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.