WEBVTT
00:00:00.000 --> 00:00:02.080
Try something with me right now.
00:00:02.879 --> 00:00:04.240
Count to thirty.
00:00:04.480 --> 00:00:07.280
You know, like 1001, 1002.
00:00:07.360 --> 00:00:09.039
You can do Mississippi's if you want.
00:00:09.199 --> 00:00:11.519
One Mississippi, two Mississippi.
00:00:11.839 --> 00:00:13.119
Do it slowly.
00:00:13.439 --> 00:00:17.839
Like you're actually reading something or deciding on something and then moving on.
00:00:18.160 --> 00:00:18.800
That's it.
00:00:18.879 --> 00:00:19.920
That's the whole unit.
00:00:20.079 --> 00:00:24.000
Open a notification, read it, recognize it's nothing you need to act on.
00:00:24.079 --> 00:00:24.800
Close it.
00:00:25.039 --> 00:00:26.160
30 seconds.
00:00:26.320 --> 00:00:27.679
Sometimes less.
00:00:27.920 --> 00:00:33.200
Maybe it's closer to two minutes if the alert is dense enough to need a second look or maybe even a third.
00:00:34.000 --> 00:00:38.560
Now, do that 40 times before lunch.
00:00:39.359 --> 00:00:41.359
Nobody hands you a form for this.
00:00:41.520 --> 00:00:43.439
It doesn't show up on your schedule.
00:00:43.679 --> 00:00:45.600
Your RBUs don't count it.
00:00:45.840 --> 00:00:48.240
It's not on your end-of-year review.
00:00:48.640 --> 00:00:53.520
Your practice tracks your patient volume down to the minute, but no one is tracking this.
00:00:53.759 --> 00:00:56.719
And I've come to think that's exactly the problem.
00:00:57.119 --> 00:01:01.920
Not the 30 seconds themselves, but the fact that no one anywhere in the system is counting them.
00:01:02.320 --> 00:01:03.600
Hi, I'm Dr.
00:01:03.679 --> 00:01:09.200
Kevin Hallow, surgeon, veteran, co-founder, and chief medical officer of Clinician Corps.
00:01:10.159 --> 00:01:29.680
Today I want to actually do the counting no one else is doing and show you where all of those uncounted 30-second pieces of your day, every small cognitive interruption that is driving your clinical decision fatigue, I want to show you where all those 30-second pieces are hiding.
00:01:30.239 --> 00:01:38.799
Let's start with what we actually know because the numbers here are better documented than most physicians realize.
00:01:39.200 --> 00:01:58.319
A systematic review in the Journal of the American Medical Informatics Association, covering 23 studies, found that physicians override clinical decision support alerts at a rate between 46% and 96%, depending on the type of alert.
00:01:58.959 --> 00:02:11.039
Nanji and colleagues studied a large academic outpatient center over three years and found a 73% override rate specifically for medication-related alerts.
00:02:12.159 --> 00:02:13.919
Think on that for a second.
00:02:14.240 --> 00:02:22.159
On a bad alert type, nearly everything that pings you gets dismissed because nearly none of it changes what you actually do next.
00:02:22.479 --> 00:02:35.280
Each one of those pings is a cognitive interruption, and each dismissal costs you somewhere between 30 seconds and two minutes of attention that you'll never get back and for which you will never get credit.
00:02:36.240 --> 00:02:43.520
Multiply a conservative estimate of that across a single working day, and you're not talking about an inconvenience anymore.
00:02:43.759 --> 00:02:52.240
You're talking about a second uncounted job that you're doing in the margins of your real one and you're not getting paid for it.
00:02:52.800 --> 00:02:58.240
Let me make this concrete because abstractions are easy to dismiss and specifics are not.
00:02:59.199 --> 00:03:01.360
Let me give you a few examples.
00:03:01.680 --> 00:03:11.599
We're talking about the duplicate allergy warning that fires for the third time this week on the same patient because the system doesn't remember you already addressed it.
00:03:12.400 --> 00:03:16.560
It's the routine refill request that reads exactly like an urgent one.
00:03:16.719 --> 00:03:19.520
So you have to open it to find out which one it is.
00:03:20.719 --> 00:03:28.879
It's the portal message about a copay question that landed in your queue instead of your front desk office staff's queue.
00:03:29.360 --> 00:03:38.719
It's the scheduling conflict flag that has nothing to do with your clinical judgment at all, but still for some reason needs your eyes on it before it's clear.
00:03:39.840 --> 00:03:42.639
None of those on their own is a big ask.
00:03:43.039 --> 00:03:45.759
That's exactly why nobody's counting them.
