Optimizing Patient Flow: Time-Saving Tactics for Physicians

One of the biggest pain-points for physicians is the paucity of time allowed for patient visits in the office. Unless you own and manage your practice, it’s likely that someone else controls your schedule.

Despite these constraints, there are some fairly simple things that you can do to optimize the time that you have available.

By focusing your attention on taking care of your patients, empowering your staff to manage routine tasks, and automating some of your EHR processes, you may be able to free up valuable time. Over the course of the work day, these small gains can improve your ability to care for your patients, reduce your wait times, and end the day feeling more in control of your time and attention.

 Pre-visit Information Collection

• Assign your medical assistant (MA) to briefly gather basic symptoms, including duration and intensity, before you enter the room. This has the added benefit of making the MA a valued part of the care team.

• Have your MA ask patients to list their top three questions and concerns. This way, you can start with pertinent issues, and be aware of any unexpected concerns. This won’t eliminate the “by-the-ways” doorknob questions, but it can help.

• Review these issues before walking into the room so you are prepared and can direct the conversation appropriately.

Standardization and Checklists:

• Develop simple checklists for common diagnoses to help guide your patients through symptom description, potential treatments, and follow-up steps. This documentation may also help when it comes to pre-authorization.

• Use protocol and instruction lists for routine procedures, common surgeries, or testing to streamline the process and maintain consistency.

Efficient Communication Techniques:

• Make use of the Teach-Back Method to confirm patient understanding quickly by having them repeat back information about their diagnosis or treatment plan. It might take an extra minute or so, but you’re likely to save time in the long run by addressing misunderstandings at the outset.

• Implement closed-loop communication techniques to ensure tasks like tests ordered or referrals made are understood. In closed-loop communication, the person receiving information repeats it back to make sure the message is understood correctly, and the sender confirms to “close the loop.”

Technology and Tools:

• Utilize EMR templates and macros for common visit types to expedite documentation

• Recommend or create patient education resources to reduce time spent on common issues, reduce post-visit in-box messages and focus more on specific concerns.

Delegate Simple Tasks:

• Delegate routine prescription refills and diagnostic test orders to nursing staff or MAs to free up time for complex decision-making.

• Assign follow-up tasks, such as checking if a patient has completed a test or started a medication, to designated team members.

Optimize Scheduling Practices:

• If possible, incorporate short buffer times every couple of hours to handle any overflow or unexpected delays.

• Whenever feasible, schedule patients with similar needs in consecutive slots to minimize mental switch costs and preparation time.

Structured Patient Interactions:

• If possible, sit down facing the patient to create an impression of focus and interest.

• Begin each visit by asking the patient what they aim to achieve during the appointment, directing the conversation efficiently. This also lets the patient know that you are focused on their needs, and can help to build trust. Over time, that may also reduce unnecessary messages to your inbox.

While you may not be able to fully control your schedule, putting these strategies into play can significantly free up some of the limited time you have with each patient. As a result, you’ll enhance both patient satisfaction and the quality of your care. And ultimately, your own satisfaction may improve.

If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.

And if you’d like to schedule a complimentary introductory meeting with me, click the link below.

Five Simple Ways Busy Physicians Can Save Time

Time is a precious commodity, but there’s only so much of it to go around. Your patients, your administrators, your family, your community—everyone wants some of it. With just 24 hours in a day, it may seem that there simply isn’t time to give everyone what they need, let alone take care of your own needs.

The reality is that, especially if you work in primary care, you might actually need 27 full working hours each day to get everything done that’s expected of you. And that’s before taking care of yourself, your personal relationships, and those who depend on you.

Ironically, despite your many years of school, training, and continuing education, you were probably never taught time management. Somehow it was just expected of you. Yet as the demands of medical practice have continued to rise, administrative burdens have increased and managing time is now critical to simply getting through the day.

