TIME MANAGEMENT IN PRACTICE

http://bmjopen.bmj.com/content/4/5/e004679.full

This is a continuation of my previous piece about time management in medical practice.

There is a lot of anger among the public over waiting in the doctor’s clinic. As  patient is in discomfort and pain, there is an expectation of relief at the earliest. When this expectation is not met- anger is likely. Some doctors do not care to organise their practice leading to time mismanagement and delays. The worst offenders are doctors who call all patients at the same time, so that they can arrive after a sizeable number assembles and then proceed to rush through the que. This is wilful waste of the patient’s time which is completely unforgiveable. Some doctors have given up on time management thinking it is a hopeless attempt and just announce their working hours. Any patient arriving within that time is seen on a first come first served basis. So essentially there is no appointment given. In all these scenarios the doctor has designed a schedule which is heavily weighted in the doctor’s favour and in favour of a patient who is disorganised consumer. Yes, some patients do feel reassured taking treatment from a busy doctor who makes them wait for hours- these patients are welcome to wait.

Working by appointments is by far the best way to work. It is good for the doctor as well as for the patient. It is the doctor’s responsibility to implement a system that ensures time management. The most important intervention to reserve the first two slots of the day to patients who are known to be punctual. Work must BEGIN ON TIME.  Second important intervention is to turn back and reschedule appointments of patients who come late. Patients should be accommodated for reasonable delay which may be upto 15 mins. Beyond that appointment stands cancelled. Thirdly, after every 4-5 appointments, an empty slot should be kept to accommodate delays and extended sessions. On certain days, when time- consuming interventions like therapy are to be done , patients come prepared to wait because I inform them in advance- so that is okay by them. I keep my side of the deal by not charging patients if I make them wait excessively, irrespective of who is at fault. Majority of patients appreciate the doctor’s punctuality. There are some patients who cannot understand all the fuss- but well the doctor has to take responsibility for clinic management not the patient.

After doing this for 15 years, I have a beautiful practice which allows me to start my day as planned and end it on time.