Practice management: Reclaiming lost time to interruptions

June 1, 2008

Nothing can make a day more stressful - and less efficient - than to have a constant stream of interruptions. To get control of your day, start by noting how often you are interrupted.

Key Points

Nothing can make a day more stressful - and less efficient - than to have a constant stream of interruptions. To get control of your day, start by noting how often you are interrupted.

Although many interruptions are small in terms of time, those minutes add up to real time lost that you could have used to care for patients.

Consider the time that interruptions waste. Physicians have three types of professional time: productive time, wasted time and time that can be delegated.

Identify the problem

The first issue to address is the reason for interruptions. Who is interrupting you - and, most importantly, why?

Dermatologists get at least 50, if not 100, telephone calls a day.

Are staff members interrupting you for many of those calls? If calls are prompting unnecessary interruptions, you need to establish with your staff which calls should merit an interruption, which ones they can handle without your input, and which ones can wait.

For example, you may tell your staff to interrupt you whenever a referring physician calls, but to take a message for all other calls.

Managing urgent calls

Before you give a green light to being interrupted during a patient encounter (which can be disruptive to you and considered discourteous by the patient), consider an alternative.

Try setting up an alert system. Ask staff to record urgent messages on a red form, and place it in a rack on the exam room door. Then, you'll see it as soon as you walk out.

Another route would be to have staff send you an instant message with a subject line of "ALERT-URGENT." If you decide to implement this type of system, carefully define the parameters for what qualifies as "urgent." Otherwise, you'll be interrupted just as often, if not more, than you are now.

Staff management

Next, examine what you might be doing to cause interruptions.

A physician who is constantly being interrupted by subordinates might be a micromanager, or she might not have hired nurses and assistants who have sufficient training or good enough decision-making skills.

Request that your staff come to you with the question - and a recommended solution. Although it takes time to ask them, "What would you do in this situation?," if they hear it enough, they'll start coming to you with a solution. Under your guidance, staff can solve their own problems.

Micromanagement can bleed away precious productive time that you should spend seeing patients. In a dermatology practice that has high-quality staff and effective protocols, micromanagement is simply unnecessary.

A high amount of interruptions could be caused by something as simple as poor message-taking.

Believe it or not, there is a skill to taking a message. A good message should include the nature of the call. A skillful message-taker thinks about the message and provides the information needed to facilitate the response.

If the caller is phoning about a prescription renewal, for example, the message-taker includes the phone number for the pharmacy to which the renewal should be called.

A good message also should include useful contact information - that means not just noting the caller's home phone number, but getting the caller to commit to being available at an approximate time and at a specific phone number for a return call.

Multitasking

Dermatologists who are multitaskers can smoothly handle interruptions throughout the day.

Those who are not multitaskers are best served by taking another tack: Carve out some time to handle these potential interruptions. Choose one or two times a day to go over non-urgent messages, or carve out an hour or two once a week to do it. You can tell patients that you'll be available at a certain time for phone calls.

Batching the interruptions won't make all interruptions go away, but it might give you a way to manage them more effectively.

Don't let interruptions eat into your productive time and cause extra stress. Try these suggestions to handle interruptions; otherwise, they'll continue to handle you.

Ms. Woodcock is a professional speaker, trainer and author specializing in medical practice management. She has focused on medical practice operations and revenue cycle management for 15 years. She has authored seven practice management books, including the top-selling Mastering Patient Flow. Ms. Woodcock is a fellow in the American College of Medical Practice Executives and a certified professional coder. She holds a B.A. from Duke University and completed her M.B.A. in healthcare management at the Wharton School of the University of Pennsylvania.

For more information, visit http://www.elizabethwoodcock.com/