Illustration by Tim Eggert
Everyone is pressed for time these days, but we doctors probably more than most. Paperwork alone is now estimated to consume one-sixth of the average American physician’s working life. Unfortunately, the explosive growth of regulations and paperwork is expected to continue, and complying with the new rules will undoubtedly demand progressively more of our time and energy. To accommodate these new responsibilities, doctors have a huge incentive to try and streamline both their home and work lives.
Physicians’ Life asked doctors from Rhode Island to California to share their best work time and down time tips for squeezing just a little more out of each day. To start, I’ll share one of my own strategies:
I find it really helpful to cut the clutter. Whether it’s in my office, my home office, or even the kitchen, the old adage about having a place for everything and everything in its place is one of the most reliable means to avoid wasting time. And speaking of the kitchen, I like to keep breakfast bars and other meal items stocked in my kitchen at work. Shopping online for these groceries and other items, and using free shipping, saves even more time, plus gas money. This kind of advance planning also lets me multitask at lunch time without having to skip a meal or resort to energy-sapping fast food.
Give it a try if you think it will help you save time, too. And read on to find even more ways that your colleagues across the country are carving more time out of their day.
"I think getting to the office an hour early saves me the most time. I can get so much more done before everyone else gets to the office." --Dr. Marta Hayne, Radiation Oncology
“I find that an organized day is a time-saving day. Outside issues, both clinical and familiar, always impinge, and organization makes allowing time for these unplanned-for issues as efficient as it can be. I also try to allow those around me with a proven track record to solve problems for me. An effective aide-de-camp is crucial. Finally, no matter the pressures (and they can be substantial for a busy clinician), do not over-schedule, and learn to say ‘no.’ You can only be so efficient if your workload is so substantial as to be unworkable.” --Dr. Joseph Weigel, Residency Training Program Director
“Probably my most productive idea was to review patient charts (yes paper, back then) the afternoon prior to their visit. This enabled me to review the last interaction, refresh my memory of any personal issues, and look for gaps in care. This was different than a team huddle in that it was a personal review and was geared towards helping me be more efficient in the one-to-one interaction with the patient.” --Dr. Michael Barr, Internal Medicine
“I've tried multiple different ways of taking notes during meetings --Livescribe pen, bound paper books, pads of paper subsequently filed, handwriting on iPad, OneNote, Evernote--and have recently settled on a process (for now) of handwriting notes or drawing pictures to reflect conversations. Then, for those notes that I know include key information I'll need to retrieve in the future, I take a picture, import it to Evernote, and add appropriate tags to support the searching function. This enables me to access these notes from any device.” --Dr. Michael Barr, Internal Medicine
“I utilize nursing staff for medication reconciliation (when appropriate) and medication administration education (how to use inhalers, insulin injections, etc). I encourage working with your EMR to customize notes that fit your workflow and thought processes. I also recommend making time contracts with patients. For example, I let them know that we only have 20 to 30 minutes today so they need to pick the things they most want to talk about.” --Dr. Curtis Cary, Internal Medicine and Pediatrics
“I order labs to be done a few days before the patient comes in for the visit, and I have a nurse call the patients to remind them and do the medication reconciliation. I also find it works best to schedule “new” patients in the first slot of the morning or afternoon, not at the end of the sessions.” --Dr. David Fleming, Internal Medicine
“The single best thing I’ve ever done to improve my personal and professional life is to keep a paid ‘homemaker’ (not a housekeeper) working in my home. She takes care of us and our home, doing the housekeeping, majority of the grocery shopping and cooking, errands, laundry, running carpools, helps us take care of our aging parents, etc. Could not possibly do everything I do without her help.” --Dr. Jacqueline Fincher, Internal Medicine
“When lists of patients who are overdue for screening, testing, etc., arrive from insurance companies or [are generated] within the practice, I have other staff members do the tracking down and reminding. With prior authorizations, I’ve gotten in the habit of putting the usual information that might be needed in the office note, so that staff can fill out the forms, leaving only those items not in the note for physician completion.” --Dr. Yul Ejnes, Internal Medicine
“Use audio tapes or CDs (Practical Reviews in Internal Medicine
, Audiodigest Internal Medicine
CDs, ACP National Scientific Meeting
CDs, etc) while driving or doing rote types of work such as house cleaning or mowing the lawn, etc.” --Dr. Stan Amundson Internal Medicine
“Voice activation is crucial to my time management and real-time documentation. Just after the encounter it’s critical for capturing complete information for coding. I see no way I could manage otherwise.” --Dr. John Borders, Internal Medicine
“My personal favorite is using a PDF virtual printer on my computer. The printers are free and install just like any other printer. Anything you can print to a regular printer you can print to the PDF printer without using any paper. It’s great for large documents, or documents you want to email or fax through your computer. No more printing things out and scanning the document back into your computer. Plus it saves some trees.” --Dr. Phil Bressoud, Executive Director, Campus Health Services
“From Ben Franklin....and Poor Richard. Rising early allows me to deal with the personal duties in my life like finances, spirituality, family issues, and supplemental reading and fitness, so that these issues don’t infringe on the work day. This entails an earlier bed time as a necessity.” – Dr. Joseph Weigel, Internal Medicine
“If I feel like I’m getting too busy I just try to make lists and prioritize what's important. I try to keep my family and good personal time (exercise) near the top of that list.” --Dr. Jeff Hatcher, Infectious Disease
“This one really works for me: my job (program director) allows me some flexibility that many people don’t have. I get to work between 5:30 and 6:00 a.m. This is a very quiet time of the day when I can get a lot of focused stuff done. I clean everything off my desk, I scan my journals, do any pending correspondence and organize my day. This allows me to leave (I work 10-hour days by choice) by 3:45-4 p.m. I then can enjoy some daylight throughout the winter in late afternoon and have a longer evening for personal and relaxing pursuits (my wife and I kayak). I do very little work-related activities at home.” --Dr. Steven B. Pearson, Internal Medicine
No matter what kind of phone you use, here are some apps I've found helpful for saving time.
For iPhone: Checkmark, Due, Evi, Vokul
For Android: Aivc, Life Reminders, ToDoReminder, Skyvi