My incomplete macros contain percentage odds and sometimes cite literature. But most importantly, they crystalize my thinking and encourage thoughtful deliberation. For any chest pain patient, my incomplete macro (.ChestRisk) reminds me to document why I am assured that this pain is unlikely to have an aortic dissection, pericarditis, esophageal rupture, pneumothorax, acute coronary syndrome, pulmonary embolism, or pneumonia.

Those blanks remind me to follow up my lab results, look at the ECG one more time, think about the history and risks, run and document my clinical decision rules like Wells and PERC, think about doing a bedside sonogram if indicated, and to read that chest x-ray myself and then document my thoughts.

A good macro does not put my mind at ease but rather keeps my mind working vigilantly with a clear goal in mind.

My incomplete macros can serve as bookends to my patient encounters. When I receive signout from another resident, my “.SBAR” macro creates a formatted progress note with the patient’s known demographics, and predesigned sections for “situation, background, assessment, and recommendation.”

I simply fill in the blanks. More than a few times, this thought process has forced me to reassess the assessment, and led to changes in the plan – including a couple of pick-ups that gave me a little bit of intern pride! And when I go to “.Discharge” my patient, my incomplete macro not only states that I discussed the discharge instructions but asks me whether I have discussed reasons to return to the emergency department with the patient. If I haven’t, I do it.

To prime and to remind. To foreshadow and to fulfill. These are the tenets of the incomplete macro manifesto. To become better doctors, we also must become better writers. And like any skill in medicine, we all need good guidance and mentorship. So for a little inspiration, try channeling someone who might as well have been the patron saint of doctors who know how to write: Anton Chekhov.

Dr. Faust is an emergency medicine resident at Mount Sinai Hospital, New York, and tweets about mE.D.icine and classical music @JeremyFaust.