An efficient practice? Start with your schedule.

How would a more efficient practice change your life?

In your efficient practice would you save time by using your resources better (so you’re not spending unnecessary time removing sutures yourself like this girl was), boost your hourly rate or finish your day and get the heck out of there earlier?

Whatever dream is – the key is to use what you already have in the best way.

Going way back to basics here: take a hard look at how you’re using your time and resources and ask if your schedule is really working for you.

News flash: you can’t have an efficient practice if your schedule sets your up for failure.

Take a Step Back

Doesn’t matter if you’re starting a new practice or deep in the grind of your current practice, take a step back and yourself:

1. What do you do?
   • For example, this could include in-person patient visits, procedures, virtual visits, operating room, etc.
2. Where do you do it?
   • It could be in a private clinic, hospital or ambulatory care centres.
3. What and where are the resources you can access?
   • For example, this might refer to procedure trays, nursing support, multiple rooms, etc.

Brainstorm Your Ideal Schedule

This is where the fun begins.

Forget logistics and the possibility of being told no (avoid the ‘no’ by finding a win-win solution). In your perfect world, where would each type of visit ideally happen?

Some factors to consider:

• If a consult might need a procedure (potentially on the same day) does it make the most sense to just see them where you can do the procedure right away?
  • ex. pap test, biopsy, screening colonoscopy, etc.
• Can part of the patient care during that visit be done by someone else?
  • ex. can suture removal, baby weights and bandage changes be handled by a hospital nurse?
• Do you have resources you’re not yet taking full advantage of?
  • ex. extra rooms, biopsy supplies, etc.
• Do some days feel packed to the point of overwhelm, while others in a different setting feel more manageable? If so, could you shift certain types of visits from the busiest days to the lighter ones?

Make your Schedule (and Resources) Work For You

Play with the pieces and find what works. It’s ok (normal?) to take a few tweaks to hit the sweet spot.

The payoff from building your scheduling effectively is huge. It will allow you to flex your efficiency muscles to reach the goals you want.

What I learned after wasting a lot of time (read: not an efficient practice)

Use every resource offered

I split my time between our private office and the hospital. When I first started out, I copied what I’d seen others do: book procedures on procedure days, then bring patients back to my office for follow-ups.

That worked fine at first until I realized this meant I was the one removing sutures and changing bandages. Important tasks, but not ones that needed to be done by me. But here I was spending unnecessary extra minutes while the waiting room filled up.

By simply moving those follow-up visits to a procedure day, the nurses could help with dressings and sutures. Time savings: huge. I’d been wasting this resource (and my time) for months.

Be creative and maximize your resources

This one was practice-changing (no exaggeration).

At my hospital, procedures with local anaesthetic are all booked for 30 minutes to allow for room turnover. Many of them, like carpal tunnel or trigger finger releases, don’t take the full 30 minutes.

At the same time, I wanted to bring in a practice extender to handle routine elective hand consults (using the patient information sheets). On my procedure days, I had an extra clinic room right next to the procedure room that wasn’t being used. Hello, opportunity!

By grouping the shorter procedures on the day I worked with an extender, a full list of consults could be running in adjacent room. The extender sees the patient and gets things started. Then, while the procedure room is being turned over, I pop in to confirm the diagnosis and review the plan and risks and answer questions.

Using this room and adding an extender meant I have a full day of short procedures and consults (an extra 13!) running at the same time.

Small scheduling tweaks snowball into big life wins

See the same number of patients in fewer hours and get back to the kids, finish your day without needing to log back into your EMR to finish notes after dinner (if this rings a bell, can I introduce you to templates?) or at the very least, use the scope of the resources you have to get tasks off your list.

Try it out and let me know – what changes did you notice?

What barriers do you face to making changes to your schedule?