Four Things You Can Do Now To Increase Your Efficiency - As Physicians In The Outpatient Practice

If your first patient is scheduled at 8 am, and you walk in the office at 8:10 am, you are already ten minutes behind. If you do not start your day on time, it is easy to feel rushed. It is easy to have the pressure to move quickly to see the next patient, without necessarily addressing the patient’s needs adequately.

The first thing you can do to increase your efficiency is to be at the office earlier than your start time. This will ensure you start your first patient on time – provided that the patient is punctual. Being in the office earlier allows you to do a few things. There is the time for you to get your mind ready for the day. This time before your full schedule starts is a crucial period. You can check the lab results and messages from the previous day. You can start delegating different tasks. You can use that time to review some patients’ charts. By the time you are ready for your first patient, you are starting “fresh” and caught up. You have more capacity to focus on the patient.

I usually go arrive at the office about forty minutes before the official start time. That is the time I use to quiet my mind and get myself mentally prepared to start a full day. After washing my hands, I clean my desk, the computer and the phone – a habit I started during the Pandemic. Then I check the lab results, mostly results from patients whom were seen the day before. I also check for any new messages from overnight. I use this time to delegate tasks so that the nurses can start early in the day to help me.

The second thing to do is to prepare your team. It is important for your team to know what you expect when you hire them. They should have an idea of what their responsibilities are and what to do in certain situations. The daily preparation for your team is to remind them of your goal of caring for patients. It is a reminder of how the team can work together to accomplish that goal. If there are certain special situations in a patient, you can use this time to alert your team and instruct them what to do. True teamwork increases efficiency. It also lets patient how the medical care is patient-focused and is a collaborative effort.

This is what I do during the morning huddle. Sometimes it is only two minutes, when the patients do not have very complicated issues; sometimes it is ten minutes. In my hematology and oncology practice, although we do not do chemotherapy infusions in the office, we do offer injections for different conditions. Some patients have infusaports for central venous access. I usually let the nurse and the medical assistant know which patients need a port flush and which patient needs an injection. This enhances the work flow as the whole team knows what needs to be done for each patient.

The third thing to increase your efficiency is through the patient encounter. Preparation is the key. If you are not quite familiar with the patient, review the chart. Check if there are any phone encounters or messages from other clinicians since you last reviewed the chart. Focus on the patient, one at a time. The better you focus, the better you can to come up with quality solutions and management. Listen attentively and communicate with the patient. This can minimize misunderstanding. The patient will feel heard and will be more willing to open up to sharing what problems or concerns there are. The more you know, the more you can tailor your treatment plan.

The first and second steps are essential to optimize the third strategy. When you are not always in a rush, when you are well-prepared, you can put your concentration on what matters during the patient encounter - the patient.

The fourth thing is to minimize redundancy. Patient documentation is one big area you can focus on. Most physicians are using electronic health records. Some physicians share with me that they usually take handwritten notes during the patient encounter, then complete the EHR after the patient encounter, or after seeing the last patient of the day. Although most physicians who have this practice do not write full notes in the exam room, recording in the EHR this way essentially is writing the same note twice. How about documenting in the EHR as the patient is talking to you?

The initial objection may stem from the belief that typing in the room is a distraction. I used to think the same way. Think about this – it is all about the patient. When you enter the information as the patient is telling you, you have the most accurate record as it is done in real time. If you complete the patient’s chart hours (or even days) later, you are likely going to forget some details. If you are taking scrap notes during the patient encounter to ensure that you have the correct information for the actual patient note, you are essentially writing that one patient’s note twice. This is unnecessary and is time-consuming. This is hindering your efficiency.

If you are unable to type in the exam room because of limited typing skills, it is still possible to be efficient. Utilize technology to help you. For example, you can dictate the encounter right after seeing the patient. Another option is to use a scribe, either virtual or an in-person scribe. There are also HIPAA-compliant artificial intelligence scribe programs to automate the patient documentation process.

There are always different things we can do to improve our efficiency at work as physicians. Being prepared is always important. Get to the office before the start time of your first scheduled patient. Prepare your team so everyone is working together. Focus on the patient and emphasize on effective communication. Enhance workflow and minimize redundancy. What is the one thing you can do now to increase your efficiency at work?