Work after clinic: seven ideas for regaining control over your time

A 2016 study of physicians in ambulatory practice found that they spend one to two hours each night working on their electronic health record (EHR) or completing paperwork.¹

Although changes are needed to address the underlying problem of administrative complexity in health care, individual physicians can take practical steps to improve efficiency and reduce the amount of time they spend working after hours.

1. Start your workday on time so you can prepare for what’s on the schedule and avoid playing catch-up all day. Identifying why you want to be done with work when you leave the office (for example, to spend more time with your kids) will help you stay motivated.

2. Use previsit planning. The key is to anticipate at the current visit what test results you’ll need at the next visit and then pre-order those labs or X-rays so the patient can obtain them ahead of time.

3. Make every second count. During visits, practice good communication skills and use agenda setting to help keep visits on track. Between visits, if you have a few spare minutes, find a task you can knock out quickly. Teach your team to do this as well.

4. Delegate low-level tasks. For example, have your medical assistants help with documentation, carry out needed screenings such as the PHQ-2 for depression, or educate patients about topics such as inhaler use.

5. Stop over-documenting, and experiment with different documentation styles that may be more efficient – typing vs. dictating, documenting in the exam room vs. documenting later, team documentation vs. physician documentation, macros, etc.

6. Read fewer messages by having them go directly to the person who should handle them, rather than having all messages funneled through you. When you receive a message, touch it only once. Read it, take action, and then move on to the next task.

7. Help each other. If a physician is struggling to keep up, the best approach involves empathy, mentoring, and accountability. Don't simply apply more pressure on an already pressured physician.

1. Sinsky C, Colligan L, Li L, et al. Allocation of physician time in ambulatory practice: a time and motion study in four specialties. Ann Intern Med. 2016;165(11):753-760.

Read the full FPM article: “Seven Habits for Reducing Work After Clinic.”