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Editorial Spotlight | Nov/Dec 2017

Time Management and Culture: The Holistic Solution

It takes a team to effectively and efficiently run a practice.

Given the ever-increasing challenges inherent in running a practice—regulations that seem to change daily, lowered reimbursement levels, and the need to constantly adopt new success strategies—it is no wonder that physicians and staff members are stressed and experiencing burnout. Yet there are ways to decrease these frustrations and improve the quality of life for everyone in the practice. A practice culture with emphasis on continuous improvement embraces personal accountability and effective time-management strategies.


Below are three cultural tenets that can improve time management in a practice, which, in turn, frees everyone to do their best, lowers stress levels, and elevates work attitudes.

Encourage continuous improvement. Developing a culture of continuous improvement through open communication and effective time management allows staff members to have a sense of control over their situation. With a culture of continuous improvement, people know that there are systems in place to review what is not working. They also have the ability to provide input on how to make something better. Without these systems, staff morale, time management, and overall efficiency plummets, and stress rises.

Take this scenario, for instance: A technician immediately gets defensive when the physician informs him that he should have done a particular test during a patient workup. This time-consuming, unpleasant, and stressful scenario can be avoided if the practice has open and honest discussions on how to improve. Making time to hold regular meetings where staff can freely discuss opportunities and successes, consider improvements, and review practice protocols and procedures can improve practice efficiency in a constructive, nonconfrontational way.

Meanwhile, being a physician has always been a stressful job. When leadership responsibilities increase, physicians too often neglect to share the workload and manage their time better. In a culture of continuous improvement, physicians are free to think outside the box. Perhaps working with an optometrist, physician assistant, or nurse practitioner who could take calls would permit uninterrupted family time or personal time. Retaining a capable manager or management team could also provide opportunities for respite. Just like having a scrub technician to assist with surgery, it takes a team to effectively and efficiently run a practice.

A culture of continuous improvement and time management takes away the feeling of powerlessness and defeat. In that type of setting, everyone can express ideas, feelings, and needs as part of a collaborative process. As a result, employees are happier because they have the power to make their work life better.

Instill accountability. Nothing can lower practice morale quicker than people who are defensive, blame others for their mistakes, and are unwilling to take responsibility. What a huge waste of time! Any efforts to improve will fail if no one owns their piece of the puzzle or recognizes how their actions fit into the larger picture.

A culture of accountability can improve time management exponentially. Just think of the minutes and hours that can be saved when coworkers trust one another to do things correctly. No longer will team members have to take time to review others’ work or fix mistakes. Freeing up time will allow practice operations to run like clockwork, with patients being seen at the time of their appointment, staff actually taking lunch at lunchtime, and the office closing at the end of regular business hours.

It is important to be accountable for own your time as well. Learn to balance life and work to recharge your batteries. Without taking accountability for our time, we tend to ignore personal physical, emotional, and spiritual needs. When this course of action continues, we become unhealthy. To make matters worse, these habits tend to be carried into the office or, even worse, into the OR. We keep going long after we should have known it was time to stop. Be accountable for putting yourself and your health first; everyone will benefit.

Focus on customer service. Customer service encompasses how everyone interacts at every level. Although outstanding, ongoing customer service might seem like it will eat up time, the opposite is true. Proper training and efficient patient interaction saves times. Work to create a culture in which the first question is always, what can I do to help? followed by, how could I have served that person better? It starts with putting yourself in the shoes of the patient, physician, or staff member to whom you are assisting. Everyone needs to work as a team. Poor interactions within the team quickly stand out in this culture environment and are unacceptable to all. Peer training and reorientation becomes a helpful tool for culture maintenance.

Returning to our earlier defensive technician example, a customer service-oriented technician would have been accountable, apologized, and asked the physician to review the protocol or case at the end of the patient session to avoid making the same mistake again. Such a response shows that the technician understands that he is there to support the physician in providing the best, most time-efficient patient care possible. How easy is that! By providing excellent customer service, he just took the stress level down 100% by creating an opportunity to improve. With work improvement comes better efficiency and time management in the practice.


Given all the outside stressors practices deal with today, minimizing hassles, reducing frustrations, and effectively managing time are essential to a healthy quality of life for physicians, staff, and patients. To achieve this, change your practice culture. Work to promote a culture of continuous improvement, accountability, customer service, and, thus, time management. It creates a positive, supportive workplace and lowers stress. It is worth the effort.

C. Jolynn Cook, RN, COE, CASC
C. Jolynn Cook, RN, COE, CASC
Laurie Brown, MBA, COMT, COE, OCS, OSA, OSC
Laurie Brown, MBA, COMT, COE, OCS, OSA, OSC

Nov/Dec 2017