Balancing appointment time and quality in your MD practice

Posted by Dr. Barry Dworkin on 22/01/19 10:30 AM
Dr. Barry Dworkin

Busy doctors often feel torn between two competing priorities: time and quality.

Of course, you must give patients adequate time to clarify medical concerns to preserve your quality of care. In my own experience, allowing patients to speak without interruption and listening carefully is invaluable in finding the correct diagnosis. Additionally, doctors in Canada, Australia, and elsewhere are increasingly encouraged to pay attention to preventative health care. Double-checking overall patient progress and risk factors during most appointments, along with managing any current concerns with the correct level of patience and listening, can add quite a bit of time to a visit.

The counterbalance to this is that there are a limited number of hours in a day and a growing number of people to see. Without keeping an eye on appointment time, your clinic could face multi-hour wait times day after day. Making patients wait too long and dragging visits out can actually diminish their experience of your care as a family practitioner, even if the intention was to be attentive and caring during the appointment.

The question I get from many doctors (particularly those starting out) is this: How do you set up a doctor’s office that balances quality care with time-efficiency? While time and quality often seem to be at odds, the truth is that in a modern doctor’s office that does not have to be the case. In fact, there are many practices and technologies that can help preserve patient flow while ensuring everyone’s health is well looked after. Here are a few of my top tips and solutions.

Tip #1: Avoid multitasking - use technology to fill in the gaps.

Many doctors think that the best way to preserve appointment time is to multitask. However, in practice, this often sabotages quality of care. Simply put, if you try to do two (or more) things at once, you will likely end up doing a half-quality job of both.

The most common multitasking mistake is updating an EMR while patients are sharing their health concerns. This type of multitasking often makes patients feel unheard and uncomfortable, with doctors rapidly typing instead of making eye contact and listening to the details. Perhaps more importantly, it often leads to low-quality notes. Trying to type at the same rate as patients speak is not always easy, so you risk missing details that end up being critical. Overall, attempting to balance these two tasks can hurt your quality of care and actually end up taking more time as you scramble to clean up notes after an appointment.

But, what is the alternative for a busy doctor? In these cases, I look to technology to fill the gaps. For example, instead of typing all my notes manually, I use voice recognition software to transcribe what happens in my office into plain text. It takes just a minute to read my observations aloud to the EMR, which is far less intrusive and time-consuming than typing away during an appointment. I would recommend all doctors look for instances they are juggling multiple tasks and find technology that will automate the secondary task to improve focus and quality of care.

Tip #2: Automate calculations and trend analysis.

In a week full of half-hour appointment slots, minutes can add up to hours very quickly. Some of those minutes are important - for example, those spent speaking with patients and working to understand their health situation. But there are other tasks which take up time that you should do away with if a more efficient method comes along.

With today’s technology, it is not necessary to spend any time calculating results from a blood test or comparing patient figures to medical benchmarks. Anything that could be characterized as “crunching numbers” can and should be automated.

Screen Shot 2019-01-16 at 11.12.02 AM

Auxita is my favourite time-saving tool for this because it integrates with my EMR and grabs all the relevant data. This saves on time spent typing and transferring over test results, as well as taking on calculations and comparisons to benchmarks. Since EMRs don’t compile figures in a way that makes them easy to see at a glance, this is a great add-on.

Tip #3: Make it visual.

Time spent listening to patients is rarely ever wasted. But time spent talking to them can be, especially if you are repeating yourself or being unclear.

Using visual aids can be helpful here. On the low-tech side, images or models of internal functions can be used to illustrate certain points. On the higher-tech side, software that graphs out trends can be a source of insight if someone’s health is improving, declining, or stagnating. For example, the image below could communicate far more to a patient than a 2-minute lecture ever could:

Screen Shot 2019-01-16 at 11.21.34 AM

Overall, when you find an effective way to communicate with patients, be sure to take note of the tactic. This will help you to better communicate information, especially on challenging preventative health topics.

How technology and automation can help you overcome the time-quality paradox

When we talk about “patient flow,” we are not referring to moving patients through your practice like a factory conveyor belt. If your goal is speed alone, you will almost always fall short on quality of care. However, time-efficient appointments can make a big difference in your own peace of mind and that of your patients.

Here’s the good news: these two goals don’t have to be at odds. Conducting thorough appointments while keeping an eye on the clock is absolutely possible with the right approach, priorities, and technology on your side.

I recommend beginning by looking for integrations for your EMR, like Auxita and voice recognition tools. These are easier to test out than unintegrated software and allow you to centralize your system around the EMR for added efficiency. No one software can do everything, but a combination of valuable medical technology can make your practice highly effective.

Want more tips on finding the right software? Read my article on red flags to avoid when evaluating new technology for your practice.

Dr. Barry Dworkin is an Ottawa-based practicing family doctor for the past 28 years and a self-admitted tech geek for over 40. He is also a Medical Advisor for and avid user of Auxita’s platform.

By analyzing patient data, Auxita turns information into valuable insights— saving time and maximizing revenue. Click here to try it for free today!

Subscribe Here!