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

Happy March! I hope everyone is having a great first day of the month. I’m looking forward to St. Patty’s Day and the start of Spring 😀 

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

In the News

Another reason to encourage regular exercise!

Here is a systematic review and meta-analysis of > 200 studies looking at the effects of exercise (specifically walking, jogging, yoga and strength training) on treatment of depression. I found a great graphic from the BMJ and added it below. In summary, the above exercise modalities were effective compared to psychotherapy and pharmacotherapy in treating depression. The effects correlated with exercise intensity. The more intense the exercise, the better the results.

Let’s keep our patients moving!

Read all about it HERE.

In Your Practice

In a previous post, I referenced an AI scribe program coming to my organization. Soon after publishing this, I was approached about volunteering to join the group of docs piloting the project. I jumped at the chance.

For the past 3 weeks, I’ve been using an AI program called DAX during my office visits. It works like this: I take my phone into the visit, pull up Epic (our EMR), and find the patient on my schedule. There is a “DAX” button and I click this on. I set the phone in between me and the patient and carry on with my interview per usual. When we are done, I toggle the button off. About 20 seconds later, a note populates in the EMR. It captures our interview, organizes it, and omits the fluff. It also assembles an assessment and plan based off of our discussion. Frankly, it’s kind of wild.

My thoughts so far:

Pros:

• Instead of typing my HPI during the visit, I can turn and listen fully to the patient, no distractions.

• DAX picks up little bits of info and details from the history I might forget to type or omit.

• The HPI is very thorough.

• When I’m done with the visit, I am pretty much finished with my note. There are sometimes some edits and adjustments but they are minimal.

Cons:

• Again, the HPI is very thorough - also very lengthy. My notes without DAX are concise and bulleted. My DAX notes read more like a short novel 😆 (however, this can be a good thing for remembering details at future visits and referencing notes at a later date).

• You have to verbalize the assessment and plan out loud in the room with the patient. This can be cumbersome at times. However, this can also be useful for the patient - they hear the final plan again summarized at the end of the visit.

• The note usually requires some edits at the end.

• Some doctors have been verbalizing the physical exam during the visit in order to pull this into the note using DAX. I found this awkward, so I have continued to rely on the macro templates I’ve previously used.

It’s been an adventure! Without DAX, I’m usually pretty good at staying caught up and closing my notes. I haven’t decided if DAX has increased my efficiency yet. Like any new tech, there is a learning curve. Stay tuned!

In Your Heart

I keep coming back to James Clear’s newsletter and quotes. This one puts a little pep in my step.

Let’s get after it today 🙂 

Have a wonderful weekend!

Ashley