Successful practices: Do it now! (Medical Economics Special Section)

September 1, 2007

Simple but powerful techniques can help you become more productive and less frazzled.

The world is flush with time management experts, but for gastroenterologist James Brown in Wenatchee, Wash., nobody beats Mom as the ultimate authority.

"My mother always said 'Do it now, and you'll never regret it,' " says Brown. "I took her advice, and she was right."

More doctors should listen to Mom, because postponing some tasks is bad for their practice, not to mention their mental health. Sometimes the "do-it-later" syndrome stems from time-honored but counterproductive routines, such as starting all of the day's charting at 5 PM-and hoping your memory is perfect. More often than not, though, the culprit is bald-faced procrastination, which takes a heavier toll than just a $2 late fee for a video. "If you're always putting off performance reviews and salary adjustments for your staff, you may demoralize some people into quitting," says practice management consultant Gray Tuttle in Lansing, Mich.

The do-it-now principle can appear simplistic if you don't view it in the overall context of working wisely. Some tasks, once commenced, are too big to be completed immediately, others need to be postponed, and still others deserve to be delegated. That's why everyone needs a strategy for setting priorities and goals, planning their work, giving themselves effective reminders to complete tasks, and organizing the tsunami of information in their lives. Cultivate the right habits, and you can do it now, whether it's something as simple as signing a letter drafted by your office manager, or making that first phone call to a recruiter that eventually leads to a new associate 6 months later. We interviewed physicians, practice management consultants, and time management experts about the Tao of "now" to give you some pointers. Why not read them now?

Batch some chores and you may botch them

The pile of 30 charts on a doctor's desk awaiting his dictation or scrawl is a prime example of saving up work and trying to complete it in one fell swoop. While this tactic may streamline a chore like paying bills, it makes clinical documentation actually less efficient. You'll spend extra time and effort trying to remember what you heard and decided during your appointment with Mrs. Jones at 8:30 AM. Even then, you may forget a crucial detail, or even confuse Mrs. Jones' complaints about abdominal pain with those of Mrs. Smith from 1 PM. Maybe you jotted down a few notes to jog your memory, but wouldn't it have been easier if you had simply charted Mrs. Smith immediately after she left the exam room, when everything was fresh in your mind?

Similar problems arise when you batch charge tickets for the end of the day. You increase the chance of a mistake that will get the claim denied, or underpaid-maybe you forget to circle a code for a service you provided.

A better routine is completing charge tickets along with charts at the end of every visit. To make this possible, however, you must build a few more minutes into each appointment slot, says consultant Gray Tuttle. "Because it's more efficient to do all your documentation on the front end, your day will be shorter."

Case in point is the four-doctor Family Medicine Center in Colorado Springs. They used to complete charts and charge tickets after their last appointment, which forced them to work until 6 PM and beyond, says FP and medical director Joel Dickerman. Then in 2002, the average appointment slot was extended by 5 minutes so doctors could wrap up their paperwork on the spot. They still see the same number of patients per day, but now go home almost an hour earlier. "We're even able to take a lunch break," says Dickerman. "Income also has risen because we're capturing our charges more thoroughly."