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Life Hacks for Doctors:An Introduction
Joshua Schwimmer, MD, FACP, FASN
www.efficientmd.com
This work is licensed under a Creative Commons Attribution-
Noncommercial-No Derivative Works 3.0 United States License.
What are Life Hacks?
Adapted from Wikipedia
Productivity strategies that solve everyday problems —
especially problems caused by information overload.
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
Image: Wikipedia
100% of Doctors. Tumor incidence =
approx. 5 per million population per year.
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 you3 seconds to write
these words on every patient...
You will spend3 hours eachyear 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” listof 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?
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.
Where should a task be performed?
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?)
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.
Inboxes 101
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 TemplatesNew 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.
Image: Fractal Hospital, Gualtiero, Flickr
The HospitalRoutine
Check Labs
Examine Patients
Write Notes
Group Your Tasks
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 TasksStrategy 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.