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Tips To Be A More Productive, Less Stressed Physician

Discussion in 'Hospital' started by The Good Doctor, Oct 16, 2022.

  1. The Good Doctor

    The Good Doctor Golden Member

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    Why should you be more productive? Because time is money? Not only that. I prefer time is family or time is go-home-sooner.

    Being more productive in medicine isn’t working more hours or faster; it means working better.

    Take breaks. Doctors rarely take breaks during their workday. Yet most employees do take two 15 minutes breaks each day. Do you feel like 15 minutes is too long? Take at least five minutes per half day. A good break should be without patients and screens. And you’ll recharge your batteries even more if you take these breaks outside the consulting office.

    Use dot phrases and templates. How long do you spend each day writing your notes? One hour? Or two hours? You can save a lot of time writing your notes by using dot phrases in your EMR. I improved my overall efficiency by at least 20 percent when I integrated these templates into my practice. Most EMRs offer a way to use templates, or you can try an external app.

    Those unfamiliar with EMR templates (also called “dot phrases”) are canned blocks of text you bring in the note field of your EMR. Templates help you avoid writing the same things over and over again. Each dot phrase is about a specific condition, like “migraine” or “ankle sprain.” When the text appears, you edit the elements to make the note correspond to the patient encounter. Templates can be text-only or formatted as forms. They are stored in your EMR or an external app, so you can reuse them for as many patients as you want.

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    Delegate tasks to nurses and administrative staff. You are likely already overworked. Free yourself from tasks that others can do.

    Examples:
    • Have your nurse take the vitals. They could even do some samples: throat, vaginal, anal, etc.
    • Do you need to talk to another doctor? Ask your secretary to reach them first.
    • Have the pharmacist renew the routine medication until the next appointment.
    • Communicate simple messages through your secretary or nurse. (“Please advise the patient that their result is reassuring.”)
    • Never touch the fax machine!
    Have your medical resources accessible. I always have Chrome tabs opened on my useful websites during my workday. Here are some examples:
    1. EMR – patient record
    2. EMR – my schedule
    3. UpToDate
    4. Medscape
    5. MDCalc (opened on Framingham score)
    6. DermNet (a good derm resource with images)
    Do agenda eliciting with patients. Patients do not always help you have a smooth consultation. The course of a patient encounter may seem quite clear to the doctor: history, physical, diagnosis, and plan. But for the patient, it’s not.

    My typical agenda: “We will assess this pain. First, I’m going to question you and examine you. Then, I will see what it can be, what we can do to help you, and answer your questions.”

    Without setting up the agenda with the patient, phrases like “Is it because I eat gluten that I have a sore shoulder?” may interrupt you while you are at the beginning of the questionnaire. Do not answer their question now; it’s an anti-efficiency trap! My reply: “I do not know because I have not yet examined you.”

    Agenda eliciting takes about five to ten seconds at the beginning of the consultation. Not only can it save you time in the end, but it also makes a smoother visit, as the patient will know you will answer their questions at the end of the encounter.

    Limit administrative tasks. Department head, committees, service meetings, subcommittee, schedule management, etc. these tasks are on top of your clinical workload. Learn to say no.

    Of course, someone has to perform these tasks, but if it’s causing you extra stress and you can afford to avoid administrative tasks, do it. We’ll contribute again when the kids are grown up.

    Watch videos of baby cats. While you might think it’s a waste of time, the Japanese have proven that seeing cute pictures improves attention! Not to mention the calming effect of baby animals.

    Limit interruptions during consultations. Interruptions are time-consuming and stressful distractions. After being interrupted, it’s difficult to dive back into a complex task like a medical consultation. Despite some value of multitasking, you can lose up to 40 percent of your productivity.

    Two essential tips to limit distractions:
    • Block all phone and computer notifications during working hours.
    • Teach your staff what situations can justify an interruption. (In my case, pharmacist or doctor calls are OK.)
    Some more quick tips

    Sleep better. OK, it’s easy to say. At least follow the essential tips for good sleep hygiene for you and your kids.

    Keep your desk clean and airy. (Otherwise, “mess creates stress.”)

    Work three or four days a week (the fourth and fifth days are unproductive anyway).

    As you can see, improving your productivity will initially require some time and organization. And some effort each day. But the rewards are nice: more time, more family, more money, and more peace of mind.

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