Unfortunately, there is no way to magically manifest more time. You might be tempted, or even encouraged, to multitask. But it’s important to realize that you can truly only do one thing well at a time. In fact, an Australian study found a nearly two-fold risk of errors with multi-tasking.

As a Physician Coach with additional certification in Time Management Coaching, it’s been my experience that when you improve your time management skills, you’ll experience greater control and clarity over the direction of your life. You’ll strengthen your own well-being. And you’ll create the margin that you need to pursue your passions and reach the goals that matter to you.

Time management doesn’t have to be complicated or convoluted. Simply starting small can lead to big improvements.

In this article, I’ll tell you about five simple ways to reclaim wasted time. These are battle-tested strategies that served me well over many years as a busy cardiologist, and have helped many of my clients as well.

1.       Organize your physical and virtual workspaces.

Make it easy to find all the tools you need for your daily routine. Don’t forget to put them back in place at the end of the day to avoid having to hunt for what you need the next morning. As simple as it sounds, an organized workspace helps to set the stage for a well-ordered day.

Keep your computer files tidy as well, and organize your “smart phrases” in your EHR. Take advantage of any available technical support at work to make things run more efficiently. Developing a system that makes sense to you means less friction in your daily routine.

2.       Commit to only touching each piece of paper or emailonce.

Block time to tackle your virtual and real-life inbox, and complete whatever task is required before moving on to the next. Even a 5- 10 minute block can make a difference. Delete (or recycle) whatever is unnecessary, and organize your virtual and real-life inboxes.

Chances are you get dozens if not hundreds of emails daily along with piles of paper. Most of it is likely unnecessary and distracting, but other documents are time-sensitive and important. Organize your inbox so that your attention is focused on those more critical communications, and let the others drop into a secondary file or forward them on to someone who can take care of them.

3.     Get your charting done before moving on to the next patient.

When you do your charts as you go, you’ll remember the details that you need to make the note accurate, and you’ll be less likely to forget to include things like orders, refills, and instructions. Patients will appreciate it, and you may have fewer requests for clarification after the appointment. I learned this early on, and it made all the difference.

Consider using AI to help with your notes if a good system is available. A scribe (or virtual scribe) can also be a valuable asset. It can be a little tricky to get up to speed with your charting, but I promise it will save you time and aggravation if you can manage to do it efficiently. The next tip will help with this.

4.       Automate and delegate your common phrases and tasks.

Use smart phrases in your EMR for common scenarios. And do your best to stay out of the weeds by delegating administrative tasks to your office staff whenever possible. Make it easy for them to know what you need. Smart phrases can be helpful here as well. And when you empower your staff this way, they may feel more connected and engaged.

5.      Streamline Team Communications

Efficient communication with nurses, assistants, and other team members can significantly reduce time spent on back-and-forth clarifications and miscommunications. Establish clear, direct, and respectful communication. Take the time to create protocols to handle common situations that don’t need your direct input. This proactive approach can foster teamwork, reduce errors, and keep your patients happy.

If you’re like most physicians, you are probably pulled in many different directions at once. It should go without saying that healthcare systems need to step up and reduce the burden on physicians. In fact, there is growing recognition that the current demands on physicians are unsustainable. But meanwhile, if you can create a little more margin in your day, you may find that you reduce your stress and have a little more time to devote to your patients.

An earlier version of this article appeared on this site in October 2022.

If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.

And if you’d like to schedule a complimentary introductory meeting with me, click the link below.

References

Hodkinson A, Zhou A, Johnson J et al. (2022) Associations of physician burnout with career engagement and quality of patient care: systematic review and meta-analysis BMJ

Porter, J., Boyd, C., Skandari, M.R. et al. (2022). Revisiting the Time Needed to Provide Adult Primary Care. J Gen Intern Med (2022)

Westbrook JI, Raban MZ, Walter SR, et al. (2018) Task errors by emergency physicians are associated with interruptions, multitasking, fatigue and working memory capacity: a prospective, direct observation study. BMJ Quality & Safety