There are three kinds of paperwork in my office.
The first kind of paperwork, the one the phrase evokes, is really mostly computer work. Although my shifts often run late, I don’t mind the time actually spent in the exam room with patients. The exhaustion hits as I finish a four-hour sprint only to realize that I have another one to two hours of documentation work. Then add on answering messages, dealing with lab results and filling out forms (some of which are on actual paper), and I can feel the joy of my job leaking away into mute surrender.
The second kind is the actual paper I give to patients. Believing in the invocatory power of the written word, I used to give written prescriptions that said things like “Patient must take 20 minutes a day to herself.” These often went to women, who were often mothers, and often ended up being posted prominently on refrigerators. Now I can type in “Patient Instructions” that will be printed out, but I think of them more as “Suggestions for Patients,” and I use phrases like “Consider walking or dancing as ways to move more” or “Try some new vegetables.” The patient is spared the struggle of reading my handwriting, and our plan is documented to help both of us remember it. I like this kind of paperwork and hope that patients find it valuable. I am touched when someone brings the page back, marked up with checks or question marks or commentary, so we can continue honing our plan together.
But my favorite type of paperwork is done on the exam-table paper. It’s the scribbles, drawings and sometimes demonstrations of how five-year-olds can write their name. The very best part is when they draw a picture and then give it to me at the end of the visit. I ask them to sign it (with whatever they consider a signature), and that paperwork comes back to my office, to encourage me on days when the first kind of paperwork wears me down.