Life in general practice is no piece of cake these days.
There is a way you may be able to make it a little sweeter
though and the recipe could be closer than you think:
right in your own appointment book.
If you're like many of your colleagues,
you come in early, start to run and keep running till
the day finally draws to its exhaustive close. That
said, you may have noticed that some days are easier
than others. Perhaps you think it's just you —
you have more energy at some times than others. That's
not necessarily the case. The fact is that some days
are more trying than others and a lot of it has to do
with the sorts of patients that present.
Every day you see a mix of patients
— the acquiescent, the complainers, the chronic
complainers, the mildly sick, the chronically sick,
the scheduled and the unscheduled. That short list may
not exactly reflect your typical patient load but never
mind, with a little effort you could categorize your
patients according to how much time and energy they
require. That could be the first step in your liberation.
Over the next week or two, pick
a day that you found particularly trying and another
that was somewhat less so (if such an animal exists!),
then go back to the appointment book and examine each
of the days on a patient-by-patient basis, assign each
to a category — quick easy visits versus long tough
ones might be a way to start.
You'll likely find that the less
stressful day was occupied in dealing with an 'easier'
mix of patients. If that's the case, you're on your
way to restructuring your practice day in a way that's
easier on your adrenals.
WHO'S
COMING IN?
Begin by looking at your scheduled appointments. View
them in terms of the amount of time each should take.
It's not news that some patients require more time than
others, even those that present with similar complaints.
Identify the ones that come in
with a long shopping list, flag the files and provide
the person who takes appointments with a list of who
they are. The aim here is to space such patients through
the day. Avoid booking them back-to-back. Consider,
for example, scheduling only one such visit in any given
hour.
Next, sort out the sick patients
from those who are coming in for followup with chronic
diseases. Generally speaking, it will take less time
administering to those with cold and flu symptoms, sore
throats and so on than chronic cases. The latter group
often has questions about medication, the prognosis
for the future and so on that will generally prolong
the visit.
Unexpected visits are by their
nature harder to deal with but if you have a handle
on the type of patients you're seeing you'll find it
easier to identify where the schedule has more slack
— during a string of 'sick' patients for example.
Encourage your receptionist to screen such calls to
determine the nature of the 'emergency.' What the patient
considers an emergency might be dealt with over the
phone.
If you're really stuck consider
this radical step, one that's worked for some of your
colleagues: ask if there are any patients in the waiting
room who would consider rescheduling. You'll be surprised
at how often you'll find someone who would rather get
on with their lives and come back when it's less busy.
The categories described
here offer only one possible approach. The general theory,
though, has wide application that has been effective
in a variety of practices. If the person handling your
appointments has some handle on how long a given patient
visit is likely to take he or she will be far more effective
in helping structure practice days that don't leave
you drained and frazzled.
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