“There is no ‘just.’”
In truth, I am more known for saying “clicks are evil.” That is equally true. Regardless, I have developed a tic. I flinch when someone uses the word “just.”
Webster’s Dictionary tells me that the definition of “just” involves having a basis in or conforming to fact or reason, or in conforming to a standard of correctness. As an adverb, it means exactly. That is exactly what I need. Just can mean very recently. I have just finished. It can mean by a little. She just made it. It can also mean simply or only. This is the usage that ruffles my feathers.
A sentence that contains the four letter word “just” is often constructed as a simple sentence with the verb “needs to” following the just. You just need to do xyz. He just needs to abc. Rarely is the verb as easy as the word “just” would imply. If it were easy, another human would not be there explaining how easy it is.
Do you follow me?
I spend much of my life helping physicians become fluent on the electronic health record. Initially, I called my lessons PET for Physician Efficiency Training. I thought that was a cute TLA (three letter acronym). (I hate TLAs, but that’s another story). I had a toy doggie robot. It was cute. Do you find it cumbersome to enter an order? Let me show you an easier way. Are you struggling to document? Let me help you with autocorrect, SmartPhrases, QuickButtons. I am here to help. I am the Doc Whisperer.
Sadly, using the word efficiency has developed a negative context. No, Dr. Masson has not crossed to the dark side. The other administrators have overused the word “efficiency.” With abuse, the word “efficiency” is no longer heard as a positive goal. Physicians now hear the word efficiency with the same part of their brain that hears “you need to generate more RVUs.”
Ack. No. I did not take this role to be an enforcer. Nor do I have kevlar in my wardrobe. No longer will I have PET sessions. I want to be able to practice medicine. I want my colleagues to be able to practice medicine. How can we make the electronic health record more intuitive? How can you avoid unnecessary evil clicks? Focus on patient care and physician wellness. Efficiency be damned! I have rechristened my tutorials “Epic Fluency.”
I am present during various conversations about implementation decisions. In these conversations, often I am the dissenter. No! I proclaim. Don’t do that. The physicians will go ballistic. Again, I do not wear kevlar. The pushback is often provided with a “just train the physicians to click here.” NO!
There is no “just.” Every click requires a thought, a motion, looking at something else that is NOT cogitating on the patient’s complex medical condition. The twenty-something-year-old whiz kid who is coding the program may think the button or click is just that easy, but it is not.
I challenge my team. As we have learned to not say but in meetings, let us similarly eradicate the use of the word “just.” I will make a concession. Let us eradicate the use of the word just as an adverb meaning simply. I am all for truthfulness and righteousness.
Lisa Masson, MD, is a board-certified primary care physician in Los Angeles. Her passion for primary care motivated her to take on an active role in clinical informatics. She is a 2018–19 Doximity Author and a proud mother of three daughters.