Hello! Welcome back to The Friday Sign Out - a newsletter for primary care physicians and advanced practice providers.

I hope everyone is having a great week! I can’t believe we are squarely in the month of August. I recently read that August can feel like the “Sunday of summer”, inducing the “Sunday scaries” and anxious anticipation of the transition from summer to fall. To combat this, I’m filling the next couple weeks with all the summer things - pool days, picnics, splash pads - going to soak it up (no pun intended)!

Here’s what I’m reading and thinking about this week.

In the News

Great news for moms - there is now an FDA-approved oral treatment option specifically for Postpartum Depression. The pill is zuranolone, a neuroactive steroid acting on GABAA receptors in the brain.

You can read more about the study in The American Journal of Psychiatry here.

In Your Practice

In my last issue, I talked about my approach to pre-charting. This spawned discussion with colleagues about their take on pre-charting and what works for them.

Dr. David McClure, an experienced and brilliant internist and someone I’ve learned a lot from over the years, shared his opinion on pre-charting. Spoiler alert - he loves it and pre-charts his entire day before it begins. Read below for his process in his words:

• LPN/MA puts a customized schedule on my desk before they leave at night. The schedule columns are pre-populated with patient data set up by me. I put notes on each patient and give it back (ie, a silent huddle)

• After emptying my inbox in the AM, I begin pre-charting.

• I use a standard note template then drop in recent labs. I briefly review the A/P of my last note and any interim consults/ ER/Admissions and add this to my note using dragon dictation.

• I make sure anything needed such as labs or health maintenance items are pre-ordered.

• Typically, I clean up the problem list as well. I try to not spend more than 3-5 minutes in each chart.

• The goal for me has been to focus on the HOPI and social talk when I enter the room as everything else is done. Mission accomplished, by the above!

I loved hearing different takes on pre-charting, and I’m inspired to see if changing up my workflow makes my day a little easier. Thanks so much for your input, Dave!

In Your Heart

Yesterday, August 10, was National Lazy Day. Admittedly, I would have had no idea this day existed except I stumbled upon this news story touting the health benefits to “laziness” or at at minimum, to scheduled relaxation (a term us type A personalities might be more comfortable with). I was inspired to take a few minutes to read my book instead of doing my 100th load of laundry as an homage to “National Lazy Day”. I encourage you to do the same!

On the same thread, I came across this article on KevinMD.com discussing “seasons” of life (see my last edition for more on this) and the importance of rest. Love it.

I’ll leave you with the beautiful beach where we were able to rest and recharge last week. Take me back! 😎 

Have a wonderful weekend!

Ashley