How can I do a better job of staying on time?

We asked your colleagues how to solve common problems in practice. The current problem: How can I do a better job of staying on time?Practise 'truth in scheduling'Dr. Janet Craig: I work with Alberta AIM, an organization that helps physicians improve access and efficiency. The two biggest reasons why physicians run late are:1. They start late. If your first patient is booked at 9 a.m. and you don't arrive at the office until 9:30 a.m., and then you have to turn your computer on and look at a few lab results, you are starting at least 45 minutes behind before you even see your first patient. Barring an emergency, plan to arrive at the office ahead of when you are booked to see your first patient.2. Their schedule is unrealistic. Many physicians book patients in time slots that are too short. If your average time to do a short visit is 12 minutes, and you book in 10-minute time slots, you are always going to be running behind. We call this "truth in scheduling." Before you decide how many minutes your time slots will be on your schedule, measure how long your visits are, calculate the average and set your schedule accordingly, and ideally allow a little extra room for unexpected delays during the day, such as phone calls.Set limits and leave slots openDr. Gerald Levine: I have been a family physician in a medium-sized town for many years and am proud that my patients have put almost no wear and tear on my waiting room chairs! These are my four keys to success for running on time:1. Do not overbook. Leave lots of space in your schedule, especially in the afternoon. My medical office assistant typically leaves eight or 10 spaces open, which always get filled without double booking. I am in a family health team, so this same-day access is not only a boon to patients, but also reduces outside use penalties. One needs to have a well-trained MOA and clear communication from you to enshrine this as a habit. Having the MOA ask the patients the reason for the visit is usually helpful.2. Make the visit fit the time slot wherever possible. Without resorting to a "one problem per visit" rule, it is possible to be efficient and effective by setting some limits. If someone has booked a 10-minute visit but has a long list or complex problems (especially psychiatric), I will tackle the most pressing problem first, ensure safety, and ask the patient to re-book a longer appointment. Using the "listen without interrupting for at least three minutes" rule helps the patient sort out the problems and feel heard-and usually shortens the visit!3. Prioritize your work time. Put patients first. During busy times I will do a bare-bones EMR entry with the patient present and complete it when no one is waiting. Forms, labs and report review are important, but again, are best done during free time when no patients are waiting.4. Arrive on time at your office! 'Nuff said.Hire more staff and delegateDr. Benjamin Barankin offers this advice:1. Learn to delegate.2. Hire more staff. Stop being cheap. Figure out your hourly and even minute value, and hire accordingly to make you as efficient as possible (in the meantime providing better service to your patients).3. Make sure your clinic room is designed to have you sitting closest to the door. When the main issue has been dealt with, start standing up, and getting your hand on the door handle.4. Have a clear policy that your staff and pharma reps are made aware of regarding when you'll consider seeing a rep (e.g., consider "Not in the middle of clinic, ever!").5. Stop overbooking so much. God forbid you have a minute to breathe when someone no-shows. The extra free time also allows you to do some charting, respond to emails, do a walk-around of your clinic to see what needs improvement, grab a healthy snack, or even to do 30 push-ups.The next problem:How do I handle disgruntled patients?Do you have tips for your colleagues on solving this problem? Send them to cleslie@ensembleIQ.com. We'll run select answers in the next issue of the Medical Post and online here at CanadianHealthcareNetwork.ca.

How can I do a better job of staying on time?

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