How to Stop Doing Patient Paperwork at Night

And then I just ended up doing it, the paperwork, during clinic, on evenings, on the weekends, because I hadn’t picked a time that actually worked. So learned, and this makes sense, that finding a time, if you’re gonna look at time blocking, if you’re gonna look at getting this paperwork out of your everyday and having a space for it to go, is finding a chunk of time that works for you and your life, both clinically and everything outside of it.

You didn’t survive residency to struggle in practice. I’m Kate, Reconstructive Plastic Surgeon, and this is the Practice Runs Podcast. Small changes to how we run our practices to get real time back so that we can show up in our lives as the person and the doctor that we want to be.

Grab your tea or coffee and let’s chat. How many times a week do you live this moment? You are wrapping up a patient visit. You’re almost about to get out of the chair, walk towards the door, and all of a sudden you see the patient reach for a bag and an envelope starts to slide out.

And you know before they even say a word what that envelope has. It is more forms, more insurance paperwork, more third party something that you have to do. Do you also get a pit of dread that starts in your stomach? Do you have to school your features to keep that hidden from the patients?

And then does your mind start going with the mental math? When am I going to do this? I maybe am already behind in clinic or my clinic is so busy. If I do this now, it’s only gonna put me further behind.

It has to get done, but when is it going to get done? And I think the real cost of that moment is schooling our features so that the patients don’t know that internally we’re thinking like one more thing that I have to do. When is it gonna get done on top of my task list that’s never getting done either way?

It’s wondering whether you need to interrupt your own self to do it now, or thinking about if it’s just going to get done later today in your evening on your weekend, piled up with everything else that’s sitting waiting for you in the background. It’s also then potentially managing their disappointment or frustration in that room if you tell them, I can’t do it today or I can’t do it right now for you.

This is the type of paperwork where, and specifically talking about that third party paperwork. So not the notes we have to do for patients, not consent forms or pre-op stuff. This is like that other work or insurance paperwork that needs to be done. I think most of us, myself included, react to it.

It would just sort of come and I had to squeeze it in or manage it as best as I can. But there is a way to be proactive about it. And that can be really great for cutting down that dread that happens, that mental math of when is it going to get done?

And it can mean that you no longer have to do it on your evenings or your weekends. You don’t have to think about when you’re going to do it. So how do we get there? Well, first off, this wasn’t something that I saw in residency and Googling did not reveal a lot of answers, but it came from sort of the productivity and business world.

And if you have ever studied for a licensing exam, you know what it is. You didn’t have a time, a word for it, which is time blocking. And what that essentially is, is it kind of self-explanatory says, is you dedicate a chunk of time to doing a specific task or a specific series of tasks.

And the key is to do it at that time consistently and to protect that block of time to do that task. So, as someone who is, let’s be honest, quite type A, I cannot chill, I can only pretend to be chill, is what I like to say. This idea really worked well with my brain because I am someone who does well with routine.

And so knowing that there was going to be a dedicated block of time to do this paperwork that I just knew was available worked really well and seemed like a great way to help reduce that middle of clinic dread and then potentially stress and thinking about it. So I looked at my schedule, and the first few times I tried to do this, I failed spectacularly.

And it made no real difference, other than feeling like more of a failure because it wasn’t working. But basically I looked at my schedule and put it at the end of procedure days because procedure days tend to run relatively on time. I have note templates for most of my procedures, so I could get through those fairly quickly.

They were fairly predictable. So it seemed like a pretty reasonable place to put it. But you know what the problem with the end of the day is, at least for me, and in hindsight, you’re like, well, of course, is that things always come up, right? Maybe you get it behind in your day.

You at least have probably other notes from the day to get done. Maybe there’s a patient you need to call that has a potential complication or issue. Maybe there’s that last meeting. There are things that come up throughout the day that can make the end of the day less predictable, which meant that even though in my head I had said I’m doing this paperwork on this afternoon at the end of the day, every time I didn’t do it, and sometimes it’s just because you’re exhausted, right?

Like you get to the end of the day. Even if the paperwork was done and there wasn’t a meeting and you could actually do it to just think then about sitting down and doing another fifteen, twenty, thirty minutes of paperwork is just like, oh. so often it would get bumped.

And the consequence of that was then the 3 a.m. Rolodex thinking about when it was going to get done. It was feeling like a failure for not doing it during the time that I said I had. It was my admin fielding more patient questions, asking about when these forms were going to get done, and then her having to come to me and say, hey Kate, like, you know, it’s been a bit.

