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As physicians, grasp how much work you can do in one day, adjust your schedule accordingly, and start fresh each new day.
I often look back on my time in medical school. The first day of classes was basically an orientation time. We met our instructors and received handouts for the first-year courses. The day ended with a nice dinner at the dean's house for all first-year medical students. As we prepared to leave for the evening, the dean's words continue to echo in my mind. He said, "Everyone go home this evening and relax. Watch the sun go down and make your preparations for the next day to come, for this will be the last day that you will be completely up to date with nothing else pressing to do."
How true those words are from 1996. Time is by far the biggest enemy for the physician in clinical practice. How many of you go into work each day and struggle to complete patient care, complete administrative paperwork, return phone calls and messages from concerned patients, meet with hospital personnel regarding the newest changes to come, etc.? It seems as if there is just never enough time to get everything done each day.
Time management is one of the most critical areas that physicians attempt to manage. In terms of patient schedules, we try to schedule patients on our appointment list with enough time to carefully listen to each complaint and manage each issue needed. As patients come and go in the office, the issue of same-day, call-in patients always comes up. We try our best to see them as best we can and attempt to leave enough empty space in the daily schedule for such open access. However, the messages to be returned, tests and reports to review and follow up on, and employee management are all factored in to this block of time. How can one manage everything effectively and go home on time at quitting time?
The short answer to the concept of time management is that no one will ever get it right every time. We try to properly educate our patients regarding same-day call ins, message return, etc., and effectively prepare them for the amount of time that they should expect before their concern or problem is addressed. Nurses triage the incoming calls for same-day visits and patient concerns and those are handled in order of importance. Fortunately for my practice, we utilize a very robust EHR that provides an intra-office messaging system. As patients call in with concerns or questions, the nurse attaches their concern to a message and it is forwarded to me. I will answer such messages between patient visits and at lunch time so that the delay is as short as possible. We also utilize a patient portal that allows me to communicate with patients via secure electronic communication without the extra step of involving the nurse or medical assistant.
I very much try my best to leave the office on time each day. Of course the daily work is not complete when I leave, but of the work that is left to be completed, I can wrap it up at home after the kids have gone to bed and after I have spent quality time with my wife. Of course this extends the total duration of my awake time, but it allows me to get the day's work completed and finished each night before I go to bed. As I go into work the next day and the nurses and medical assistants review my message replies, they will joke with me and say, "...you were up pretty late working last night weren't you doctor?", as they are able to see the timestamp on the replies.
The take home message regarding time management is that we can never master our day completely. However, after physicians have been in clinical practice for a certain period of time, we are able to effectively grasp exactly how much work we can complete in a day and we adjust or tailor our schedule as needed.
I have colleagues that can see patients faster than me and have colleagues that see patients slower than me. Whatever your pace may be, adjust it so that you are able to complete each day's work within that day. Never get yourself into the bad habit of procrastination. Do your best to work hard and efficiently while you are at work and most importantly, do not take away time from your family on a routine basis.