Top 10 tips to be a more productive, less stressed physician


Having 10 years of medical practice under my belt and three young boys at home, I appreciate the importance of efficiency. I’d like to share some tips on increasing your productivity at work... without increasing your stress!

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

Being more productive in medicine isn’t working faster or working more hours, it means working better. Here are my 10 tips.

Finish your note before seeing the next patient

Are you among those who push back your notes to the end of the day? Worse: do you bring this task home? Finish your notes before seeing another patient! The information will be fresh in your mind. It's also an unnecessary stress to have another "to do" on your list.

Are you afraid of falling behind if you write your notes this way? If so, consider to have fewer patients on your schedule.

Take a break!

Doctors rarely take breaks during their workday. Yet most employees do take two 15 minutes breaks each day. You feel like 15 minutes is too long? Take at least 5 minutes per half day. This should be 5 minutes without patients, without medicine and especially without screen. And you'll recharge your batteries even more if you take these breaks outside the consulting office.

Throw away your pen!

How long do you spend each day writing your notes? 30 min? 1 hour? You can save lots of time writing your notes directly into your EMR. Do you think you're faster with a pencil than with your computer? Not likely. It's much more efficient to write your notes on a computer, even if you're very slow on the keyboard.

The use of medical notes templates has been growing rapidly in recent years. I improved my overall efficiency by at least 20% by incorporating templates into my practice in 2011. These are actually templates (example: cystitis) that you can copy into your EMR. All you need to do is edit the elements that apply to your patient. As templates are stored in a software, you can use them for as many patients as needed. You'll avoid writing the same things over and over again.

Most EMRs offer you the ability to use templates. You can also use our own medical template application: Dilato!

Delegate tasks to nurses/secretaries

You are probably already overworked. Free yourself from tasks that can be done by others.

Have your nurse take the vitals. She could even do some samples: throat, vaginal, anal, etc.
Do you need to talk to another doctor? Ask your secretary to reach him first.
Have the pharmacist renew the routine medication until the next appointment.
Communicate simple messages through your secretary or nurse ("please advise patient that her result is reassuring").
Never touch the fax machine!

Have your medical resources accessible

I always have Chrome tabs opened to my useful websites during my workday. Here are some examples:
1- EMR, patient record
2- EMR, my schedule
5- MdCalc, open on Framingham score
6- DermNet NZ, good derm site with images
7- PetalMD, to easily see who's at the clinic

You can also set up Chrome to open all these tabs automatically when you launch. Chrome > Settings > On startup > Open a specific page or set of pages on startup.

Don't neglect the initial contract with the patient

Patients do not always help you have a smooth consultation. The course of a consultation may seem quite clear to the doctor: history, physical, diagnosis, plan. But for the patient, it's not.

Without an initial contract, phrases like "Is it because I eat gluten that I have a sore shoulder?" may occur while you are at the beginning of the questionnaire. Do not answer his question now, it's an anti-efficiency trap! My reply: "I do not know, I have not yet examined you."

An initial contract only takes 5-10 seconds at the beginning of the consultation. Not only it can save you time in the end, it also makes a smoother visit, as the patient will know you will answer his questions at the end of the visit.

My typical initial contract: "Okay, we'll evaluate this pain. I'm going to question you and examine you, then we'll see what it can be and what we can do to help you."

(I have to admit I often don't do an initial contract with the patient ... but I should!)

Administrative tasks: Not for everyone

Department head, committees, service meetings, subcommittee, schedule management... these tasks are often added on top of the clinical obligations you already have. Learn to say no. It was very liberating for me not to renew my mandate as a service manager a few years ago.

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

Watch videos/images of baby cats

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

Limit interruptions during consultations

Interruptions are time consuming and stressful distractions. It's difficult to dive back into a complex task like a medical consultation after being interrupted. Despite the value of some multitasking, a study has shown a loss of productivity of up to 40%.

Two basic tips to limit distractions: block text/email/facebook notifications during working hours (settings > notifications) and teach your secretaries what does or doesn't deserves an interruption (in my case : pharmacist or doctor calls = ok).

Sleep better

Ok it's easily said. At least follow the basic tips for good sleep hygiene.

For yours
For your children (and yours!)

Some more quick tips:

Keep your desk clean and airy ("mess creates stress").
It can be beneficial to explore the advanced features of your EMR. Most of these softwares have improved a lot in the last years and yours can definitely make your life easier. Omnimed MobileMed Medesync
Work 3 or 4 days a week (the 4th and 5th days are not really productive anyway...)

As you have noticed, working to be more productive will initially require a little time and organization. And a little effort each day. But the rewards are great: more time, more family, more money, less stress...

We want to know what you think: info@dilato.ca

About the author:
Charles Tanguay is a general practitioner in Montreal, practicing in clinics and emergency dept. Founder of Dilato, he first became interested in productivity for his own practice.

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