Tip: Answering the question, “what do you want me to write?”

By Sheila Duhon, MBA, RN, CCDS, A-CCRN, CCS

Let’s talk about a scenario that’s repeated itself over and over again with multiple physi­cians. Some physicians, when presented with a query, will just look at the CDI specialist and ask any number of the following questions:

• How do you want me to answer this?
• What do you want me to say?
• Just tell me what you want me to write.
• Can you write what you want and I’ll just sign it?
• Which answer gets more money?

Now, I may be the only CDI specialist that has ever encountered this manner of response from a physician, but I doubt it. This seems to be a pretty common theme across our profession. So, what are we to do?

I finally learned how to get direct and to the point in my response to these questions. No amount of explaining my role, their independent clinical decision-making, their role as the attending physician, etc., ever seemed to make a difference. It still boiled down to the essence of “What do you want me to write?”

I changed my approach by simply redirecting that question right back in the form of “What I want you to write is what, in your clinical judgment, is the condition you are treating. And then, describe that condition as specifically as you possibly can.” This response seemed to ease tensions, as it is direct, to the point, and nonleading to be sure, but it also increases physician engagement. Then you can just smile and give yourself a pat on the back.

Editor’s note: This article is an excerpt from CDI Workbook: Investigating Complex Cases and Formulating Queries.