5 time-saving tips for doctors who want to work more efficiently
Physicians already average ~55 clinic hours/week before after-hours EHR work, so small workflow fixes can meaningfully affect burnout, inbox load, and end-of-day documentation.
EHR mastery, templates, smart phrases, dictation training, and patient questionnaires can reduce repetitive charting while preserving face time during visits.
Scribes and portal coaching shift work away from the physician: scribes cut after-hours documentation, while better portal use can streamline labs, scheduling, and routine communication.
If you feel like you work too many hours a week, you probably are—at least according to the statistics. Last year, the average physician logged ~55 hours per week in the clinic. This doesn't include late-night administrative tasks that are only becoming a larger burden on physicians' work-life balance.
Considering that the average doctor easily tops the conventional 40-hour workweek, time-saving tips are likely of great benefit. Here are five to consider.
Show EHR who’s boss
Electronic health records (EHR) were always meant to be a timesaver, but mastering their nuances can be tricky and time-consuming.
It may be a good idea to engage in additional training sessions and webinars to master your practice’s software. Additional training is not only a good idea for you, but also for your coworkers. Don’t rely on one office “expert” (who may call in sick or switch roles).
As detailed in a blog post in the American Academy of Family Physicians' journal FPM, certain steps can be taken to improve efficiency with EHR.
First, set up the computer in the exam room in a fashion that allows you to alternate between the screen and looking at the patient with minimal change in gaze. Don’t have your back toward your patient.
Ask your patients to complete electronic questionnaires to facilitate data collection and input for common conditions like sleep apnea, ADHD, and others, which can reduce the number of questions you need to ask your patient.
Master the use of templates and smart phrases to decrease the amount of typing needed. This step is especially important with repeated notes and phrases.
Avoid long paragraphs in lieu of short phrases (eg, CAD, TID, BID, PO).
Train your dictating software to increase precision and accuracy.
Finally, you may want to read up on new rules proposed by the Centers for Medicare & Medicaid Services that could affect EHRs.
Related: The EHR 'second shift' costs docs more than time: Try these expert-backed fixes to reduce inbox overloadGotta get a scribe
Scribes are a phenomenal and often-overlooked resource who can save you time and keep you concentrating on what’s most important: helping your patients. These documentation assistants transcribe information during clinical visits in real-time. They input patient data, orders, and referrals into the EHR so the physicians don't have to.
In a small cross-over study published in JAMA in 2018, the use of scribes was linked to a boatload of benefits. Primary care physicians (PCPs) who used them reported less time spent in after-hours EHR documentation, with documentation more likely to be completed by the next business day.
Moreover, PCPs using scribes were more likely to report spending more than 75% of the visit directly communicating with patients. Of note, patient perception of scribes was good, with 61.2% reporting a positive influence on the visit, and only 2.4% reporting negative sentiments.
“Medical scribes were associated with decreased physician EHR documentation burden, improved work efficiency, and improved visit interactions,” concluded the study authors. “Our results support the use of medical scribes as one strategy for improving physician workflow and visit quality in primary care.”
A 2020 review in the Annals of Emergency Medicine highlighted additional perks: Scribes help clinicians see more patients and generate more billable work, and both provider and patient satisfaction improved with the use of scribes.
Promote your digital portal
Not only is it a good idea for physicians to be on top of their digital game, but patients who make the most of technology can also save physicians time.
Despite the availability of portals, 63% of insured patients don’t use them, according to research cited by the AMA. The reasons attributed include a preference to speak directly with the physician, no perceived need to use the portal, lack of online medical records, no internet access, and concerns over privacy. Of note, 40% of patients report they were not offered a portal.
Make sure staff coaches patients on how to use the portal and assures these patients that portals are a safe option when accessing appointment schedules, medical histories, and lab results. Patients should also be apprised of when it is prudent to text or email the physician via the portal, and how long it will take to respond.
Set limits
In a perfect world, there would be no time constraints on physician appointments. In fact, results from an older qualitative study from the Journal of General Internal Medicine found that physicians would much prefer not to be constrained by time.
“[A]lthough the strategy of disregarding managed care limits on time spent with patients—and accepting financial consequences—might serve as a potential strategy other physicians are willing to try as they seek to cope with an unpalatable policy, our findings suggest that there may be a larger price to pay in terms of satisfaction with the profession in general,” the authors wrote. “In any case, this strategy does little to address broader and more deeply entrenched structural arrangements that determine how physicians are compensated and how doctor-patient interactions are managed. Tackling these matters will require sustained collective action on the part of physicians, professional associations, politicians, and the public at large.”
In reality, time limitations must be imposed on a patient visit to get through the day and meet professional responsibilities. One strategy is to let the patient know that you have a limited amount of time to begin with and work on prioritizing needs. Of course, if an appointment occasionally needs to spill over, allowances can be made.
Finally, in addition to creating efficiencies in the workplace, carving out more free time in your personal life can improve your work-life balance.
Related: How ‘buying’ time can make you a happier doctor