As January 1 looms, Americans across the country are crafting plans to get in shape, learn Spanish, make more home-cooked meals and finally finish their novels.
These, and most, New Year’s resolutions require time—a commodity the average physician is constantly short on.
To help physicians wrangle more free hours for themselves, The DO talked to efficiency and medical technology experts and crafted a list of 10 “life hacks” clinicians can use to increase productivity at work and at home.
A popular term in the blogosphere, a life hack is a strategy employed to save time or complete a task more efficiently. Whether you’re looking to streamline your use of electronic health records, put in more hours at home or make space in your schedule to accomplish a long-term career goal, the life hacks below can help you get started on an ultra-productive 2015.
Looking to squeeze some productive moments into his daily commute, Robert T. Hasty, DO, turned to Audio-Digest, a company that compiles audio recordings of lectures and seminars for health care professionals. DOs can earn AOA Category 2B continuing medical education credits for listening to Audio-Digest materials.
“Audio-Digest records some of the best lectures in the world,” says Dr. Hasty, the associate dean for postgraduate affairs at the Campbell University Jerry M. Wallace School of Osteopathic Medicine in Buies Creek, North Carolina. “You can listen to these great programs and submit for CME. For me, it turns a commute into a classroom. I’m smarter every single day I drive to work because of Audio-Digest.”
Annual subscription rates for Audio-Digest vary by specialty and number of “issues”; they range from about $450 to $900 for U.S. physicians.
Lifelong learners, physicians invest significant time in familiarizing themselves with the latest medical and health care policy developments. But many can get this information faster and easier than they realize, says David Pizzimenti, DO.
“There are lots of apps and newer technologies to stay up to date on medical education,” says Dr. Pizzimenti, the director of medical education for Magnolia Regional Health Center in Corinth, Mississippi. “You can be at home and on your smartphone or iPad. When there’s little breaks in the day, you can read things.”
One of Dr. Pizzimenti’s favorites is the free app NEJM This Week, produced by the New England Journal of Medicine. The app provides an audio summary of each week’s issue as well as research articles, editorials and more.
The Prognosis: Your Diagnosis apps make good teaching aids for residents, says Dr. Pizzimenti, who gives lectures on integrating technology into medical education. Available for several different specialties, the apps provide case studies and other clinical information on various diseases.
Looking for a more streamlined way to keep tabs on news from multiple journals? George Smolinski, MD, uses Feedly, a news reader app on his smartphone, and RSS feeds, which allow users to compile new content from multiple sources in one place. In Feedly, Dr. Smolinski set up RSS feeds from PubMed on topics that interest him, such as platelet-rich plasma injections (PRP).
“Whenever a new PRP article comes across any of the journals on PubMed, the article synopsis is sent through that RSS feed to my phone. So once or twice a week, I get a couple of articles on PRP injections. The app allows me to breeze through a ton of specific abstracts really quickly,” says Dr. Smolinski, a physiatrist with the U.S. Army and creator of the lifestyle blog Four Hour Physician. Dr. Smolinski notes that his views are his own and don’t necessarily reflect the views of the Army, the Defense Department or the U.S. Government.
Despite the ostensible conveniences of electronic health records, many physicians complain that they take more time than paper charts. Save time by setting up macros—keyboard shortcuts for longer phrases—in your EHR, suggests Dr. Hasty, who has given lectures on medical technology at universities and AOA conferences.
“One of the biggest things I’ve found is that physicians often don’t go into their EHRs and customize them,” he says. “If you find yourself typing a certain phrase on a daily basis, you can significantly decrease your time per patient just by creating a macro field.”
Dr. Hasty noticed that for nearly every patient he saw, he would type in his hospital’s EHR that he explained the risks and benefits of a particular procedure to his patient and obtained informed consent. Instead of dictating that text every single day for every single patient, Dr. Hasty set up a macro so he can press a smart key and all the text appears.
“That was probably taking me an extra 30 seconds on every patient,” he recalls. “You multiply that times about 20 patients a day, and you’ve added 10 minutes to your life each day. There are multiple examples in which I’ve done that in my own EHR, and it’s made a big difference in what I do.”
Almost every EHR system supports macros, Dr. Hasty says. A recent AOA webinar addresses the legal risks of adopting EHR efficiency techniques such as macros and offers strategies to minimize those risks.
By using templates and dictation in addition to macros, Dr. Hasty can record a patient encounter in his EHR in just a few minutes, he says.
“Using dictation software has been a big game-changer for me,” he says. “Most hospitals either have it available or allow physicians to acquire it on their own. And most of the EHR systems in office practices should have that capability.”
Dr. Hasty uses Dragon Medical, which dominates the market. He charts outside the exam room after he leaves the patient. When he’s with patients, he just uses old-fashioned paper and pen to take notes.
“If I use the EHR in the room, the patients notoriously complain about watching the doctor’s back and there’s a perception that they actually spend more quality time with me when I don’t use the EHR,” he says. “I’ve found that I can actually manage my transition times a little better without the computer in the way. I can make the most out of my encounter and then leave. It’s significantly quicker for me to do it outside of the room, yet patients have a perception that I’m more dedicated to them when I’m in the room with them.”
