Editor’s Note: Welcome to “Eye Catching: Let's Chat,” a blog series featuring contributions from members of the ophthalmic community. These blogs are an opportunity for ophthalmic bloggers to engage with readers with about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The series continues with this blog by Donna Suter, president of Suter Consulting Group. The views expressed in these blogs are those of their respective contributors and do not represent the views of Ophthalmology Times or UBM Medica.
The ‘Sharpening Your Saw’ illustration used in time management circles means it is up to you to shape your workday. Ask any group of eyecare professionals to describe their most pressing work problem and you are bound to hear that there are “not enough hours in the day” or “too many fires to put out.”
Change is an inside job. Are you unhappy with your practice’s growth? Take the often overlooked option of offensive time management. Actively shape your day by establishing what I like to call selective control. Refocus and harness the time you can control, and institute defensive measure to minimize the impact of the demands you can’t control.
To illustrate this, let’s walk through a typical day of doctor I know.
By 9 am, the doctor is in the office and ready to see patients. From then until noon, she sees 15 patients.
After a 90-minute lunch break, she sees 20 more patients until clinic ends at 6:30 pm.
This doctor leaves and her support staff closes the lanes, refreshes everything used, closes out the ledger, and finishes up in optical. They are on-site until 7 pm.
After dinner with her fiancée, she relaxes and maybe watches a little TV. Then, her planning time starts.
For an additional 3 hours, she delves into the business side of operating a private practice. Because she is able to log onto her practice management software from her home computer, she doesn’t stay at the office or go back. She addresses the following issues on a rotating basis:
The remaining nine hours of her planning-week are spent working through her Master To-Do List. This planning of her workload is key to productive time. Her time may be spent at the office – before or after clinic training or having a one-on-one coaching session with an employee she is wanting to delegate a task to.
She and her associate eat lunch together once a month and she also uses her lunch break twice a week to meet off-site with key employees.
Because her practice is less than five years old, she keeps to the above schedule 6 days a week. In addition, she is president of her local professional association and a committee chairperson for her state association. She makes time for these two organizations because she feels it is vital to form relationships with peak performers. (She wants to hear their ‘pearls’ and avoid their mistakes.) She spends about 2 hours a week meeting these obligations and her involvement with other professionals averages about one weekend trip each month.
How does she do it?
This doctor and her associate have a support staff of 15 and invest in training on a regular basis. The office closes for ½ day each month and a full day each quarter. Because adult training is a skill that both doctors admit is not in their wheel-house, trainers are brought to the office.
Her practice is hitting its goals and her budget-based spending plan allows her to make spending decisions quickly and decisively.
I want you to make decisions on how to spend your time based on your lifestyle and unique practice circumstances. Please answer the following three questions truthfully.
How much routinely scheduled, uninterrupted time do you spend on practice management issues?
Are you able to see a patient and finish inputting into your EHR system within 15 minutes?
How much time do you spend training a new employee ‘with prior experience?’
Compare your answers to the typical day overviewed above.
I challenge every eyecare practitioner who owns his or her practice to duplicate this doctor’s day-in-and-day-out commitment.
Her day exemplifies three habits any business owner can duplicate.
1. Set aside time each day and work from a Master To-Do List.
Time management pundits more famous than I have been explaining the power of a master list for decades. Simply put, the human brain problem-solves at peak efficiency when only working a minimum number of problems. Experts, furthermore, have proven that remembering lists, a cluttered environment, and interruptions (either from staff or e-mail pop-ups) reduce not just how quickly you solve a problem or work through a task, but lower your IQ.
Want to learn more? An internet search of master to-do lists with one of the following names will produce more links than you have time to explore (ex: master to-do lists plus Covey, Winston, or Ramsland)
2. Know how to use your EHR system and eliminate ‘finishing up’ a chart post-patient encounter.
Before you ask, in the illustration given at the beginning of this blog, neither the doctor or her associate use a scribe in the lanes. Just like you, she wants to get faster with documentation and referrals to specialists. That is why her total patient count (comprehensive and brief) is only 35 per day. Her current daily scheduling goals are 18 comprehensives and 17 briefs fit into pre-determined slots. Her telephone handler/appointment scheduler knows that the practice’s no-show/cancelation rate runs about 20%. What this means is that the 17 briefs are double-booked with at least four comprehensive exams.
Your patient flow should match your ability to “git’r done” by the end of clinic. Approach each day like a timed event or test. Be 100% present (no texting or checking baseball scores), equip all of your exam rooms the same, and delegate raw data collection to your technicians to the extent he/she is trained. Use the same advice my golf instructor gave me about my game to improve your pace in the lanes.
“A good round doesn’t happen by luck or chance. If your shot didn’t go where you wanted it, make a mental note on what you were doing when your game went south to review when you are next on the driving range. Playing 18 is not the time to work the kinks out of your game. Enjoy where you in the process and improve with intentional practice without an audience.”
Outside of a medical emergency in the lobby, this doctor’s staff doesn’t interrupt her. She also includes five minutes transferring the patient from the clinic to the dispensary in that 15 minute practitioner performance standard.
My point? You will never have time to work on practice management issues if your office time is shortened by clinic back-ups or you making notes in a patient’s record.
3. Invest regularly in staff training.
Early in my relationship with this doctor we made a list of training resources. Her list included regional hospitals, Chamber of Commerce, large CPA firms, non-healthcare-specific trainings held by national training firms within an hour car-ride of her practice.
She supplements practice-specific, online trainings with off-site, generic trainings covering customer service, telephone etiquette, day-of-service collections, making a good first impression, professionalism, delegation, and problem solving.
She and her associate have a budget for quarterly team meetings. The entire staff participates in strategic planning once a year and look forward to quarterly ‘social connection/team building’ exercises.
In conclusion, achieving life balance takes mindfulness. As mentioned last month, change is an inside job. Are you unhappy with your practice’s growth? The most local thing to change is you, the owner. Change how you do that which you are now doing and look for improvement!