Time Managers: Secrets of Effective Leaders

Where does the clinician find time to successfully complete the tasks that fill the healthcare plate on a daily basis? Tasks such as clinical patient care, teaching and supervising medical students and residents, personnel issues, budgetary responsibilities, and research expectations add to the complex role of faculty in an academic setting.

Where does the time go? It's as much a question as an admonition. One constant is the fact that there are only 24 hours in a day. Yet, we keep trying to stretch that number to accommodate the daily demands from an expanding work environment. Practitioners wear many hats, from the clinician to the academician, to the office manager and supervisor. This paper provides some lessons from a corporate framework that provide strategic building blocks for an assessment of daily obligations and the impact they have on the physicians' ability to function effectively in a 24 hour day. ₁

Although time management (TM) principles can be traced to the 6^th century AD, ₂ it wasn't until the industrial revolution in the 18^th century that TM was viewed as a means to improve efficiency in the work environment. ₃ The application of time management theories progressed from the assembly line productivity of the 18^th and 19^th centuries to the prioritization of needed skills and motivation of office personnel in the 20^th and 21^st centuries. ³,₄,₅ Recognition of the impact of time management strategies within the health care industry became apparent with the influx of managed care. Working harder and longer does not always mean earning more money or enjoying more success. ₆

Realizing that focused effort increases productivity and recognizing the human propensity to waste time on insignificant duties lays the foundation for effective management techniques. Six strategies are developed within the time management literature. ³,⁴,⁵,⁶,₇,₈,₉ for efficiently addressing the multiple tasks and responsibilities of the academic clinical practitioner.

Strategy 1: Establish a Goal

Basically, establishing a goal requires identifying where you want to get to by the end of the day, week, or year. Make the goal as specific as possible, stay away from vague or broad statements and identify what you really want. If you identify more than one goal, then rank them according to priority. Some tasks are more important than others in the grand scheme of things. Other tasks are optional or less importance to accomplish. ₁₀

Identify the steps you will need to climb in order to achieve your goal. Envision yourself on the middle step by a certain date, then on the top rung.

Strategy 2: Develop a “To Do” List

While establishing a goal is a broader statement of where you want to get to by the end of the day, week, or year, a “to do” list is basically tasks that you perceive need to be done during the day. Developing a “to do” list for 5 minutes each morning helps establish a routine (Strategy 3) and prioritize tasks according to “should do” and must do” items. ⁸ Re-evaluate your list at the end of each day to verify what's been accomplished and what still needs doing. You may find some tasks continue to be “left” on the list and therefore, need to be re-assessed for their importance. Perhaps these tasks are put on hold because they appear too formidable. Breaking them down into smaller steps can help chart progress towards their completion.

Strategy 3: Establish an Efficient Routine

We all have routines that are followed during the day; however, we rarely stop to acknowledge them. Often we establish a routine around specific tasks such as getting up in the morning, showering, getting coffee. However, these routines are not always an efficient use of our time. Step back and look at the routines you have built around specific tasks at work, such as checking the office emails and responding to mail. Can you re-negotiate how you spend time around these every day tasks? Can you write a response directly on a letter instead of transcribing a separate response? Will a phone call take less time? Can an office assistant check your mail and/or emails?

Strategy 4: Delegate

This strategy is the cornerstone of any successful administrator. Delegate tasks that can be accomplished by someone else. ₁₁ An office assistant can open and organize the mail; complete article searches, summarize abstracts, and contact colleagues to set meeting times. The nursing assistance can escort patients to the exam room, to the billing counter, and to the lab. The clinic nurse can take the patient's oral history and physical, vital signs, retrieve lab and/or x-ray results, change bandages, etc. ₁₂ Recognize that you can not be the office manager, clinician, teacher, researcher, and administrator all at the same time and function successfully. As Mariano states (2001), “you have enough time to do anything. You just do not have enough time to do everything. “ ⁹

Strategy 5: Set Timelines

An important ingredient in time management is the setting of reasonable and specific timelines for accomplishing tasks. This also involves setting realistic timelines for tasks delegated to others as well.

Strategy 6: Downtime

Effective time managers realize the importance of downtime. Allowing time away from the stresses of work requires practice. Often, work follows us home as forms need completing, charts need reviewing, and articles need publishing. Take time to refresh yourself. At the office push the chair away from the desk for five minutes and close your eyes. Focus on your breathing. Take slow, steady breaths. Post a “please do not disturb” sign on the door and reinforce its importance to colleagues. If they ask what you are doing, simply respond that you are trying to stay focused.

It is possible to identify daily “time eaters” and establish new, more efficient routines that involve delegation and realistic timelines. While it is true that there are only 24 hours in a day, the implementation of time management strategies within the office practice facilitates better utilization of the clock to successfully manage the myriad of job related tasks that fill the day.

Correspondence to

Susan Hart-Hester, Ph.D. University of Mississippi Medical Center Department of Family Medicine 2500 N. State Street Jackson, MS 39216-4505 601-984-5410/fax: 601-984-5411 email: shart-hester@familymed.umsmed.edu