Your Maximum & Unique Value

Ask any professional paid to provide me some type of service, and I think you'd hear something similar: I am a strange client who takes things off track (other than with lawyers — I know what they charge).

The other day, I had an appointment with a new primary care physician at the VA. My condition is handled by my neurologist, so the primary care visits are generally uneventful. After a brief run through of blood test results, I started asking about her recent switch from private care to Veterans Affairs.

I'm fascinated by how professionals arrive at various stages in their careers, and I come away from these types of conversations with more to think about than just the obvious reason I'm there (my therapist gives me a hard time for constantly trying to learn more about him even though I'm paying him to learn more about me).

Among a number of differences between the two practices, she said, one of the biggest is the amount of clerical work she is expected to do as a VA physician.

She asked, rhetorically, "Does the VA really want me spending my time on entering things into charts instead of focusing on time with patients and analysis of their complex conditions?"

I love this question. I see three potential answers:

1: "Yes, because it's your job." This answer skips over the driving force of the question — that a skilled physician's maximum and unique value is in the patient work itself — and gives a practical but surface-level response. This is the way things are done here, so this is how you will do things here.

2: "Yes, because this is the best use of your time." This answer contemplates the intent of the question, and then states that the physician's time is actually well spent on clerical work. Perhaps the thinking there would be that the physician will provide more accurate chart notes as compared to an assistant who doesn't actually have the physician's knowledge.

3: "No, now that you mention it." This answer not only takes the question seriously, but also considers changes that could be made to optimize how the physician's time is spent.

I don't know what the right answer is, but I do know that intentionally building a system that maximizes the value this physician brings is the in the best interest of patients. As in just all about all things, that intentionality is key.

After we wrapped up our conversation, I headed to the front desk to check out. The receptionist pulled up my account and told me that I should take a seat, since the physician hadn't yet entered her notes, making it so that the receptionist couldn't yet book me for follow-up appointments. I got the impression that this happens a lot with this new physician's patients.

I didn't mind. I'd like to think she was taking some extra time to think through my medical needs and enter thoughtful notes in the chart. That is, after all, part of the value she is uniquely positioned to add.