Top 10 Tips: Time Management for Family Doctors
Learn to be home by 5pm with no homework. Get undisturbed lunch for 90 minutes. Learn to love paperwork, patients with lists, Mondays and on call.
Dr. John Crosby has launched 2 new e-book resources for 2023 to support Family Physicians, Nurse Practitioners, Physician Assistants and Medical Residents, sharing practical tips for successfully managing time, avoiding burnout and preserving the joy of practicing medicine. Dr. Crosby is an experienced Family Doctor from Ontario and is Assistant Professor of Medicine, University of Toronto and Family Medicine, McMaster and Queens Universities.
Time Management for Family Doctors 2023: an e-book with updated insights on technology such as templates, on line booking and patient filled in tablets.
Top 10 Time Management Tips 1. DELEGATION Only do your MD job. The secret is to shift the initiative. Get your staff and co- workers to not dump all their problems on you but to bring you their solutions.
Secretaries are the most important people to help you stay on time. You need to be in constant communication (weekdays) with them by text or email. Copy them on all emails you receive pertinent to the office. On lab results and imaging you need to be very specific on how you want each result handled. Meet with them for lunch monthly (you buy) to discuss office efficiencies. They are trained to run a tight ship and need your blessing, back up and co- operation. I talk to my secretary every Monday morning to discuss the upcoming weekly schedule to avoid overload and conflicts. On line booking of appointments is like booking a seat on a plane. It improves access for patients, and avoids your phones ringing off the hook and making you and your staff crazy busy. It also helps patients get through and not go to a walk in clinic which costs you money if you are in a rostered practice or takes away the easy cases in a fee for service practice and interrupts continuity of care for your patients.
Nurses can help you stay on time. If you can’t afford a full time nurse, hire one for one afternoon a week and have her help you do all the needles, well baby examinations, prenatal examinations and full physicals (which should be done only every 3 years). She will pay for herself many times over.
With nurses at the hospital or nursing homes you should communicate by responding to their phone calls, faxes, emails or texts STAT.
Nurse Practitioners and Physician Assistants can do everything a family doctor can do including prescribing, ordering MRI and CT, narcotics, referring to specialists and taking away driver’s licenses (why they would want to is beyond me). I work with one and she covers my entire office and two
nursing homes in an excellent fashion when I am away. She does all my paper and computer work and phone calls. We text or phone each other using patient initials to keep care coordinated. I have worked with a physician assistant and trained PA students. With pharmacists, communicate by fax or secure text or email stat. This avoids a phone call. Use E prescriptions. Specialists: Family physicians are like generals in the army, leading and coordinating care. The buck stops with us. With specialists you have to be very precise in what you want them to do and in your consult letter send them everything you have done with regard to prior diagnosis and treatment, even things that failed. Don’t order tests for cardiology or respirology consults (eg stress tests, spirometry etc.). Leave them for the specialist who might repeat them and can coordinate them better than you. This saves the patents and you and your staff time and the taxpayer money. There is now e consult with online specialist help. Delegate to diabetic day care, COPD clinic, CHF clinic, podiatrists, physio, social workers, etc.
The Patient: get them to take an active part in their care for better buy in and compliance.
2. TOO MANY PATIENTS: This is a huge problem world wide with an aging population and sicker more demanding patients.
Barriers to Change: Many doctors are afraid their income will drop if they hire more staff and have to pay them. However, you will find that you become more efficient and will make more money. To prevent getting too overloaded, don’t take any new patients without exception. Even if ‘Aunt Mabel’ calls you and begs you. Tell her you are overloaded and this will decrease care for all and stress you out. Offer to get her in to see another doctor. Also if a physician in town quits and there are a lot of orphan patients don’t get guilted into taking them. It will diminish care for your existing patients. You did not cause the problems and don’t have to solve it.
3. PAPERWORK, COMPUTER- WORK, TEXTS, ADMIN AND E- MAILS: Do them every weekday at a booked time, for example 8 am until 9 am or if you have young kids, noon until 1 pm while eating lunch. Do not do them after hours. Guard this time with your life. Turn off your iphone, landline, texts and emails. Tell your staff to not interrupt you. If you are in a room with other people try to get an empty office to be alone in or wear headphones, sunglasses and a sign on your forehead to not interrupt you. Bring in patients for big insurance and lawyer forms (chartomegaly)and charge the provincial rate ($300 per hour in Ontario). Put the money in a fun fund so paperwork and admin time is happy not sad. Come back a day early from vacations to get caught up. Templates: Use templates (see book for examples). The Rourke Baby Form, workers compensation forms and provincial antenatal forms are templates.
Download the free e-book for more tips:
Joy of Family Medicine: Time / Stress / Risk Management For Family Physicians
After practicing Family Medicine for 50 years, Dr. Crosby still enjoys the "joy of medicine." This e-book looks at causes of burnout and how to fix it, plus practical tips on time management.
The Top 12 Causes of Burnout are:
Paperwork and computer work.
Less control over workload.
Physician voices are ignored.
Government can’t manage the system.
Rising patient entitlement.
Health ministry rules.
Fear of college complaints and lawsuits.
Lack of a unified voice.
Electronic medical records.
Low collegiality between doctors.
Bullying from colleagues.
The number one cure is passion.
Download the free e-book to learn more:
Dr. John Crosby https://www.countryquack.com