Chapter 23: Time management – making the most of your day by working smarter
|"I recommend you to take care of the minutes, for the hours will take care of themselves."|
- Lord Chesterfield.
Most doctors are very busy people. In fact, many of us take pride in the long hours we work and the large number of patients we see everyday – and the ultimate "status symbol” for a doctor is a packed waiting room, with many patients ( and their families ) anxiously waiting for a chance to talk to the doctor. However, the fact that patients need to wait for hours to see you is actually a symptom of a disease common to many doctors – poor time management skills.
It is true that doctors do need to wear many hats - not only do you have patients to look after, you have many other responsibilities as well– for example, managing your clinic, looking after your investments, buying shares, attending meetings and taking care of your family. As time goes by, you get busier and busier, and you may find that your life is getting out of control – instead of running your life, you may find that your activities are running you. Time is the only resource in a physicians practice that cant be exchanged for money. You cant buy more time and you cant save it up for future use. Once its gone, its gone.
As a highly skilled professional, time is your most important resource and you need to use the science of time management to regain control of your life. While it may not necessarily enable you to see five more patients a day ( which may not even be in your best interests in the first place – more is not always better !), it will help you to juggle your professional and personal activities with greater ease. And youll also be able to find time to catch up on your reading and keeping up to date with the medical literature as well.
Step number one is the most important – and often the most difficult as well. You need to start by identifying your top priorities in your life. This prioritization helps you avoid dissipating your precious hours and energy on a legion of low-level activities. Once you know what deserves a Yes, its easier to say No to whatever else comes along. Dont limit your prioritizing to the professional realm. Defining your life’s goals is not easy – but it’s helpful to list the five most important things in your life in the space of one minute.
To define a goal, use the SMART rule –
S Specific - Get it clear
M Measurable – so you can define it
A Achievable – so you can stretch yourself
R Realistic - anchored in reality and attainable
T Timed - a deadline is set and provides a degree of urgency
Once youve identified your ideals, you then need to compare them to reality. The diagnostic tool for this is a diary of what you do every waking hour. You may get a rude shock when you find , for example, that there is a big gap between your desire to be with your family and the amount of time you actually spent with them. However, don’t get disheartened by this. In fact, this simply means that you need to manage your time much more effectively than you are doing at present – and there are many techniques for doing so.
One reason most doctors are such poor managers of their own time is that we get so used to being told what to do and when to do it , as medical students and residents. We are so accustomed to following orders, we forget that as practicing doctors, we are masters of our own time – and we need to organize our life and clinic around our priorities and goals. Also, most of us have never been exposed to the science of time management, with the result that we often use our time very wastefully. However, we need to remember that our time is our most valuable resource – and we need to utilize it efficiently. Any doctor who makes his patients wait for more than 60 minutes on a routine basis is a poor time manager. Not only is this very disrespectful to your patients, it can also cause you considerable aggravation, because you get pressurized by the large number of patients waiting to see you – and you no longer enjoy seeing patients anymore. While a busy clinic full of patients seems to be the hallmark of a "good doctor” in India – and many doctors find such a full clinic boosts their ego ( "see how busy I am ") – it’s actually likely to lead to poor clinical care, as complex problems can get missed or overlooked.
A useful time management tool is a 2 X 2 matrix developed by Stephen Covey that classifies activities as important or unimportant, urgent or not urgent. Dealing with junk mail, for example-something neither important nor urgent-epitomizes Quadrant IV. Greeting certain drop-in visitors may qualify for Quadrant III-urgent, but not important. Quadrant I is familiar ground to doctors: When a heart-attack patient comes to the ER, say, the situation is both urgent and important. Planning and relationship-building fall into the often neglected but critical Quadrant II-not urgent, but important. For purposeful productivity, you need to spend more time in Quadrant II.
Basic planners marketed by many companies for busy executives can help you to
map out your day in detail. ( I am surprised that no pharmaceutical company has recognized the need for planners designed especially for doctors as yet – I am sure these would make very useful and popular promotional giveaways !) Planners usually include: a task list, appointment schedule, daily expense log, and space for diary entries, as well as monthly calendars for upcoming events and an address book/telephone directory, so that everythings in one place.
For doctors who are computer-friendly, or are addicted to their laptops, computerized planners such as Lotus Organizer or Microsoft Outlook offer similar facilities – and have the ability to remind you automatically of tasks to be accomplished as well.
The following time-saving techniques can help you find more time to do the important things in your life.
Control your paperwork . Most doctors dislike paperwork , so that this often piles up. An office littered with piles of papers can sap your energy. Three simple rules govern how you handle a piece of paper .
2. File it-assuming that its valuable
3. Throw it away.
Follow this system, and youll end up throwing away lots of paper – and don’t forget to buy a really large wastepaper basket !
Delegate. Refusing to delegate jobs squanders your time. An efficient nurse can double your productivity – and this is why most senior doctors have at least one staff member who has been working for them for many years, who keeps the clinic ticking like clockwork.
Learn to say No. As a doctor, you are a respected member of society, and will receive many requests to serve on committees and clubs, and you may find that you are spending endless hours doing so . However, you have to learn to become Dr. No in order to protect your time for what is valuable to you. The easiest way to say no without hurting the other person’s feelings is to say – " I cant help you, but I know someone who can. " You can even build goodwill this way.
Learn to focus. When you are seeing a patient, concentrate only on the patient – refuse to take telephone calls during this time. Not only will this help you take better care of your patients, your patients will appreciate this as well !
Learn to analyse what you do. If you have a task to perform, instead of just doing it in the mechanical fashion you routinely do, use the Rule of 3 Ds: Do you really need to do it in the first place ? If not, then Dump it ! Can someone else can do it ? If so, then Delegate it ! Is there a quicker and easier way to do it ? If so, then Discover it !
We all have only 24 hours in a day – but how well we make use of this time is what separates the successful doctors from the unsuccessful ones ! If you find that you are always rushing from place to place, trying to catch up with your work which is constantly piling up, and have no time either for yourself or your family, you need to learn basic time management skills, so that you regain control over your most precious asset – your time !