Many physicians take pride in their appearance and consider projecting a professional, put-together image to be an essential element of the job. But you don’t have to be a slave to your iron—or your dry cleaners—to do this, Dr. Hasty says.
“All my shirts are noniron,” he says. “I don’t waste time going to the dry cleaners, and that decreases costs as well. And when my laundry’s done, I have what looks like pressed shirts in the basket. It saves a lot of time.”
Do you spend a lot of time ordering routine blood tests and giving patients vaccines? Standing orders can shift those tasks to your support staff and give you more time to spend with patients who have more complex problems.
“Try to set up standing orders as much as humanly possible,” Dr. Hasty says. “For instance, if somebody comes in who meets criteria for a flu vaccine, have a standing order to the nurse for your patients to receive the flu vaccine if they don’t have any allergies or complications, so the nurse can get started on it.”
Many patients, such as those on blood thinners, need their blood drawn and tested each month. Standing orders for blood draws can save massive amounts of time, Dr. Hasty notes.
“Instead of taking a physician’s time every single month to actually go into the computer system and order that particular blood test, you can create a standing order to have that done on your patients, so you wouldn’t necessarily have to take time out and interrupt your practice to do that,” he says.
Practice laws dictate which procedures are eligible for standing order in each state, Dr. Hasty says, so make sure to double-check that any standing orders you set up are permissible under your state laws.
Physicians often devote the majority of their days to communicating with ancillary staff members and patients, Dr. Hasty notes. And while physicians want to provide nurses and administrators with support, Dr. Hasty sees a way to reduce the time spent communicating while continuing to lead effectively.
“Every time a staff member comes up to you and asks you a question, it slows down your productivity,” he says. “If you can go ahead and answer questions before they even happen, it dramatically improves your productivity.”
Dr. Hasty likes to give “if-then” instructions. When he asks a nurse to complete a task, he anticipates a few different outcomes and tells her how to move forward for each one.
For instance, when he tells a nurse to call patients and give them their lab results, he asks the nurse to schedule a follow-up appointment if the patient has any questions.
If-then instructions can work with patients, too, Dr. Hasty says. As an example, a physician might instruct a patient to take Tylenol if he or she develops a fever.
“We’ve been doing if-then instructions for a long time in medicine, but the more of these that you can do repeatedly, the more time you can save,” he says.
Properly timing your evening sleep and any naps you take can really amp up your productivity during your waking hours, says Whitson Gordon, the editor-in-chief of Lifehacker.com.
“Keeping a regular sleep schedule is obviously more important than anything else,” Gordon says. “But when you can’t do that, know when to plan your naps and how long to take them. Ten to 20 minutes is a lot better than an hour. Napping for an hour is going to make you a lot groggier when you wake up.”
If you’re sleep-deprived, your sharpness will peak about an hour after waking and start to wane two hours after that, according to a sleep scientist quoted in New York Magazine.
Tackle arduous or important tasks during that time, Gordon says.
“Planning your tasks for the time you know your energy is going to be highest is a great way to work more efficiently,” he says. “There are a lot of tasks you can put off until later, when you’re a little bit less productive, and the difficulty level is the same. But those really important tasks, you have to do them when you know you’re going to have the most energy.”
One of the biggest ways Gordon wastes time is by trying to multitask, he says. When he multitasks, he’s noticed, he loses a lot of time jumping between projects.
“You’d be much better off scheduling out your day ahead of time and breaking it into chunks for different tasks,” he says. “And schedule some free time. This is especially true with doctors. You can have your full day scheduled and a bunch of stuff comes up that you didn’t really expect, and you end up having to do all that later on, after hours.”
For instance, physicians can schedule time to answer emails in bulk instead of interrupting other tasks to respond to them throughout the day. And they can reserve time at the end of the day to address odds and ends that came up.
Inspired by productivity guru Jay Shirley’s “Must, Should, Want” method, Gordon sets out each day to tackle something he must do, which he defines as “something that is high priority and urgent which is going to have an immediate impact on your work.” He also makes time every day for a task he should do; a task that contributes to his longer-term goals. “These are the things that end up sitting on our to-do lists for a long time and we never get around to them because we have so much in the day that’s much more urgent,” he says. Finally, Gordon also seeks to do something he wants to do every day. This could be anything you genuinely want to do. For Gordon, it’s writing.
“I’m running Lifehacker now,” he says. “I’m doing a lot more management-style tasks than I used to when I was a writer. But writing is still my favorite part. Even though I’m very busy and I don’t have a lot of time for it, I try to force myself to write anyway. Spending a little bit of extra time at the end of the day writing, even if it is work, makes me walk away from the day much happier.”
Goals alone can help physicians be more productive in their work, Dr. Pizzimenti notes.
“If you have a goal for where you want to go with your practice and your professional and personal life, that will help govern how much you want to work and exactly what you want to do,” he says. “It will help you stay organized and keep control over the flow of your day as well as your patient care interactions.”
However, Dr. Pizzimenti also cautions physicians to keep patients front and center when brainstorming ways to increase efficiency.
“Always remember that patient care is the most important thing and that it shouldn’t be sacrificed for any other goals,” he says. “Even when you’re planning your day and planning out how you’re going to use technology, know that you can never go wrong if you’re always keeping the patient’s best interest in mind.”