00:03:46.000 --> 00:03:58.240
Each one is a small cognitive interruption, unworthy of complaint on its own, and there are enough of them, but by the time you notice the pattern, the day's already gone.
00:03:58.879 --> 00:04:02.639
Here's the distinction I actually want to leave with you.
00:04:04.000 --> 00:04:10.400
It's not really about how many minutes this adds up to, though it does add up.
00:04:11.120 --> 00:04:14.080
It's about the fact that this is invisible labor.
00:04:14.159 --> 00:04:21.519
No one schedules it, nobody staffs for it, nobody asks you about it, and you are not getting paid for it.
00:04:22.079 --> 00:04:33.519
The AMA's most recent national data found physicians report roughly 13 hours a week, of what gets classified as indirect patient care.
00:04:33.759 --> 00:04:39.839
You know, order entry, documentation, test result interpretation, and everything adjacent to it.
00:04:41.040 --> 00:04:51.519
Alert review lives inside that number, uncountered as its own line item, folded into a category broad enough that its true side never gets named.
00:04:51.920 --> 00:04:58.480
See, you experience every one of those 30-second units individually, one at a time, all day.
00:04:59.040 --> 00:05:03.040
But the system that generates them only ever sees the aggregate.
00:05:04.079 --> 00:05:06.720
If it sees it at all, which it probably doesn't.
00:05:07.040 --> 00:05:15.839
That mismatch between what you feel and what gets measured is exactly why this problem has been able to hide in plain sight for as long as it has.
00:05:16.800 --> 00:05:19.360
Left unnamed, it doesn't just cost time.
00:05:19.439 --> 00:05:30.879
It compounds into a real clinically silent form of clinical decision fatigue that affects you every single day in your practice.
00:05:31.519 --> 00:05:37.439
So what does it actually look like to count this instead of just absorbing it?
00:05:38.319 --> 00:05:40.639
Well, it starts with a basic premise.
00:05:41.040 --> 00:05:45.120
Not every notification that reaches you deserves to reach you.
00:05:45.680 --> 00:06:02.959
A system that's actually counting would ask, before it ever interrupts you, whether this specific alert for this specific patient at this specific moment genuinely needs your attention, or whether it's routine enough to be handled, batched, or routed to someone else entirely.
00:06:03.519 --> 00:06:14.000
That's the design principle behind HCO practice HQ, the organizational communication module inside clinician core.
00:06:14.399 --> 00:06:23.120
We're all aware, urgency-scored routing that treats your attention as the finite valuable resource it actually is.
00:06:23.279 --> 00:06:27.279
Instead of assuming that every message earns an equal claim on it.
00:06:27.759 --> 00:06:36.720
Fewer cognitive interruptions, less clinical decision fatigue, more of your day actually counted as your day.
00:06:37.439 --> 00:06:42.399
Here's what I want you to take with you from this podcast.
00:06:43.360 --> 00:06:52.000
The next time that you catch yourself dismissing another alert that changed nothing, I want you to notice it.
00:06:52.319 --> 00:06:53.680
Really notice it.
00:06:54.319 --> 00:07:00.319
Because that 30 seconds that nobody counts 40 times a day is your day.
00:07:00.560 --> 00:07:02.959
That time belongs to you.
00:07:03.439 --> 00:07:17.920
You did not train for over a decade to spend a meaningful fraction of your working life absorbing cognitive interruption and clinical decision fatigue for which nobody is keeping score.
00:07:18.319 --> 00:07:19.680
Neither did I.
00:07:20.639 --> 00:07:28.319
The fix is not asking you to move faster through the noise, it's building a system that finally starts counting.
00:07:28.560 --> 00:07:41.120
Clinician Core's HCO Practice HQ is there beside you during your day to filter the noise from your practice so that you can concentrate on being a physician.
00:07:41.439 --> 00:07:46.319
If you want to see what that looks like, we're in soft launch now ahead of our full September release.
00:07:46.480 --> 00:07:50.319
The wait list is open at cliniciancore.comslash wait list.
00:07:50.879 --> 00:07:52.959
Visit our website and sign up.
00:07:54.240 --> 00:07:55.759
That is our podcast for today.
00:07:55.839 --> 00:07:56.160
I'm Dr.
00:07:56.240 --> 00:08:00.319
Kevin Hallow, co founder and chief medical officer of Clinician Corps.
00:08:00.800 --> 00:08:02.720
You can go and take care of your patients.
00:08:02.800 --> 00:08:04.720
We'll do the counting for you.
00:08:04.959 --> 00:08:06.240
Thanks for listening.
