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Life Hacks for Doctors: An Introduction

This work is licensed under a Creative Commons AttributionNoncommercial-No Derivative Works 3.0 United States License.

Joshua Schwimmer, MD, FACP, FASN www.efficientmd.com


What are Life Hacks? Productivity strategies that solve everyday problems — especially problems caused by information overload.

Adapted from Wikipedia


Life Hacks Are Often Simple Discrete Nonintuitive Clever Surprisingly Effective


Have you ever heard a lecture on...?

Image: D’Arcy Norman, Flickr


Pheochromocytomas?

Image: Wikipedia


Lectures on Pheochromocytomas 100% of Doctors. Tumor incidence = approx. 5 per million population per year. Image: Wikipedia


Have you ever heard a lecture on efficiency?

Image: D’Arcy Norman, Flickr


Lectures on Efficiency Only 20% of doctors, and most paid for the lecture themselves. Source: Sermo


Is there a misalignment of priorities in medical education?

Image: Caro Wallis, Flickr


Being a good doctor depends not only on who you are and what you know — but on the systems you use.


HDR Image: Aurorus Reflectus Colosseo, Stuck in Customs, Flickr


Q. Should you write “No Scleral Icterus?”


If it takes you 3 seconds to write these words on every patient...


You will spend 3 hours each year writing “No Scleral Icterus.”


Is this really the best way to spend your time?


Principles of Productivity


Reflective Questions


Who is the best person to perform a task?


Probably not you. (Don’t be offended.)


How much is your time worth?


Example: $150,000 per year / 60 hours per week * 50 weeks per year = $50 / hour. A useful oversimplification.


(Writing “No Scleral Icterus” is costing you $150 a year.)


Who should perform a task? Someone who can do it well whose time is worth less than your own. Always delegate when appropriate. Don’t make other people do work that’s rightfully yours.


Create filters or rules so you never see tasks that you should never perform.


HDR Image: Fireworks Over Lake Austin, Stuck in Customs, Flickr


What should you do?


(One option.)


A Better Option Become comfortable with “to do lists�: Write them Rewrite them Cross items off Review them often


To Do Lists Organize different lists by location Office Hospital Phone Errands Home


Group similar tasks together to save time lost in “task switching.�


Keep a “mission critical� list of tasks that must be performed that day.


The 80-20 Rule: 80% of the effects come from 20% of the causes.


Concentrate on your most important tasks.


When should you perform a task?


If it’s simple and quick, do it now.


The Calendar If a task should be performed at a particular time or on a particular day, put it on your calendar. Your calendar is not your to do list.


Parkinson’s Law: “Work expands to fill the time available.”


Where should a task be performed?


Where should a task be performed? First, perform tasks that are particular to a place. See hospitalized patients in the hospital. File charts in the office. If tasks are “mobile,� consider performing them elsewhere. Make calls while commuting. Take paperwork home to review.


Why perform a task?


Rediscover your motivation.


Why? Why are you performing this task? Why are you doing it this way? Why are you practicing medicine?


Ideas


Most doctors’ desks are organizational disasters.


The solution? Inboxes. (You went to medical school for this?)


Inboxes 101 All new labs and mail go in the inbox. Pick up the top item and deal with it. Sign and file labs, recycle junk mail, write down a “to do,� etc. Never put any item back in the inbox. Empty your inbox regularly.


HDR Image: Hong Kong, Stuck in Customs, Flickr


An Open Secret: Most doctors never learn how to document properly.


Many doctors live with constant anxiety that they are over-coding or under-coding.


The Solution: Craft Individualized Note Templates New Patient or Consult Notes Follow Up Notes Include all the items you need to bill at the highest level when appropriate. See wiki.efficientmd.com for more details.


The Hospital Routine

Image: Fractal Hospital, Gualtiero, Flickr


Group Your Tasks Check Labs Examine Patients Write Notes


An Example of Grouping Tasks Six patients on a hospital floor. 15 seconds to walk to each room. 5 seconds to walk from room to room.


Grouping Tasks Strategy 1: Examine patient, write note, repeat. (15 + 15) * 6 = 180 seconds. Strategy 2: Group Tasks. Examine all patients, then write all notes. (15 * 2) + (5 * 5) = 55 seconds. Strategy 2 (grouping tasks) saves 8.7 hours a year ($434).


Learn Efficiently


Choose one textbook for your specialty and read a few pages every day.


Keep a list of clinical questions. Regularly look up the answers and cross them off your list.


Fill an iPod with medical lectures and podcasts. Listen while you commute.


Sources of Free Podcasts and Lectures New England Journal of Medicine JAMA Archives of Internal Medicine HDCN.com Google on [medical podcasts] and [grand rounds podcasts]


Refresh Your Information Sources Medical Blogs Google Scholar Google Book Search Google Alerts & Google News UpToDate


For More Information on Life Hacks for Doctors www.efficientmd.com wiki.efficientmd.com casesblog.blogspot.com


Thanks.


Life Hacks for Doctors