaking down the 2023 documentation guidelines

Stimulus - Learn Tools to Crush It in Your Medical Career