Time Management and Organized Decision-Making

Keeping up work–life balance as a doctor requires figuring out how to improve productivity and successfully deal with the constrained asset of accessible time.

In fact, pressures on doctors have as of late expanded, halfway because of changes in doctor repayment what's more, a lessening in the accessibility of financing to help insightful and persistent focused attempts. Doctors as of now deal with a developing number of progressively complex patients in less time, manage a bigger volume of regulatory desk work, and are all the more effectively available by means of email, pagers, cell phones and other innovative propels, all components adding to high paces of expert burnout.

Why should practitioners care?

Poor time management means patients are kept waiting, you get stressed, your work becomes less enjoyable, stress can build, you lose your sense of humour and you lose valuable time for family, exercise and sleep.

Effective time management can:

• increase productivity
• help deliver better patient care to more patients
• give you more time to listen properly to colleagues
• accelerate your career advancement
• limit your stress and avoid potential burnout
• enhance personal satisfaction.

In a literature review completed by the Boston University Medical Center in 2014, the examination of 5,624 studies looking at doctors, burnout, career development and time management found 212 which stressed the importance of time management but only 12 with actual time management techniques for doctors. Applying techniques can make you more effective. Some of us are naturals or at least appear so. However, it’s all about a balance and sacrifice. Using a time management technique can provide great assistance and have a panacea effect on your healthcare practice.

Using a decision matrix

Through the internet and large number of time management publications, different time management models are re-stated in many ways. The Eisenhower Box is also called a method, matrix or decision grid. Stephen Covey includes a similar matrix in his popular book, The 7 habits of highly effective people. These have broad application and are suitable for all healthcare practitioners.

Consider dividing your tasks into these four categories such as urgent and important or less urgent and less important.

	Urgent	Less urgent
Important
Less important

Practitioners can use this type of grid system every day for daily tasks, be it in your mind or on a notepad.

	Urgent	Less urgent
Important	Treating a patient with chest pain	Filling out repeat prescriptions for a patient
Less important	Returning a call to the nurse manager	Draft referral letters

And for long-term goals when you break things down into smaller elements.

	Urgent	Less urgent
Important	Complete mandatory education for interns	Complete on-demand CPD for health records management
Less important	Attend mentor sessions with ward consultant	Review long term career goals

Prioritise by importance and urgency

During your day colleagues will make requests of you in among the time you also spend with patients. From their perspective, their requests for your time are equally as important as everything else on your list, within reason. However, you’ll have to decide what’s more or less important and what’s urgent and what’s not. That said, when a superior asks you to do something, you’ll be forced to push other things aside to make it a priority – that's a challenge you’ll have to endure in your career.

Pushing back and saying no

If you are a junior practitioner it means you’ll have to manage up and down. Normally, the most junior employees would only manage up but doctors and dentists by way of their knowledge and ability provide direction to fellow staff from day one in addition to taking direction. Saying no or suggesting an alternate approach to a consultant, senior doctor or nurse may seem daunting but can be better for you and patients (probably best not to do this in your first few weeks). However, colleagues will respect you if you push back in a constructive and polite way.

Priority by category

If you are more suited to placing each of your tasks within a category other than their urgency/importance, then you may benefit from an approach with set categories. This is from the perspective of a hospital doctor and would vary between healthcare practitioners.

Category prioritisation	Referrals Job 1 Job 2 Job 3	Investigations
	Discharges	Lower priority ie Medcharts, cannulas etc

Adding the 80/20 rule

This is a great technique, also known as Pareto analysis, you can add this in addition to using a grid/matrix. The 80-20-rule assumes that 80% of the productivity can be achieved by doing 20% of the tasks. In other words:

• 20% of your tasks should take up 80% of your time
• The other 80% of your tasks can be done in the remaining time

In day to day terms, if you have 10 tasks, then focussing on 2 of the 10 tasks will give you more productivity. This helps to identify what’s important and frees your mind so you don’t feel guilty spending more time on things once you’ve identified these as urgent and important (note how this can relate back to other techniques).

		What you do		Your results
The 80/20 rule (also known as Pareto analysis)		80%	→	20%
				80%
		20%	→

A research, “Recapturing time: a practical approach to time management for physicians”, Gordon et. al attempted to identify Time Management techniques, skills and practices that may promote a physician’s professional success and personal satisfaction.

Additionally, effective time management strategies can also be separated into four distinct principles:

(1) setting short and long-term goals;

(2) setting priorities among competing responsibilities;

(3) planning and organizing activities; and

(4) minimizing ‘time wasters’.

 

Reference:

1. Gordon, C. E., & Borkan, S. C. (2014). Recapturing time: A practical approach to time management for physicians. Postgraduate Medical Journal, 90(1063), 267-272. Retrieved from: https://pmj.bmj.com/content/postgradmedj/90/1063/267.full.pdf

2. Medical Indemnity Protection Society (2018). Smart time management for healthcare practitioners. MIPS Retrieved from: https://www.mips.com.au/articles/smart-time-management-for-healthcare-practitioners