28 years ago, the die was cast for how emergency department encounters were documented.  Since then, we've had note bloat, click fatigue, and too much attention placed on things that really didn’t matter. All of that is slated to change in 2023 with dramatic new documentation guidelines (that today’s guest calls ‘refreshing’) are implemented. When was the last time you heard the word ‘refreshing’ used when it came to charting? And a massive thank you and hat tip to my friend Matt DeLaney who now runs ERcast - he was the first to alert us to these guidelines and interviewed Jason when they were first announced.    Episode Sponsor: Ivy Clinicians. Curious if there’s a better clinical opportunity out there? Ivy is the simplest way for physicians, PAs, and nurse practitioners to match with jobs they love. With Ivy, you can find all 5,549 emergency departments, filter by your preferences, and connect securely with the right employers. All for free. Guest bio: Jason Adler, MD is  a clinical assistant professor of emergency medicine at the  University of Maryland where he is also the director of compliance and reimbursement. He is also the vice  president of acute care solutions at LogixHealth. Mentioned in this episode: The Awake and Aware Physician conference sponsored by Wild Health. Jan 13-15 Sedona Arizona. Use the code CONSCIOUSPHYSICIAN for 15% off (that’s 15% off the whole package – lodging, meals, the course) Interested in one-on-one coaching? Learn more at roborman.com To support the show - visit our Patreon site and help keep the wind in the sails. For full show notes visit our podcast page We Discuss: History and physical documentation are now at your discretion; Heavy value is placed on cognitive work and medical decision making; History from a non-patient source is valued in these guidelines; Ordering a test is equally valued as not ordering a test; Consideration of escalation or deescalation of care; In addition to documenting your shared-decision making conversations, your MDM should include; Population health - Stable means something different when it comes to documentation; Social determinants of health; There is a heightened emphasis of independent interpretations of separately billable procedures (EKGs, X-ray, CT, U/S); Jason’s take home points; And More.