Annals of Long Term Care

Neil Baum, MD

Neil Baum, MD, is Clinical Associate Professor of Urology, Tulane Medical School, New Orleans, LA, and author of Marketing Your Clinical Practice-Ethically, Effectively, and Economically, Jones Bartlett Publishers.

A physician’s time can easily be divided into clinical time, time that he could or should delegate, and wasted time (Improve Your Practice, Advisory Publications, 2002). In order to determine the doctor’s productivity, you conduct a time and motion study for just an hour’s worth of patients. So, if you see 8 patients in an hour that’s 7.5 minutes per patient. However, if that hour included 40 minutes of clinical time, 12 minutes of time that could be delegated, and 8 minutes of wasted time, that means that the doctor’s clinical time was equal to 5 minutes per patient. At 5 minutes per patient, an efficient doctor could see 12 patients per hour and this translates into significant increase in productivity and increase in the bottom line of the practice.

So what can you do to improve productivity and increase the clinical time while also reducing wasted and delegated time? First, begin on time. No doctor or staff can possibly be at peak productivity if the doctor does not start on time. Have everything you need on the chart, in the EMR, and in the room at the time of the visit. That means all laboratory and X-ray reports, all the equipment that is needed for any procedures, and all the assistance that you will need to perform any procedures. If you have to call the lab or a report, you will waste many valuable minutes. Don’t use your valuable time doing actions that could be done by your staff. For example, you don’t have to go to medical school to take a history of the present illness, to conduct a review of symptoms, or to ask about the past medical history. This is time that can be delegated to others and make it possible for you to see other patients or perform procedures that only you can do.
 
Bottom line: Make physician efficiency and productivity near the top of your practice management priorities. You can’t be at the peak of your productivity if you are wasting time or doing actions that could easily and profitably be delegated to others.