Are You Educating Physicians—or Just Quoting the Guidelines?
Article Reference Code: NAMAS.02.06.2026
Written by: Brenda Edwards, Director of Auditing at Crossroads Health Resources
There may be a fine line between teaching and telling our physicians what to do in terms of documentation. Which is the most appropriate way to communicate with our physicians? Do you believe there is one answer to this question?
Let’s start first with the definition of each.
⇒ Telling is to communicate facts or information, feeding information without any real background of what or why. An example is “this is the guideline; follow it”.
⇒ Teaching is to show or explain how to do something. To unveil the why and how behind the what. Teaching involves questioning, discussing, and problem-solving.
Is one better than the other?
I present the annual ICD-10-CM and CPT® coding updates to physicians, coders, billers, and anybody else who is interested. In my earlier days, when I listened to somebody present these to me, I would get frustrated if all I was being told was the new code and description. I want to learn why it changed or the background of the condition. When I present the coding changes, I teach when I do a presentation as well as when I meet with a provider to go over audit results. I want to explain or make a comparison to something outside of the audit that will have a lasting impact.
Education is not a one-stop shop, and different personalities may require a varied approach to sharing audit results. Physicians who are intuitive and more creative may respond better to understanding the “why”. In comparison, physicians who are structured and conscientious need quick and direct information.
While we need to tell the physician what documentation expectations are (i.e. to support the service that is submitted for payment, as well as medical necessity), we should also educate (teach) how to accomplish this.
We, as auditors and educators, need to take a step back and remember that the physician’s focus is on caring for the patient. Documentation is not the priority in their world like it is in ours. We sometimes become overzealous quoting the Evaluation and Management (E/M) Guidelines as if they are laws, but it is right in the title – guidelines. So how do we communicate the guidelines? There is a difference in the language a physician uses in comparison with what the guidelines state.
Let’s compare Dr. A with Dr. B. Dr. A who is a highly competitive, driven physician who hardly stops during his day that includes hospital rounds, office visits, and charting. The personality of Dr. A is analytical and may sometimes come across short or abrupt. He is impatient and a perfectionist. Dr. B, on the other hand, is more laid back and intuitive. Dr. B has an easy-going personality that seems less stressed and patient. Will it work to approach both physicians in the same manner? Probably not.
Dr. A may appear to argue why the coding is correct from their clinical standpoint. While it may sound defensive or argumentative, it really is just an explanation from their perspective. This physician would benefit from the “tell me what I did wrong and how to fix it” in a brief meeting. Dr. B’s education may be very different because the response may be more conversational and “help me to understand”. This education may dive deeper into elements of the visit and more of a type of hands-on education. You may explain the E/M Guidelines in detail that could even include examples.
This is just an example; there are many different personalities, but you may have seen two providers you are familiar with in this scenario.
Why does it matter if we teach or tell? When we teach our providers, we are teaching them “Here is the guideline” compared to when we tell them, “Follow this guidance”. Knowledge that is told can be forgotten, especially in a new or complex area. Teaching helps to cultivate understanding.
Next time you are presenting audit findings, performing education, or even in a provider meeting, consider your audience and if you are teaching or telling the provider.
Happy auditing!
Contact Brenda on LinkedIn by Clicking her Name Below:
Brenda Edwards, Director of Auditing at Crossroads Health Resources
Brenda has been involved in the healthcare arena for over 35 years with experience in chart audit, coding and billing, education, consulting, practice management and compliance. She has worked closely with practices, providers and residency programs to ensure documentation is compliant and accurate. Brenda has written many articles for national publications including Healthcare Business Monthly, American Academy of Family Physicians (AAFP) and BC Advantage. Her humorous and engaging presentation style has made her a conference favorite at both national and regional conferences for AAPC as well as local chapter meetings across the country. Brenda is also an AAPC workshop and webinar presenter. Brenda became a Certified Professional Coding Instructor (CPC-I) in 2001 and has assisted countless students obtain their coding credentials through the AAPC Professional Medical Coding Curriculum. She is also an AAPC ICD10-CM/PCS Training Expert. She served on the AAPC Chapter Association Board of Directors from 2010-2014 and held office as Chair. She has been intimately involved in the development and continuation of the Hardship Scholarship Program for AAPC. Mentoring fellow members of AAPC is a passion for her. She is co-founder of the northeast Kansas (NEKAAPC) AAPC chapter and has served many offices.
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