I am sobered by the number of hours in my workday devoted to tasks that have little to do with my calling as a physician. I reply to patients who e-mail questions about their health care coverage, send faxes to obtain authorizations, fix my documentation to assure accurate coding, and so on. These tasks sap my energy and enthusiasm for medicine.

On top of this, as the chief of a large residency-based family medicine clinic, I spend 60 percent of my week doing administrative work such as hiring and firing staff, performing employee evaluations, reviewing relative value units, petitioning for more staff, reviewing space allocation, and handling patient and staff complaints. While this is not what I envisioned on my first day of medical school (or even my last), I have come to accept that at least a portion of this work is the new reality of health care.

Support staff shortages can force an unusually large number of administrative tasks onto physicians. How we handle these tasks is integral to our professional success. Here are my suggestions for managing this unpleasant yet necessary work:

Put the patient first. Administrative tasks often arise that have a direct impact on a patient's care. This is not the time to argue about whose responsibility it is to fax forms and make phone calls. We remain true to our calling when we make caring for our patients our priority and fight the administrative battles later.

Quit complaining. If you've ever been on the receiving end of a litany of complaints without any proposed solutions for change, you know how useless these complaints can be. If you find yourself complaining to your colleagues or staff, follow your complaint with a reasonable idea for a solution. Unproductive complaining depletes the morale in your practice without leading to positive change.

Take action. Sometimes the functioning of a clinic seems so automatic that no one considers what is not working or what could be improved. Step back and ask how a situation should be managed, and try to bring current practice in line with that vision. Remember, small changes usually go more smoothly than large changes, but with patience and diligence, you can improve on the status quo.

Delegate tasks. Do not get into the habit of doing things yourself because you can do them better, faster or more easily. This is how physicians drown in administrative work. Follow your organization's policy for obtaining medical records, providing letters for patients, scheduling appointments or refilling medications. Delegate administrative tasks to those responsible for completing them.

Get organized. Even a small amount of paperwork will seem unmanageable if you can't find the supplies or information you need to complete the task. So take the time to organize your office, from your in-box to your files. Find a method that works for you and stick with it.

Achieve a balance

While administrative tasks are frustrating at times, they do not need to be overwhelming. By incorporating the suggestions above, you can make your administrative tasks less burdensome. This will leave you more time to focus on your patients, or to get home in time for dinner.