Dear Reader,
You know that feeling—the one that hits about thirty seconds before your patient walks in. Your heart does this little lurch when you remember: I ordered labs. Did I review them? When did they come in?
It's a distinctly uncomfortable sensation. Like being caught unprepared for something you absolutely should have been prepared for. My heart does this lurching thing that feels almost like choking.
I used to tell myself this was just the nature of clinical practice. Things get busy. Details slip through the cracks. But as these moments became more frequent, I started to notice something deeper at play.
The Story I Told Myself
I had convinced myself that my lab ordering process was "personalized." Patient by patient, I would thoughtfully consider which lab company might be most convenient for them, which panels might save them money, and which approach felt most tailored to their specific situation.
What I didn't realize was that this "personalization" was actually creating chaos. Not just for me, but ultimately for my patients.
I was juggling labs from four or five different companies at any given time. Not specialty labs that required specific expertise, just basic panels. I never developed familiarity with how different companies reported results or how their turnaround times worked. I was constantly doing mental gymnastics to save patients a few dollars here and there—dollars they hadn't even asked me to save.
And here's the part that's hardest to admit: I think I was unconsciously avoiding ordering labs altogether.
The Avoidance Pattern
When a clinical situation arose where labs might be helpful, I found myself hesitating. Not because the labs weren't indicated, but because the process felt overwhelming. I would tell myself it was "clinical preference" to try other approaches first. I would rationalize that we could always order them later.
But the truth was simpler and more uncomfortable: the chaos of my lab ordering system was so mentally taxing that I was unconsciously avoiding it.
This is where workflow dysfunction crosses the line from inconvenient to harmful. When our systems are so painful that we start avoiding clinically appropriate interventions, we're no longer just managing our own overwhelm; we're compromising patient care.
The Mental Bandwidth Tax
Every time I went to order labs, I faced the same mental drain: weighing company options, remembering different pricing structures, and navigating unfamiliar portals. These weren't clinical decisions—they were logistics masquerading as medicine.
The irony was stark: in trying to personalize everything, I was providing less personalized care. By the time I'd burned through my mental energy on ordering mechanics, I had less bandwidth for the nuanced work of connecting results to treatment plans.
What Actually Needs Customization
Here's what I discovered: the things I thought required constant customization fell into two categories.
First, there's complexity that makes us feel thorough but serves no one well. My lab ordering process is a perfect example. I was burning mental energy on logistics—which company, what pricing, how to navigate different portals—that had nothing to do with clinical care. I told myself this was "personalized," but my patients didn't care which lab company I used. They cared about getting accurate results interpreted thoughtfully.
Then there's the customization that matters to patients. This happens when you're not distracted by needless complexity. When I finally standardized my lab ordering, I started noticing patterns I'd been too scattered to see before. I could focus on the subtle differences between patients rather than the mechanical differences between systems.
The real insight: when routine processes become reliable, your attention can focus where it belongs: on the clinical work that truly requires your expertise.
The Observation Practice
This shift began when I got curious about how I actually worked versus how I thought I worked. I started paying attention to the moments when I felt that familiar dread, and asking myself: What am I avoiding here?
Here's what I discovered: many of the things I thought required constant customization benefited from consistency. The mechanical aspects of ordering labs, scheduling follow-ups, and even structuring initial treatment plans. These could be systematized without losing the human elements that truly mattered.
The Contemporary Relevance
Here's what I find exciting: once you can clearly articulate your processes, you suddenly have options you didn't have before. When I tried to explain my old lab ordering system to a potential assistant, I realized how much of it lived only in my head. Every "it depends" moment required my personal judgment call. I couldn't delegate, couldn't take time off, couldn't even create reliable backup systems.
But practitioners who've moved beyond "it's complicated" to "here's exactly how this works" can train staff effectively, delegate meaningfully, and approach new technologies like AI from a position of clarity rather than desperation.
This clarity becomes especially valuable as AI tools enter healthcare. For example, because I now have a standardized lab ordering process that I can document step-by-step, I'm able to think strategically about which parts could benefit from AI assistance. You can only enhance what you can clearly define.
The Results
When I finally standardized and systematized my lab ordering process, something unexpected happened. I started ordering more labs, not fewer. The friction was gone, so I could focus on the clinical question at hand rather than the logistics of getting it answered.
Now I track all my lab orders systematically, and I've built an AI agent for initial interpretation. It's another layer of systematization that frees up mental bandwidth for the nuanced work of connecting results to treatment plans. I'm releasing this lab interpretation AI agent template later this week. If you'd like to be notified when it's ready, please sign up here if you haven't already.
The specific tools matter less than the principle: when routine processes become reliable, your attention can focus where it belongs: on the clinical work that truly requires your expertise.
Questions for Your Own Practice
If this resonates, here are some questions that might be useful:
- What routine task are you avoiding because the process feels overwhelming?
- Where are you mistaking complexity for thoroughness?
- If you had to train someone else to do your most "personalized" process, what would you discover about how it actually works?
- What might you start doing more of if the friction disappeared?
The craft of good clinical care includes the craft of good systems. Both require attention, both deserve our thoughtfulness, and both ultimately serve the same goal: being fully present for the people who trust us with their health.
Sometimes the most personalized thing we can do is get the mechanical stuff out of the way, so we can focus on what truly requires our human attention.
With care,
Katy
P.S. I'm curious - what's your version of the lab ordering chaos? Where in your practice do you find yourself creating complexity in the name of "personalization"? I'd love to hear what resonates (or doesn't) from your own workflow struggles. Just reply and let me know.
