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 By Neil B. Gailmard, OD, MBA, FAAO, Editor June 11, 2003 - Tip #73 
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Are your days not long enough?


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A reader wrote me recently with the following statement: "Time management is the most difficult aspect of practice". He described how he never has enough time in the day to complete various tasks, and how he often leaves the office late. He wondered if I had any tips for fitting it all into a day and maybe even getting some time to himself.

Actually, my workdays don't seem too rushed. I have time to check and respond to email many times, take and return phone calls, read the mail, scan a journal, talk to staff members and the office manager, write a referral letter, etc. I also have plenty of time for lunch. I'm on time for patient appointments about 95% of the time.

How? I delegate a lot. Probably more than most optometrists.

I see patients at a good clip - but not crazy. We schedule all visits in our 4-doctor practice in 15-minute slots. That includes new patient comprehensive exams and follow-up office visits. Based on experience, we place 2 blockouts in the morning and 2 in the afternoon, for all doctors, to allow us to not fall behind and to see emergencies. The last appointment slot in the morning and afternoon are strategically placed to allow my staff to finish the last patient and be ready for lunch or closing on time. That keeps me at a comfortable pace and it allows me to occasionally have free time for work at my desk - and the other things that pop up every day.

I also schedule myself for a 1.5 hour lunch break - which builds in time to relax, or work on unexpected personal or professional tasks. Staff members get a 45-minute lunch - which creates two shifts during the 1.5 hour lunch period when no appointments are scheduled. This allows us to not close the office during lunch.

It may sound strange, but I actually don't mind no-shows. It's another way I get a little time to catch up, or work on other projects. My staff still tries to prevent no-shows by calling to confirm all appointments the day before, and we don't get too many, but they still happen. My staff also calls every no-show patient to reschedule.

If you never seem to have enough time in your day, take a look at what makes you run behind and make some decisions. You could simply schedule fewer patients per day, which would create more time for you, but I don't recommend that. It would cut into revenue. Better than that, what could you delegate in the exam process and in your administrative burden? Ask yourself... if I had the staff and the instruments and the space, what could I delegate? Dream a little, it will help you brainstorm how to creatively solve your time crunch. Then take steps to make the model you just created happen. I'll bet it is not as out of reach as you might first think.

Another strategy that helps me find time is to schedule it. By giving yourself 1 or more management days per week - days with no patients at all - you will do wonders for your practice. Of course, you must still come to work. And be ready to meet with staff and develop marketing ideas and improve your operations. Also, I would only advocate this if you can find a way to do this without seeing fewer patients per week. I would not want to reduce your productivity by 20% by taking a management day. But most practices could easily re-distribute the one day's worth of patients into the other 4 days, if they improved delegation and efficiency.

Think you can't afford to hire more staff? I've always found that every time I added a staff member, my practice productivity increased way more than the increase in payroll.


Best wishes for continued success,

Read Past Tips Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week


A Proud Supporter of

Send questions and comments to neil@gailmard.com.

Dr. Gailmard offers consulting services to eye care professionals through Prima Eye Group; information is available at www.primaeyegroup.com.
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