Why you need to start dictating your clinical notes.


Let me ask you a couple of questions…

How fast can you type?

100 wpm ? 25 wpm ? Or maybe you are the Joe Blogs average who manages a poultry 40 wpm?

Don’t believe me? Why not test yourself  https://www.keyhero.com/free-typing-test/

I managed 96wpm. Not too shabby and I consider myself to be a reasonably nifty typist. But by no means can I be complacent because none of us can type as fast as we can read. On average we can read 300 wpm, and if you can read 300 wpm chances are you can speak 300 wpm too. Into a little machine. Like…. a Dictaphone.

You might be thinking, “But Cath, I don’t need to type anything because I hand write my notes the old fashioned way, with a pen”.

What is your handwriting like?

If it’s anything like mine it doesn’t matter how posh the Montblanc pen, the scrawling still resembles patterns that might have been created by a spider on ketamine (in one of those 1970’s psychology experiments). Best case scenario, I will be able to recognise half a dozen words and it will all come rushing back to me. Worst case scenario, I will have to check in with a pharmacist to translate what I have written.

So, what’s holding you back from dictating all of the documents you create in your private practice?

I’m not just talking about letters, I’m talking about dictating the clinic notes too?


Let’s reverse engineer the timing for this, and do some sums…

Okay, so let’s say we have 20 minutes of dictation and you speak at the same pace that you read, that’s approximately 300 words per minute.

20mins x 300 words = 6000 words. If you’re an average Joe Blog typist, typing around 40 words per minute,

6000 words divided by 40 wpm = 150 minutes. That’s two and a half hours of your life you won’t get back…

In 150 minutes, you could see five patients for a 30 mins session. For a doctor in Private Practice, it’s realistic to expect an average fee of around £150 pounds per 30 mins session.

That makes it £750 for that two and a half hours that you are faffing around with a keyboard.

Want to know how much this would cost to get this done for you?

Most medical transcriptions service costs start at around £1.30 plus VAT per recorded minute. That would make our total approximately £31.20.

£750 income versus £31.20 expenditure. Hmmm I wonder…

Now you might be saying, “But Cath I’ll have to check the letter and they will need to be emailed out”.

This is true, however, once you have worked with a particular transcription service for a while and everyone gets to know everyone else’s little nuances, checking through becomes an absolute bare minimum in terms of your time.

Many transcription services provide a level of service which enables them to log into your web-based practice management software system, and then they can type directly into the patient’s notes. This can be set up in a secure way, and because it is their livelihood, the vast majority of them are GDPR compliant. That means you’ll be in safe hands.

Even if you are already using the services of a medical secretary, it’s worth considering freeing him or her up for managing appointments, booking theatre sessions and developing relationships with patients rather than wasting time assembling your wretched paper clinic notes. Step away from the paper! There, I’ve said it!

Top Private Practice Ninja tips for a good dictation.

  Get an encryptable Dictaphone. You can use your smartphone plus ‘Dictamus’, but you will have to remember to use encryption software such as ‘Egress’ on your phone to email out the recorded voice files to your typist. It’s very important to keep GDPR compliant. Using a Dictaphone prevents pancaking your smartphone battery.

Encryptable Dictaphones: Olympus DS-3500 Digital Voice Recorder, Olympus DS-7000 Digital Voice Recorder and Philips DPM8000.

   Plan it out a little bit and learn to say the same things where you can. I am totally a creature of habit and so I tend to start with “Thanks very much for referring this delightful patient who presented with X,Y, and Z.” (BTW, when I don’t call the patient ‘delightful’, it means something. Like a code for those who know me, except it won’t get me in trouble.)

   Dictate the punctuation, full stop. It sounds a bit daft, comma, but if you want it to read how you have said it, open bracket (with no room for ambiguity,) closed bracket, so, you will need to state the words “comma” and “full stop” and you will soon get the hang of it.

  Speak clearly ,don’t mumble, and learn how to be dexterous with the pause button, so that you can mentally reach for the phrase rather than having to re-express the sentence over and over again because you keep fluffing it.

   Don’t eat whilst you are dictating, and whilst you are at it, try not to yawn (OK, I’m sometimes guilty of this, if it has been a mahoosive clinic).

   State at the beginning of the dictation what the date is and which clinic location you are sat in, and remember to list to whom the letter should be sent, e.g. to Mr Foxy Fox – Consultant in Forensic Psychiatry, cc the GP, cc the patient.

   Dictate the moment the consultation ends. Don’t wait until the end of the clinic, when all the patients tend to blur into one.

Dictating your notes which become your letters, is something I feel passionately that all clinicians should be doing.

It doesn’t matter whether you are a Physio or an Osteo, a Brain Surgeon or a Proctologist. It’s a no-brainer when it comes to money and your patients will feel truly loved when they receive correspondence each and every time they come to see you. Let’s face it, they are going to forget the vast majority of what you say to them anyway and so it’s best that they have it all written down.

Your time is most valuable when you use it seeing your patients, free yourself from the tyranny of keyboards and bad handwriting.


If you feel like your Private Practice needs help with systems, gaining referrals, effective ways to work within social media or if you have got any questions about GDPR and would like to discuss getting your GDPR compliance done and dusted. Please do not hesitate to contact us here…

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