Wednesday, July 27, 2016

The optimally busy doctor.


Most doctors have a sweet spot for everything we do , including seeing patients. Thus, if we see about 10 patients a day and it takes us about half an hour to see a patients, that means we're busy working for about 5 hours and this gives us a sense of professional satisfaction that we've done a good job, and it allows us to spend enough time with each of our patients , so they're happy as well. If we assume this is our sweet spot, then this is the optimal number of patients we should plan to see everyday. We then need to price our fees so that seeing this number of patients would allow us to earn as much money as we require.

The problem arises at both the ends of the spectrum -  either we don't have enough patients to see, which means we end up twiddling our firms doing nothing; or we have too many patients to see , which means we're so busy , that we really don't have enough time to devote to each patient, and we may end up missing the diagnosis . A rushed doctor creates a lot of patient dissatisfaction, because patients are made to wait for too long, and they don't get to spend enough time with the doctor.

Having too many patients to see paradoxically also reduces the amount of professional satisfaction for doctors. It upsets our work life balance , and if we spend too much time in the clinic because there're too many patients to see, we don't have enough time either for our self or for our family.

The key is to find the optimal middle path. When you're just starting practice and you don't have too many patients, your major focus is on acquiring new patients. Sadly, this is a slow process, and it's not a good idea to take shortcuts . When you have slack time , rather than complain about this, you should learn to utilize it gainfully - for example, by sharing your knowledge online, by publishing patient education articles and creating patient education videos. This will allow you to make use of your knowledge, so you can serve lots of patients, even though they are not physically present in your clinic. It will also allow you to build up your online presence and your digital reputation, but of which are priceless assets.

If you have too many patients, then it's much easier to cut down on the number of patients you see. The tragedy is that most doctors aren't mature enough to realize that there is a price they pay for being excessively busy.  The more senior they get, the busier they want to be ! Often, this is because they don't have any other hobbies or interests; or they're completely focused on maximizing their income. Some doctors are quite masochist, and take a lot of pride in the fact that they are working all the time, and they are so busy taking care of patients, that they don't have any time for themselves or their family, because they're always available for their patients.

While their devotion can be remarkable, I don't think this is in anyone's best interests - either the doctor or the patient. If the doctor is too busy, he is likely to be tired; may miss important information; and is more likely to make errors  because he's not able to devote enough time to each individual patient. It's not good for the doctor either, because while it's true that if you see more patients you earn more money, the quality of time which you spend with each patient deteriorates sharply as well, and this can be a heavy price to pay. You don't have enough time and energy to spend on solving the challenging problems posed by difficult patients, because there are
so many other patients waiting to see you. Doctors do find workarounds for this  - for example , by employing assistants, but the quality of care they provide does suffer.

Senior doctors need to have the maturity to be able to say enough is enough - I need to do more with my life than continue seeing more patients. One way of cutting down your workload is by increasing your fees, so that patients will go elsewhere . An even more graceful method is to refer your easy patients to your juniors ! They will be grateful for this gesture, because you are helping them to grow their practise.

I personally feel that doctors who are too busy just have poor time-management skills, and they are being unfair to themselves, their patients and their family.

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