TL;DR
- Purpose: Avoid the shortcuts that can creep in once you start practicing.
- Do this first: Examine the thing the patient came in for (sounds simple but you’d be surprised how many skip this).
- Red flags: Rushing, assuming, skipping exams, diagnosing from the doorway.
- Initial checks: Did I look, touch, listen, and document what I actually did?
- First-line strategy: Stay curious, be hands-on, and talk to people like they’re humans.
- Follow-up: Build good habits now so you don’t end up lazy and jaded later.
The Reality of Medicine
Once you start practicing, you figure something out pretty quickly: not everyone does this job well.
It’s not because people are necessarily bad providers or bad humans. It’s usually a byproduct of burnout or ego.
But shortcuts can add up and patients are the ones who pay for them.
You don’t have to know everything, but you do need to actually show up and do the job.
Here are the types of habits you don’t want to pick up, and what to do instead.
1. The “I Don’t Touch Patients” Provider
This one seriously baffles me. You’ve probably seen it before. The provider walks in, asks a few questions, never touches the patient, then leaves.
Why this is a problem:
Physically examining the patient is a key part of figuring out what’s wrong with them. When you skip the exam, you can miss critical findings. Vaginal discharge without a pelvic? Missed retained tampon. Twisted ankle without examining the foot? Missed metatarsal fracture.
Do this instead:
Put your hands on the patient. Look at the thing that hurts. It’s not that difficult. If you don’t want to touch people, you may want to find a different job.
2. The Doorway Provider
Half in the room, half out, arms crossed, already mentally onto the next patient.
Why this is a problem:
It feels rushed and dismissive and patients notice it immediately.
Do this instead:
Sit down, even if it’s for 30 seconds.
It changes the whole vibe of the visit and helps you actually focus on what the patient is saying.
3. The “I Charted It But Didn’t Do It” Provider
This is another one that confuses me. It’s the provider who documents a full exam they never actually did.
Alert and oriented x4… on a patient with dementia.
Why this is a problem:
Your documentation is a legal statement. If you chart it, you own it, and if something goes wrong later, your note is the first thing everyone looks at.
It’s also unsafe. If you didn’t actually assess something, you have no idea what you missed, and the next provider is relying on your exam.
Do this instead:
Chart what you actually did, no more, no less.
4. The Z-Pak Enthusiast
You know exactly who I mean. Everyone gets the same cocktail: antibiotic shot, steroid shot, maybe a Z-Pak for fun (!).
Why this is a problem:
It’s lazy and sloppy medicine. It also sends the message that you’re not willing to think past the quickest option.
Do this instead:
Treat what’s actually in front of you.
How To Avoid Becoming Any of These
This is not complex, it just takes checking your ego at the door and remembering why you work in medicine.
Do the basics well — and do them consistently:
- Sit
- Listen
- Touch the patient
- Examine the thing that hurts
- Ask questions
- Don’t assume
Doing those six things alone separates you from a surprising number of clinicians.
FAQ
Do I have to do a full exam on everyone?
No. But you do need to examine the problem they came in for.
What if I’m not comfortable with certain exams?
Then it is time to learn them. Not being comfortable is not an excuse.
What if my schedule is insane?
Still sit down. Still touch the patient. Cutting corners saves time now but creates bigger problems later.
How do I avoid turning into one of these providers?
Understand the signs of burnout. If you ever catch yourself rushing, assuming, or checking out, pause and reset.
Wrapping Up
You do not need to be the perfect provider, or the smartest, or the one with 20 years of experience.
You just need to show up fully, be curious, and do the job the way it is supposed to be done.