And then I just ended up doing it, the paperwork, during clinic, on evenings, on the weekends, because I hadn’t picked a time that actually worked. So learned, and this makes sense, that finding a time, if you’re gonna look at time blocking, if you’re gonna look at getting this paperwork out of your everyday and having a space for it to go, is finding a chunk of time that works for you and your life, both clinically and everything outside of it.

That also is a reliable time that you can do consistently. Right? I mean, it makes sense, but when you think when you look at your schedule, sometimes you get influenced by some things. But that consistency, being able to consistently do that paperwork at the same time every single week, made a bigger difference than I thought.

So for myself, that ended up being Thursday mornings before clinic, because in the mornings, there’s less, at least for me, it is a consistent time that I can make work. There typically are less interruptions or people calling about asking patient questions. There are. It is a time that generally speaking, I wouldn’t have to bump because the likelihood of having other things going on was much lower.

And by being able to do this every Thursday morning, all of a sudden, the question of when things were going to get done were answered before I had to do it. My admin could tell patients, if you have paperwork, you can bring it on your day, on the day of your procedure, she’s not gonna be able to do it then.

It’s gonna be done by the end of the next Thursday. If the nurse that I work with in my practice or the nurses at the hospital got asked, they could say it’ll be done by the end of the next Thursday. If the patient still asked me, I could just say end of the next Thursday.

And they’d already had it prefaced. So I didn’t have to manage their disappointment or frustration in the visit as much. There’s the odd patient, of course, but generally speaking, and I also didn’t have to have that dread and that mental math of when is this gonna get done, right?

Right. There was a dedicated home for it. I could just say, yep, you’ll be done by the end of the day, Thursday. And that mental load off of just having that, it didn’t mean I was interrupting myself in clinic anymore to get this done or just doing it on my evenings and weekends.

There was a home for it. And that lightening of the mental load is just one more way that you get a little bit pinch of time back, right? You’re not doing it during your clinics, interrupting yourself, but it’s also just one less thing that’s taking up space, that’s taking up bandwidth in your mind that you don’t have to do, because there’s just a home, a place that this is gonna get done.

And it’s small. Yes, I know. You still need to do the paperwork. Getting that done the most effectively is gonna be a different episode. But this is just having a space to do it so it doesn’t actually make you fall further behind or make you more stressed about it.

And in terms of blocking that time, I dispersonal think like to give myself more time than I think I usually need. And at the very least, in the best case scenario, I should say, if that paperwork gets done in less time than I blocked for it, then you can use that time to do other things.

Maybe you have 10 more minutes that you could spend doing your results or navigating the work email. Let’s not like get into that one here. Or you could choose to spend that time and invest that in your admin. Have a conversation with her or him and create the dynamic, create that work culture that you want to have in your practice.

That time can always be used, but we’re starting to get it back so we can start doing things with it that isn’t thinking about when all this paperwork’s going to get done. This is a relatively small change, but I truly believe in my core that our schedules are actually one of the best tools that we have to not only get time back, but to be proactive in our practices so that our practices can run in a way that allows us to show up as the person and the doctor we want to be in our lives.

And it is a tool that we can learn to use. And that will be, there’s honestly going to be a number of episodes about this, but this is just the first step of using that your schedule proactively. And lightning the clinic dread, lightning the mental load, the 3M Rolodex, a little bit of when this stuff is gonna get done and it’s not getting done on your evenings and your weekends.

So if you take a look at your schedule this week and you find a time that seems to work consistently, try it out. And you know what? If it doesn’t work, keep trying other ones. I had to do it a few times until I found the one that worked.

But time blocking and then protecting that time, putting it in your schedule, letting your team know that that is when it’s getting done, knows your admin is not going to book anything during that time. Your admin, your team also knows when they can tell patients, when they can expect all that paperwork to be done.

And it just is this really beautiful upward spiral of less questions and time and things that you are thinking about because it’s booked and scheduled and it’s for all of your team benefits from this. So if you’re thinking, okay, this kind of seems useful, this this it seems useful.

Sorry, I’ll speak clearly. The last two episodes too, but I’m a much more visual person. Welcome to the club. You can get all of this if you want written out with a few more examples and details.

You can go to practice groundspodcast.co slash resources. There’s a PDF down there you can download if you think that would be helpful. Otherwise, we don’t, this won’t make the paperwork go away, but it helps you to stop interrupting your own clinic, stop thinking about when it’s going to get done, stop managing your own dread in the patient room and also managing the disappointment or frustration from patients and your team.

It is the first step as well to use to using your schedule as a tool, something we are proactive about, rather than something that we just react to. Thank you for listening, and I hope you have a wonderful day. As always, thank you for being here. Now go get some time back and have a great day.

Chat again next Tuesday.