Time-saving tips from your physician peers

Time. Using it more efficiently is a common New Year’s resolution and popular year-round pursuit. When the Medical Post asked doctors to help their colleagues by sharing their favourite clinic time-saving tips, they didn’t waste any, um, time in making suggestions. From the tried and true to contemporary creations for our hyper-digital age, we collected and condensed their (anonymous) suggestions from our 2024 Physician Survey.Train and delegateOne key theme among survey respondents was heavy, unapologetic delegation. One survey respondent wrote, “My favourite tip for time-saving in the clinic is to delegate tasks whenever possible. For example, nurses and medical assistants can often handle routine tasks, such as taking vital signs, obtaining patient histories and administering medications. This frees up the physician to focus on more complex tasks, such as diagnoses and treatment plans.”Dr. Stephanie Zhou, an FP and addictions physician in Toronto who has been in practice for three years, puts this at the top of her time-saving to-do list. “If you have access to students or residents who do electives or rotations in your clinic, they are a resource who can help enormously with time management,” she said in an email interview. “There is an investment of time in the beginning teaching them the flow and how things run in your clinic, but once they know the EMR and clinic team, they help save time by filling in forms, charting and counselling patients. They can also be the source for locums which can be hard to find these days.”Dr. Zhou also said she has a clinic co-ordinator who’s in charge of doing all the referrals and following up on wait times.We have the technologyWhile learning the many features of your EMR system can seem time-consuming and complicated, it pays off, say survey respondents. Features like e-prescriptions, communication with other physicians, automatic reports, scheduling reminders, patient portals, lab integration, quick links to frequently used medications and diagnostic codes etc., can improve efficiency and save time.“Learn to use your EMR efficiently—especially helpful for using templates to save time on charting,” said Dr. Zhou, adding that she knows colleagues who use AI scribes to help with charting, but has not tried it herself. Like training students or residents (to delegate to, see above), learning to use your EMR efficiently takes an upfront investment of time, but there are resources from the EMR vendor as well as training and support from provincial medical associations.Templates are your friendOf all the EMR features, using templates was the most touted among survey respondents, whether they are standard EMR templates or customized.“Templates can be used for documentation, order sets and other routine tasks,” wrote one respondent. “This can help to reduce the amount of time spent on repetitive tasks, and it can also help to ensure that all necessary steps are completed.”Another respondent wrote: “By using standardized screening tools, clinics can quickly identify patients who are likely to have a particular condition and begin treatment, rather than having to take a detailed history from every patient.”Dr. John Crosby, a recently retired family physician in Cambridge, Ont., who counsels and mentors physicians on time management, said in an interview that templates are his favourite time-saving tool. In his free e-book Crazy Busy Doctor, he offers copyable custom templates for diagnosing and treating common complaints FPs see. “Take the time to set them up. They are a huge time-saver and make you more thorough.”Added Dr. Zhou: “All of these strategies might have an initial time or monetary investment but they allow you to run a more efficient clinic over the long run.”Too many patients, too many problemsThere’s no getting around the fact that the demands on doctors from patients are great and getting greater, especially given the aging population. More than one survey respondent suggested creating an online booking portal for patient appointments to free up staff for other tasks (See ‘Delegate,’ above). A booking portal also allows patients to provide details and fill in forms to make appointments more efficient.Several physicians suggested enforcing the “one visit, one problem,” rule.When faced with a patient with a laundry list of complaints, Dr. Crosby suggests taking a slightly softer stand. “I think it’s tacky to have a note on your wall saying, ‘Only one problem per visit,’ and so do the colleges of physicians and surgeons and the Canadian Medical Protective Association. The second problem might be lethal.”Instead, Dr. Crosby suggests asking to see their list and saying, “I see you have five problems today. To be fair to you and give us lots of time to solve them all, please choose your top two concerns . . . and set up another appointment to check for the other three.”Limiting medical concerns makes finishing charts during the appointment—something he and many survey respondents strongly recommend—more feasible and manageable.Dr. Crosby also recommends making Mondays more manageable by not booking in-advance appointments on that day but leaving it for the many same-day call-in urgencies after the weekend. This also speaks to a recommendation another survey respondent made: “See patients soon after they identify a need. Otherwise, they will have too much time to think of other needs that probably aren’t really needed. Also, it prevents the ‘It’s better now’ visit.”To-do or not to-do, that is the questionSteve Jobs is credited with saying, “People think focus means saying ‘yes’ to the thing you’ve got to focus on. But that’s not what it means at all. It means saying ‘no’ to the hundred other good ideas that there are.” In the world of 24/7 news and communication, there is much to say no to.Hence, the “not to-do” list—a favourite of one survey respondent. “This list includes things that I don’t need to do such as checking mail constantly or attending unnecessary meetings. By doing this, I can have time to do things that are important to do.”Timothy Ferriss, an American podcaster, lifestyle guru and author of The Four-Hour Workweek, has been an advocate of this. In his blog, “The Not-To-Do List: 9 Habits to Stop Now,” Ferriss includes on his list such things as “Do not email first thing in the morning or last thing at night,” “Do not let people ramble,” and “Do not work more to fix overwhelm—prioritize.” Several physician respondents also vehemently agreed with one of his don’ts—don’t leave email open and incoming all day. Instead, look at it and answer only a few times a day at specific designated times (same with texts). Similarly, batching together other similar activities, like reading lab reports and calling specialists or patients, was highly recommended.At the top of Dr. Crosby’s not-to-do list is taking phone calls in the office from anyone besides specialists. If patients complain about this inaccessibility he recommends saying, “I’m sorry, this is our office policy. We value your time and want to be on time for you . . . and offer same-day appointments for urgent cases. If I spoke to everyone I wouldn’t have time for my office patients.”The not-to-do list echoes another currently popular list-making strategy—the “got-done list.” This involves making a list of what you did do, even if it wasn’t on your to-do list. For example, tidying your office, learning a new EMR shortcut, talking to staff etc., might not make your to-do list, but can still be important contributions to a well-run practice—and taking note reminds you of what you do accomplish in a day, even if the official to-do list remains long.Finally, expect some things to take longer than expected and other to-dos to pop up. “Don’t book every single minute,” advised one respondent. “A few minutes here and there and time for lunch allows you to finish up charts, squeeze in emergencies, and clean up your emails. Leave some slack in your day.”

Time-saving tips from your physician peers

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