00:00:00.000 --> 00:00:02.080
Try something with me right now.
00:00:02.879 --> 00:00:04.240
Count to thirty.
00:00:04.480 --> 00:00:07.280
You know, like 1001, 1002.
00:00:07.360 --> 00:00:09.039
You can do Mississippi's if you want.
00:00:09.199 --> 00:00:11.519
One Mississippi, two Mississippi.
00:00:11.839 --> 00:00:13.119
Do it slowly.
00:00:13.439 --> 00:00:17.839
Like you're actually reading something or deciding on something and then moving on.
00:00:18.160 --> 00:00:18.800
That's it.
00:00:18.879 --> 00:00:19.920
That's the whole unit.
00:00:20.079 --> 00:00:24.000
Open a notification, read it, recognize it's nothing you need to act on.
00:00:24.079 --> 00:00:24.800
Close it.
00:00:25.039 --> 00:00:26.160
30 seconds.
00:00:26.320 --> 00:00:27.679
Sometimes less.
00:00:27.920 --> 00:00:33.200
Maybe it's closer to two minutes if the alert is dense enough to need a second look or maybe even a third.
00:00:34.000 --> 00:00:38.560
Now, do that 40 times before lunch.
00:00:39.359 --> 00:00:41.359
Nobody hands you a form for this.
00:00:41.520 --> 00:00:43.439
It doesn't show up on your schedule.
00:00:43.679 --> 00:00:45.600
Your RBUs don't count it.
00:00:45.840 --> 00:00:48.240
It's not on your end-of-year review.
00:00:48.640 --> 00:00:53.520
Your practice tracks your patient volume down to the minute, but no one is tracking this.
00:00:53.759 --> 00:00:56.719
And I've come to think that's exactly the problem.
00:00:57.119 --> 00:01:01.920
Not the 30 seconds themselves, but the fact that no one anywhere in the system is counting them.
00:01:02.320 --> 00:01:03.600
Hi, I'm Dr.
00:01:03.679 --> 00:01:09.200
Kevin Hallow, surgeon, veteran, co-founder, and chief medical officer of Clinician Corps.
00:01:10.159 --> 00:01:29.680
Today I want to actually do the counting no one else is doing and show you where all of those uncounted 30-second pieces of your day, every small cognitive interruption that is driving your clinical decision fatigue, I want to show you where all those 30-second pieces are hiding.
00:01:30.239 --> 00:01:38.799
Let's start with what we actually know because the numbers here are better documented than most physicians realize.
00:01:39.200 --> 00:01:58.319
A systematic review in the Journal of the American Medical Informatics Association, covering 23 studies, found that physicians override clinical decision support alerts at a rate between 46% and 96%, depending on the type of alert.
00:01:58.959 --> 00:02:11.039
Nanji and colleagues studied a large academic outpatient center over three years and found a 73% override rate specifically for medication-related alerts.
00:02:12.159 --> 00:02:13.919
Think on that for a second.
00:02:14.240 --> 00:02:22.159
On a bad alert type, nearly everything that pings you gets dismissed because nearly none of it changes what you actually do next.
00:02:22.479 --> 00:02:35.280
Each one of those pings is a cognitive interruption, and each dismissal costs you somewhere between 30 seconds and two minutes of attention that you'll never get back and for which you will never get credit.
00:02:36.240 --> 00:02:43.520
Multiply a conservative estimate of that across a single working day, and you're not talking about an inconvenience anymore.
00:02:43.759 --> 00:02:52.240
You're talking about a second uncounted job that you're doing in the margins of your real one and you're not getting paid for it.
00:02:52.800 --> 00:02:58.240
Let me make this concrete because abstractions are easy to dismiss and specifics are not.
00:02:59.199 --> 00:03:01.360
Let me give you a few examples.
00:03:01.680 --> 00:03:11.599
We're talking about the duplicate allergy warning that fires for the third time this week on the same patient because the system doesn't remember you already addressed it.
00:03:12.400 --> 00:03:16.560
It's the routine refill request that reads exactly like an urgent one.
00:03:16.719 --> 00:03:19.520
So you have to open it to find out which one it is.
00:03:20.719 --> 00:03:28.879
It's the portal message about a copay question that landed in your queue instead of your front desk office staff's queue.
00:03:29.360 --> 00:03:38.719
It's the scheduling conflict flag that has nothing to do with your clinical judgment at all, but still for some reason needs your eyes on it before it's clear.
00:03:39.840 --> 00:03:42.639
None of those on their own is a big ask.
00:03:43.039 --> 00:03:45.759
That's exactly why nobody's counting them.
