Racing The Clock - 15 Minute Time Management For Doctors

Dan Greenfield is co-founder of Health Space Design ( and heads up marketing and business operations. He is a marketing strategist and business development executive with more than 20+ years of experience in politics and corporate America. He has organized more than a dozen conferences around the country on social media, which featured some of the world’s largest corporate brands and his articles have appeared in numerous marketing publications.

##A look at how doctors can use interior design and technology to aid time management##

As a physician, time is one of your most valuable assets. Time

You often have 15 minutes or less to diagnose an ailment, suggest a course of treatment, and answer patient questions. All along you must be efficient and comforting, responsive but authoritative.

Go over your allotted time with several patients, and your appointments can get backed up like planes on a runway.

And these days rushing patients out the door is not an attractive option.

First of all, there is the growing scrutiny of online performance review sites like Healthgrades. And then there’s the Clinician and Group Consumer Assessment of Patients Waiting to be SeenHealthcare Providers and Systems (CGCAHPS) survey which impacts reimbursement rates. It asks whether “the provider spent enough time with patient” and how well the provider “explained things in a way that was easy to understand.”

Fortunately there are steps you can take to manage both the actual clock and patient perceptions of the time you actually spend in consultation.

In fact, the simply sitting face to face with patient can shape perceptions of the quality of care.

According to data from researchers at KU Hospital, patients believe doctors who sit during a hospital room visit stay longer than those that stand — even when doctors who sit don’t stay as long as doctors who stand.

So let’s look at how we interior design and technology can help save time without undermining your relationship with your patient.

###Interior Design – Space Planning###

Interior design is more than furniture and finishes. It’s about understanding user needs and behaviors. Medical interior design focuses on protecting and enhancing the health, life safety and welfare of the public.

One important role of medical interior design is planning a space to increase productivity. In combination with time saving technology, the smart design of the exam space can maximize performance, minimize movement, endorse patient safety and facilitate better patient doctor interaction.

###Place Furniture and Equipment to Facilitate Patient Interaction###

The placement of chairs, table and monitor in the exam room can support good eye contact and interaction between doctor and patient. As a physician, you need to avoid having your back to the patient. Face time with a patient directly translates to higher patient satisfaction.

Kenneth Bertka, MD, vice president of physician clinical integration, at Mercy St Vincent Medical observes:

This can be a challenge because often exam rooms are retrofitted for computer equipment, not designed with it in mind.

He recommends a half-moon (semicircular) table with the flat side against a wall and the patient and physician sitting along the curve with the computer monitor on an adjustable arm in the center. It allows you to maintain eye contact with the patient by looking past the monitor and pivoting the screen toward the patient to share test results or educational materials.

He also suggests you consider the movable carts often found in hospitals. If space permits in an office setting, the cart can move along with you. You can then sit and take a patient’s history and then stand when you perform the physical exam. As you explain the course of treatment, the cart can again be moved and adjusted to meet the needs of the patient-physician interaction.

###Consider identical Exam Room Layouts###

It may sound simple, but identical exam room layouts allow physicians and their staffs to develop and take advantage of “reflexive” knowledge of the location of supplies and equipment. The added cost of plumbing means higher up front costs for identical room layouts. But in the long run, the time saved with each patient can add up. It can also reduce mistakes in stocking the rooms and increase medical assistant productivity.

###Cluster Exam Rooms###

In a course of a given day, the average physician does a lot of walking from one exam room to another. Clustering exam rooms around a centralized horse shoe shaped nursing station will reduce steps and fatigue. It can save time that can be better spent on patient doctor interaction.

##Digital Tools and Mobile Apps##

###Select patient friendly apps###

Digital tools are alluring. Designed to increase productivity, they can also strain the patient relationship. Technology can wind up competing with your patients for your attention and adding to their stress.

John Cox, CEO of Visible Health, a clinician-patient-centric platform for patient education, engagement, and condition management offers this perspective:

One of my favorite scenes from a movie is in “The Running Man.” Actor Jesse Ventura laments that he can’t use his own technology to try and defeat Arnold Schwarzenegger. The point is that sometimes the use of technology is unnatural and feels forced. Does the technology distract from the conversation? Does it make the interaction less personal? Does the clinician spend more time clicking, tapping, and twirling 3-D models than explaining what’s going on?

John stresses that tools have to be simple, yet powerful. They have to contribute to the conversation, not distract from it. They have to be intuitive. They have to create opportunities for patients to continue learning and understanding beyond the visit, and ideally create a channel for additional dialogue between patient and provider — all of which can reduce a physician’s time with a patient.

###Let the patient see your screen###

As many as 80 percent of physicians use some type of iPad or tablet. They are convenient and allow for greater mobility.

Unfortunately, Manhattan Research has found that smartphone screens have largely remained for physicians’ eyes only — few use so-called “swivel apps” to share what’s on their smartphone’s screen with patients during consultations.

Letting the patient see the screen can improve communications by engaging the patient in his or her treatment. One physician Aaron Neinstein observed that sharing the screen has led to “bonding” moments with his patients.

##Remember a Picture Is Worth a Thousand Words (An Interactive One – Even More)##

###Physician Time Management###

Consider apps on handheld devices that make it easy to point out the anatomic structures and to show how they relate to one another. This allows for more productive and possibly fewer questions that can aid with time management. Old school: Taking out a piece of paper during the exam and doing a rough approximation. New school: Tapping apps like drawMD, where you can manipulate, annotate anatomical illustrations to meet the needs of your particular patients. You can then print, or even e-mail, these images to patients for later review.

###Time Management Starts with Communication###

The integration of technology, interior design, and time management is a work a progress, and best practices will continue to evolve.

The dynamic between physician and patient will also evolve — especially as patients increasingly go online for information and become more comfortable with technology.

As John observes:

As empowered as your patients are becoming with access to medical information on the Internet, the vast majority of the information flow is from you the healthcare provider.

Interior design and technology should be viewed as tools to improve communication by making conversations between you and the patient more productive. It is important to stress that interior design and tools can aid, not replace, physician’s traditional role of healing and promoting patient well being.