The Practice Manager's Guide to Time Management

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14.1 A TIMELY INTRODUCTIONDoctors probably do not see themselves as “executives”. The word "executive" conjures up imagesof middle level managers, driving company cars to company offices, to carry out or create companypolicies for sales, production, and employment. Hospital management, the person next door, or abrother in law is an “executives”, not a doctor.Peter Drucker, the most credible of all management experts, disagrees. He defines “an executive” as:... “a knowledge worker who makes decisions, controls the allocation of resources within anorganisation, and is responsible for the results of the organisation 1 .”Virtually all doctors and practice managers are executives under Drucker’s definition, however,many doctors and practice managers do not see themselves this way. Doctors and practicemanagers are entrepreneurs, using capital to run businesses, responding to the market forces, whichinclude competition, to generate a profit. Therefore, time management, the productive use of time,is a crucial skill. It is also the only finite resource we have.This skill is particularly relevant where doctors face significant claims on available time, other thanfrom patients. These could include pressure from family and friends. It should be remembered thatmany doctors own their own businesses: therefore, there is a much greater incentive to managetime well. It is the practice results that are being improved, for their own benefits and interests, notthose of anonymous shareholders.There is only so much time available, so it should not be wasted. This means making sure time isspent productively, by allocating it in line with personal and business priorities and objectives. Themanner in which a doctor manages his or her time has a direct impact on the practice, as it affectsthe number of patients the doctor can treat, and the level of service that doctor can provide to eachpatient. As the practice manager role is to reduce the principal doctor’s involvement in alladministrative and managerial aspects of running the practice, it is important that practice managersassist doctors with time management, as well as manage their own tasks efficiently.Why time should be managed betterAs a general rule, doctors are good time managers. The economic and physical logistics of practicemean most doctors are very focused on seeing patients: a long line of patients in the waiting roomtends to distract thoughts to how to deal with a lot of work in a short time, yet still achievemaximum efficiency and effectiveness. Years of training in a demanding academic environment alsohelps develop intuitive time management skills.Time management methods should not be perceived as a magic wand to convert a doctor’s day froma hurried experience, balancing loads of equally urgent tasks, to a serene experience whereeverything runs smoothly and without hiccups. That is an unrealistic expectation.1 Butterworth Heineman, 1967, The Effective Executive, Peter Drucker, pages 7 to 8.4
AN EXAMPLEAssume that just one hour a day, or five hours a week, can be saved by improving timemanagement. Add, say, five hours a week for say, fifty weeks, and the equivalent of more than fivefull working weeks are wasted each year. What could be done with an extra five weeks a year?Answer: see more patients and make more profit, presumably an extra 20%. (Yes, that’s right, anextra 20%). Fees will go up by 10% assuming a 50-hour week, but costs should virtually not go up atall. Assuming costs of 50%, this means profit will go up by 20%. Or more. Alternatively, the sameamount of work could be done, and an extra five weeks could be spent on the beach over summer.Or a bit of both could be achieved.This is why time should managed better. There are two classic books relating to the area of timemanagement, which will be referred to in this module. They are “The Effective Executive” by PeterDrucker” (Butterworth & Heineman 1967), and “The Time Trap” (Alec Mackenzie, AmericanManagement Association 1990). Both books are recommended reading. They underpin virtually alllater writings on time management.Further reading:Kron J, 2010, Australian Doctor, Torn over time, 9 April 201014.2 TIME MANAGAEMENT TECHNIQUES FOR DOCTORS AND MANAGERSIn part 2 of “The Time Trap”, Mackenzie identifies the twenty biggest time wasters, along withsuggestions on how to respond to them. The following extracts follow this suggested format, withsome additional comments and concerns added, purporting a sensible way to survey the range ofpractical tips for managing time better, and achieving enhanced results. As the practice manager is adelegate of the doctor, and needs to assist the doctor with the managerial aspects of the practice,doctors and practice managers should both benefit from the information. Practice managers havethe ability to assist principal doctors, as well as improve the management and productivity of thepractice as a whole.PatientsDoctors create income from treating patients, therefore, the more patients a doctor treats; the moreincome a doctor can generate for the practice. This does not mean that a doctor should see tenpatients an hour, as this habit will most likely result in reduced quality of the services, and will alsobe likely to breach various professional standards. Appropriate allocation of time is necessary inorder to provide an adequate service, while at the same time maintaining realistic time efficiencies.A common concern amongst general practitioners is that patients consume much of the doctor’stime on “small talk”, and only get to the point of their visit towards the end of the consultation. Thismeans that valuable time is spent on ‘socialising’ with patients, which could be more efficiently usedto provide medical advice. It also means that some patients “steal” away from the doctor’s time,5
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