Time Management for New Registrars

Written by Dr Kari Sims, Registrar Liaison Officer

Sometimes time feels like it moves at a snail’s pace, like when you’re waiting for the next two minute cycle of a cardiac arrest cycle. At other times, however, like when you’re running behind time, it feels like it is flying by!

Time management and sticking to your 15-30 minute consultation times is difficult. On the odd days that I run to time and am actually waiting for my patients to arrive, it feels strange. I wonder if I have missed something, but I haven’t. If I leave on time, I feel like the teacher has given me an early minute from class.

At times in general practice, as a registrar and once you’ve fellowed, you will struggle with your time management.

Don’t panic! You are not alone. If you watch your colleagues, wherever it is you work, you will soon realise that everyone has good days and bad days in relation to time. It only takes one mental health or chest pain patient to throw your good timing out of whack.

Oh, my fur and whiskers! I’m late, I’m late, I’m late!
– Alice in Wonderland

You can’t “fix” your time management issues in one day, but there are a number of suggestions around that can help you out – try some, stick to them and then add in some other options.

  • Get into work 15 minutes early to check results and have a look at your list of patients for the day. If you know you might have a patient who will run late, try and make sure they are followed by a ‘catch up slot’ which may include lunch.
  • Spend a minute acquainting yourself with the patient’s file prior to calling them in from the waiting room. Since you last saw them, there may have been some correspondence from a specialist or hospital that requires your attention. It might help you work out why they are there and also helps you look like you know the patient.
  • “Thanks for waiting” is more positive than “sorry I’m late”.
  • Try and keep quiet for the first minute of the consultation, this helps the patient get the whole ‘list’ out.
  • Get the ‘list’ early, prioritise what you know is important and recognise this might not be what the patient thinks.
  • Watch for the “wind up” time and develop a habitual move. This might be at 12 minutes into a 15 minute consultation you take off your stethoscope or finalise the paperwork and say ”okay” in a definitive manner.
  • Even if you are running behind, do your notes either during the consult or as soon as the patient leaves the room. You are much more productive this way and you can ‘complete’ one patient before moving on to the next one. Plus, it takes less time than at the end of the day – trust me!
  • Learn to say no. Practice the “that’s a lot of issues for today (or a complex problem). Why don’t we work out what’s most important to address today and we can make a plan to follow up on the other issues?”
  • It’s also good to say “I think we need to give this issue the attention it deserves, so let’s follow up in..”
  • Don’t be afraid to let patients know that they have taken too long or gone overtime. You should bill them for a longer consult, so warn them that they have taken too long or that they should book a double appointment next time.I have learned that sometimes no matter what you do, you are just going to run late.In those situations, I highly recommend that you simply breathe in and out, make a cup of tea or use the bathroom if you need to and ensure the time you spend with each individual patient is focused on them.

 

Patient care is central – not the clock.

 

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