Friday, November 18, 2011

The work Isn't Done until the Paperwork is Completeed


The Work isn't Done until the Paperwork is Completed

When I was a mental health clinic manager I had one therapist who did not comply with the simple concept stated in the title. She had no problem with seeing clients. Her clients liked her. She was open to feedback about clinical issues and became a better therapist while she worked in the office. But she did not write progress notes about each and every visit as required by every insurance company and mental health provider organization.

Apparently shortly before every chart audit she would hurriedly compose notes for every client she had seen during the time being audited. When the auditors told us in advance what specific charts would be reviewed, she would write notes in only those charts. She wrote intakes, which were always monitored, treatment plans and updates, which were reviewed frequently, and occasionally she would write discharge summaries, which, you guessed it, were seldom reviewed.

I was blissfully unaware of the situation (everybody else wrote progress notes) until she went on vacation. One of her clients had a crisis. I saw the client and smoothed things over until her next scheduled appointment. Then I wrote a progress note and went to put it in the client's chart. I noticed that for a long-term client she had a very thin chart. When I opened the chart to insert my note, I noticed that the most recent note was dated several months earlier. The client had told me she had been coming in regularly. The clinic was small enough that I had often seen her in the waiting room waiting for her session. I pulled other charts of clients she was working with and found that none of them contained current progress notes. All were months behind. I borrowed a key and inspected her office (but not her locked desk.) If she had written but not filed the notes there should have been reams of notes. There were not.

I called my boss. He went through all the cabinets in her office (but not her locked desk.) The therapist had not written the notes. My boss wrote up a plan of correction with the therapist. Under his weekly guidance and monitoring, she did catch up and write current notes. She promised she would keep up the paperwork, and was notified in writing that failing to do so would be grounds for losing her job. She continued to write notes until the day he stopped personally reviewing her charts. Then she stopped.

My boss instructed me to keep closer track of her paperwork performance. I did. I discovered her lapse. She was eventually fired. She appealed to the powers that be and lost.

At another job one of my duties was to complete internal chart audits as practice for when the real auditors came. I discovered that one of the psychiatrists wrote a progress note for every therapy session. The problem was that he wrote exactly the same note, word for word, each time. I discussed it with him. He said he did not see that as a problem. I suggested it might be. I left it to him and his supervisor to sort it out.

What has this got to do with writing? The novel isn’t done until all the incidental work is completed. Once you finish writing a great novel, you still have paperwork to complete. A publisher may or may not help you find a cover and get the cover formatted. The publisher will not write the description on the cover, front and back. Nobody else will write the one to three paragraph synopses that will be in the publisher’s catalog. Nobody else will write answers to interview questions that will grab potential readers by the collar and have them thinking, “I gotta read this.”

As unfair as it seems, after you worn your fingerprints off typing and poured your very soul into your writing, you need to sweat the remaining details with every fiber of your being. Especially if you are a new writer, the cover art, the words on the outside and your words about your book will have a great deal to do with whether or not someone who has never heard of you will actually put money down and buy your book.

15 comments:

  1. Authors of one and of many books stress that writing the end on a story doesn't mean the work is finished. The book has to be launched and nurtured until it can walk on its own.
    However, I do sympathize with anyone who hates paperwork, especially medical paperwork. I was always told, it's not done until it's written in a note. Guess what, human ingenuity has found a way around that--write it up in the best progress note possible and then don't do it.
    As a nurse manager, I found creating a paperwork team to monitor notes helped. People who like writing progress notes have a different mental outlook than people who hate writing about what's already done.

    ReplyDelete
  2. The other part of a writer's paperwork is documenting research. I've run across interesting articles or facts and have forgotten to write down where I found the information and who wrote the article. It's easy to forget when cruising the Internet. But if your book is published, even though it isn't an academic work, you still should be able to back yourself up.

    I try to have a file for each book and keep my references in it. Key word there is "try."

    ReplyDelete
  3. I did not think to add that an author needs a one sentence pitch, a one paragraph pitch and some funny stories about writing the book to prepare to ask for bookstore readings and to readings. I always find it easier to have those written out and practiced aloud beforehand. For "Heartland" my one sentence pitch is -
    Think LITTLE HOUSE in bleeding Kansas.

    ReplyDelete
  4. Gosh, Warren, are ya trying to remind us how overwhelming a career we've gotten ourselves into? ;)

    My husband is in sales for an international company. It's his number one job to produce and get in front of the customer. But... the company also wants documentation to back up every place he goes to and the customers he sees. There are times he is so backlogged with paperwork he can't get to the customer. What's wrong with this picture?

    And, yes, I can understand the counselors needing to documment for the sake of malpractice and for the benefit of the client. But I can sense that by the time they do all that is required *they* need a counselor.

    As authors we are required to write the best book within us. Now we're required to market and brand and read and research, oh my!

    Paperwork may be a necessity, but it's certainly an evil necessity in my opinion. It interferes with the creative process and an author's ability to produce quality work. Thought-provoking post as usual.

    ReplyDelete
  5. One other area where a writer needs paperwork comes if you claim your writing expenses on your taxes. Most of the time that paperwork will just fill a file folder, but if you have an audit it will come in handy.

    ReplyDelete
  6. I have so many papers surrounding my desk, yet they all seem important. I have some see-through folders I've put some into, but I keep making exceptions anyway. I don't know how people can manage by just using the computer for storing stuff.

    Morgan Mandel
    http://morganmandel.blogspot.com

    ReplyDelete
  7. Excellent comments Donnell and Maris. Another observation is to check your spelling as I obviously DID NOT making me look sloppy and not even worth considering. The reader/editor/bookseller will not know or care that I was jet lagged when I wrote this. They will judge it on its appearance. It's my responsibility to get it right.

    ReplyDelete
  8. Morgan, I have stacks and cabinets full of files as well as book cases with files. I need to go through them right now to find something, Arrgghh!

    ReplyDelete
  9. So true more than ever! These days publishers do little to promote a book. As authors, just writing the book is no longer enough. We have to promote our own work to readers.

    ReplyDelete
  10. Very good points, all of them. The biggest problem I have, though, is doing the paperwork involved in submitting what I've written. Since I write a lot more short stories than novels, this is a big task. Keeping track of submissions also requires "paperwork" although I now do most of that on the computer. I used to dream of having a maid. Now I dream of having an assistant.

    ReplyDelete
  11. Dear Jan,

    That is so true. What I need help with often is remembering the titles. I read my list of in progress or submitted work and wonder what I called my stories.
    Even after they get published you have to hang on to the elusive critters to submit them again for award or short story collections.

    ReplyDelete
  12. So true, Warren--a writer's work is never done. And what about all the guest blogs we write in support of each new book? More paperwork. Though we no longer write on paper.

    ReplyDelete
  13. Good point, Marilyn,

    Guest blogs and personal blogs also take up time that could be spent writing the writing blogs support. Of course we often write about writing.

    ReplyDelete
  14. You're so right, Warren. And so are the people who've commented. I have notes everywhere from a dry erase board to slips of paper and a card file. About the time I finish the book and sort everything, I start receiving forms from the publisher. Sometimes I think there's more paperwork involved with writing than I've ever had on any job. But it's worth it.

    ReplyDelete
  15. Marja,

    Yellow sticky notes are helpful too.

    ReplyDelete