8 ways to save hours each day in your physician practice

Magnified by the impact of the COVID-19 pandemic on the health care workforce, there is an urgent need to find time to make meaningful changes and more structured interventions. And, given the current labor shortages, the focus must be on removing unnecessary work so that physicians can get back to “doctoring.” The “AMA STEPS Forward® Saving Time Playbook” (PDF) can help.

AMA Director of Practice Redesign Marie T. Brown, MD

The playbook was developed to help physicians and health systems reduce burnout by being more efficient and working smarter, not harder. In turn, physicians will have more time to take care of patients and themselves. Learn more by reading, “Want to save time in your practice? There’s a playbook for that.”

Reducing physician burnout is a core element of the AMA Recovery Plan for America’s Physicians. You took care of the nation. It’s time for the nation to take care of you. It’s time to rebuild. And the AMA is ready.

Far too many American physicians experience burnout. That’s why the AMA develops resources that prioritize well-being and highlight workflow changes so physicians can focus on what matters—patient care.

“After meeting the challenge of the Covid pandemic head on many physicians are exhausted. The incivility they are experiencing and frustration in their day to day is almost too much to bear. We cannot ask them to do one more thing without taking some unnecessary tasks away,” AMA member Marie T. Brown, MD, said during an education session at the 2022 AMA Annual Meeting. Dr. Brown is also a geriatric and internal medicine specialist at Rush University Medical Center and director of practice redesign at the AMA.

“They’re just so overwhelmed. They’re burning out. They’re leaving. They’re frustrated,” said Dr. Brown. “Our focus at the AMA … is really to see what we can do to take some of the unnecessary burden off our colleagues so that they can look above the water and see where we could make changes.”

“It’s all about having time to spend with our patients, but we’re busy doing other things that we’re unable to do that and it really eats away at us,” she said.

Here are some ways to eliminate unnecessary work and remove obstacles that interfere with patient care to reduce physician burnout.

1. Debunk regulatory myths

   1. “Almost 80% of wasteful rules are completely within the administrative control of our institutions—a well-kept secret,” said Dr. Brown. “Out of fear, many organizations are overinterpreting these rules.”
   2. “Organizations are shooting themselves in the foot by having over interpreted these rules quite often. SO go back to the source, which we’ve done for you in as many places as we can,” she said. “If you find some, please bring them to our attention. We’ll put it up on the Debunking Regulatory Myths page.”

2. Take steps to get rid of “stupid stuff”

   1. With some tasks, nobody intended for them “to be there, but it wastes an enormous amount of time.”
   2. “And in this staff shortage crisis, we can't hire more staff. We have to just take the unnecessary work away,” she added. “Maybe you might have tried some of these things years ago, but now because of the staff shortage and the pandemic, the C-suite might be listening a little bit more.”

3. Follow the de-implementation checklist

   1. “Also available is the de-implementation checklist, which was just developed a year ago and reviewed by The Joint Commission,” said Dr. Brown, adding that “these are low hanging fruit that you can get rid of.”
   2. If a physician saves an hour a day, it’s 20 hours a month or 30 days a year, she said. With that time saved, “maybe they could take a vacation, spend uninterrupted time with their family and not have to look at their email while they’re on vacation, which is what’s happening out there. Many physicians have not had even 24 hours without logging on to their EHR in years.”

4. Find ways to tame the EHR

   1. “Instead of hiring more staff to empty the inbox, go upstream. Many items  never should have entered the inbox to begin with and we have provided a list of these items to share with your organization Dr. Brown said, referring to the “AMA STEPS Forward® Taming the Electronic Health Record Playbook.”
   2. The playbook also suggests physicians and health systems “get rid of unnecessary work, then share it, use the team, use the tools that are there in the EHR and then sell it upstream to the C-suite,” she said, adding there “is a list of things that are under your control … and an approach to removing unnecessary tasks.”

5. Simplify medication management

   1. “Some people say: Well, where do you start? Simply changing your refill of chronic meds to 90 times four. Ninety times four, call me no more—will save an hour or two a day,” said Dr. Brown. “I didn’t think that my patients would like it. … I was pleasantly surprised. We freed up so much time that when a patient missed an appointment, we were easily able to reach out to them because we were alerted that they didn’t follow up."
   2. “When I did this … the night calls went down, errors went down and patient satisfaction went up,” she said. “You continue to see your patients as often as they need to, and you’ll have team members who can do something more important than sit on the phone with refills all day long.”

   3. Related Coverage

      4 smart strategies to tame the EHR and cut physician burnout

6. Stop doing these six things now

   1. There are some things medical practices and health systems should stop doing to help physicians thrive. For example, “refills for just six months,” automatic notifications about scheduled appointments and reading laboratory results ordered by other physicians, said Dr. Brown. This can save hours a day. “And what are we going to do with those hours we save a day? Well, you’ll be able  to spend more time with your patients, finish work at work and develop additional efficiencies with your team.”

7. Implement pre-visit planning

   1. “Some of the things that you might want to think of and that your teams or your quality people or your practice management people want to espouse is pre-visit planning,” said Dr. Brown. This “takes time, so when you have the time, we have a toolkit to show you how to implement pre-visit planning.

8. Allow team documentation

   1. “We forget because of the pandemic that the AMA and the house of medicine fought hard for team documentation. And we won. We decreased the burden,” said Dr. Brown. “But because we're busy taking care of patients during the pandemic and saving lives, we haven't implemented much of this.”
   2. “We wouldn't think of asking lawyers to record legal proceedings, so why would we think doctors can do this when what you’re doing with your patients in that 20 minutes or 30 minutes may be a little bit more important,” she said.  
   3. “Often implementing some of the things I've talked about can save three to five hours a day,” Dr. Brown said. “And, again, what are we going to do with those extra hours? Build trust with our patients, which has eroded greatly in our society today across all institutions.”

Read about the other highlights from the 2022 AMA Annual Meeting.