00:03:46.000 --> 00:03:58.240
Each one is a small cognitive interruption, unworthy of complaint on its own, and there are enough of them, but by the time you notice the pattern, the day's already gone.
00:03:58.879 --> 00:04:02.639
Here's the distinction I actually want to leave with you.
00:04:04.000 --> 00:04:10.400
It's not really about how many minutes this adds up to, though it does add up.
00:04:11.120 --> 00:04:14.080
It's about the fact that this is invisible labor.
00:04:14.159 --> 00:04:21.519
No one schedules it, nobody staffs for it, nobody asks you about it, and you are not getting paid for it.
00:04:22.079 --> 00:04:33.519
The AMA's most recent national data found physicians report roughly 13 hours a week, of what gets classified as indirect patient care.
00:04:33.759 --> 00:04:39.839
You know, order entry, documentation, test result interpretation, and everything adjacent to it.
00:04:41.040 --> 00:04:51.519
Alert review lives inside that number, uncountered as its own line item, folded into a category broad enough that its true side never gets named.
00:04:51.920 --> 00:04:58.480
See, you experience every one of those 30-second units individually, one at a time, all day.
00:04:59.040 --> 00:05:03.040
But the system that generates them only ever sees the aggregate.
00:05:04.079 --> 00:05:06.720
If it sees it at all, which it probably doesn't.
00:05:07.040 --> 00:05:15.839
That mismatch between what you feel and what gets measured is exactly why this problem has been able to hide in plain sight for as long as it has.
00:05:16.800 --> 00:05:19.360
Left unnamed, it doesn't just cost time.
00:05:19.439 --> 00:05:30.879
It compounds into a real clinically silent form of clinical decision fatigue that affects you every single day in your practice.
00:05:31.519 --> 00:05:37.439
So what does it actually look like to count this instead of just absorbing it?
00:05:38.319 --> 00:05:40.639
Well, it starts with a basic premise.
00:05:41.040 --> 00:05:45.120
Not every notification that reaches you deserves to reach you.
00:05:45.680 --> 00:06:02.959
A system that's actually counting would ask, before it ever interrupts you, whether this specific alert for this specific patient at this specific moment genuinely needs your attention, or whether it's routine enough to be handled, batched, or routed to someone else entirely.
00:06:03.519 --> 00:06:14.000
That's the design principle behind HCO practice HQ, the organizational communication module inside clinician core.
00:06:14.399 --> 00:06:23.120
We're all aware, urgency-scored routing that treats your attention as the finite valuable resource it actually is.
00:06:23.279 --> 00:06:27.279
Instead of assuming that every message earns an equal claim on it.
00:06:27.759 --> 00:06:36.720
Fewer cognitive interruptions, less clinical decision fatigue, more of your day actually counted as your day.
00:06:37.439 --> 00:06:42.399
Here's what I want you to take with you from this podcast.
00:06:43.360 --> 00:06:52.000
The next time that you catch yourself dismissing another alert that changed nothing, I want you to notice it.
00:06:52.319 --> 00:06:53.680
Really notice it.
00:06:54.319 --> 00:07:00.319
Because that 30 seconds that nobody counts 40 times a day is your day.
00:07:00.560 --> 00:07:02.959
That time belongs to you.
00:07:03.439 --> 00:07:17.920
You did not train for over a decade to spend a meaningful fraction of your working life absorbing cognitive interruption and clinical decision fatigue for which nobody is keeping score.
00:07:18.319 --> 00:07:19.680
Neither did I.
00:07:20.639 --> 00:07:28.319
The fix is not asking you to move faster through the noise, it's building a system that finally starts counting.
00:07:28.560 --> 00:07:41.120
Clinician Core's HCO Practice HQ is there beside you during your day to filter the noise from your practice so that you can concentrate on being a physician.
00:07:41.439 --> 00:07:46.319
If you want to see what that looks like, we're in soft launch now ahead of our full September release.
00:07:46.480 --> 00:07:50.319
The wait list is open at cliniciancore.comslash wait list.
00:07:50.879 --> 00:07:52.959
Visit our website and sign up.
00:07:54.240 --> 00:07:55.759
That is our podcast for today.
00:07:55.839 --> 00:07:56.160
I'm Dr.
00:07:56.240 --> 00:08:00.319
Kevin Hallow, co founder and chief medical officer of Clinician Corps.
00:08:00.800 --> 00:08:02.720
You can go and take care of your patients.
00:08:02.800 --> 00:08:04.720
We'll do the counting for you.
00:08:04.959 --> 00:08:06.240
Thanks for listening.
