Physicians are barraged with hundreds of messages every day. The most stressful and inefficient way to handle all your phone calls, e-mails, faxes, reports and order requests is to decide on the fly what to answer next. Prioritizing your messages according to a standard framework that you develop will help you manage your time and give you the peace of mind that comes from knowing you've responded not to the latest and loudest, but to what is truly most important for your patients and practice.

Define your priorities

My colleagues and I recently worked with a solo family physician who had previously been in salaried positions with large clinics. Now a business owner in practice by himself, he recognized that his dramatic career shift required new ways of managing his time, as well as some new priorities.

First, to feel satisfied in his work as a doctor, he needed to know he was providing excellent medical care to his patients. This meant he needed systems in place to ensure that he did not miss information that affected his patients' health.

Second, to maintain his practice, he had to take good care of his business, which included focusing on reimbursement, staff morale and customer satisfaction (not just patients, but referral sources such as nursing homes as well).

Our goal was to apply these priorities to the dozens of messages on his computer and the piles of paper on his desk. Your own priorities might be different, and they could change over time.

Categorize and prioritize

We began by taking inventory of the kinds of messages this physician received. We sorted through them one by one and categorized them by type (e.g., lab results or refill requests), making sure the categories fell under the larger priorities of patient care or business care. Messages that didn't match his priorities were either delegated or deleted.

From there, we determined whether each category was “urgent” or “routine.” Urgent messages consisted of the following:

• Lab, X-ray and study results. The tests he orders for his patients are the most important because he bears primary responsibility for the follow-up. When the reports arrive, the nurse screens them and files them according to their results, “normal” or “abnormal.” From there, the top priority is to respond to any report that comes back with an abnormal reading.

• Phone calls from other physicians. If another physician is taking the time to call, it's probably important. From a time management perspective, he finds it's best to answer calls from other physicians as they come in – to avoid playing phone tag. When he simply cannot take a call, he handles the message and returns the call as soon as possible.

• Phone calls from nursing homes. Since these tend to involve frail, elderly patients, a speedy response can prevent a trip to the emergency department or the deterioration of a serious illness.

• Phone calls from patients. The nursing staff screens these messages and funnels to the doctor those that the clinic staff cannot answer.

Routine messages involved the following:

• Medication refills. Processing medication refills quickly means greater patient satisfaction, as well as greater staff morale because it lessens repetitive calls and faxes.

• Orders for nursing homes and home health agencies. Signing orders in a timely fashion helps him stay on top of things and may generate income.

Once we prioritized the messages into urgent and routine, we created a checklist that this physician could refer to when determining what needed to be done.

Save valuable time

Using a checklist to prioritize your incoming messages will help you improve your communication turnaround. When you don't have to ask yourself over and over which messages should be answered first, you will save a surprising amount of time. Make sure to discuss with your staff the reasoning behind your priorities so they know how to screen and route messages accordingly. Once everyone is on board, you will be on your way to a more efficient practice.