Life Hacks for Doctors:
                   An Introduction



                                    Joshua Schwimmer,
   Thi...
What are Life Hacks?

 Productivity strategies that
 solve everyday problems —
especially problems caused by
    informati...
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

  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 you
  3 seconds to write
these words on every
         patient...
You will spend
   3 hours each
    year 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 oversimplifica...
(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 wh...
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” list
 of 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 cal...
Parkinson’s Law:
“Work expands to fill the
    time available.”
Where should a task be
    performed?
Where should a task be
    performed?
 First, perform tasks that are particular to a
 place.
   See hospitalized patients ...
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?)
Inboxes 101
All new labs and mail go in the inbox.
Pick up the top item and deal with it.
 Sign and file labs, recycle jun...
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 Templates
New Patient or Consult Notes
Follow Up Notes
Include all the items you ...
The Hospital
  Routine




    Image: Fractal Hospital, Gualtiero, Flickr
Group Your Tasks

Check Labs
Examine Patients
Write Notes
An Example of
    Grouping Tasks

Six patients on a hospital floor.
15 seconds to walk to each room.
5 seconds to walk fro...
Grouping Tasks
Strategy 1: Examine patient, write note,
repeat.
 (15 + 15) * 6 = 180 seconds.
Strategy 2: Group Tasks. Exa...
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
 Goo...
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.
Life Hacks For Doctors
Life Hacks For Doctors
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Life Hacks For Doctors

  1. 1. Life Hacks for Doctors: An Introduction Joshua Schwimmer, This work is licensed under a Creative Commons Attribution- MD, FACP, FASN Noncommercial-No Derivative Works www.efficientmd.com 3.0 United States License.
  2. 2. What are Life Hacks? Productivity strategies that solve everyday problems — especially problems caused by information overload. Adapted from Wikipedia
  3. 3. Life Hacks Are Often Simple Discrete Nonintuitive Clever Surprisingly Effective
  4. 4. Have you ever heard a lecture on...? Image: D’Arcy Norman, Flickr
  5. 5. Pheochromocytomas? Image: Wikipedia
  6. 6. Lectures on Pheochromocytomas 100% of Doctors. Tumor incidence = approx. 5 per million population per year. Image: Wikipedia
  7. 7. Have you ever heard a lecture on efficiency? Image: D’Arcy Norman, Flickr
  8. 8. Lectures on Efficiency Only 20% of doctors, and most paid for the lecture themselves. Source: Sermo
  9. 9. Is there a misalignment of priorities in medical education? Image: Caro Wallis, Flickr
  10. 10. Being a good doctor depends not only on who you are and what you know — but on the systems you use.
  11. 11. HDR Image: Aurorus Reflectus Colosseo, Stuck in Customs, Flickr
  12. 12. Q. Should you write “No Scleral Icterus?”
  13. 13. If it takes you 3 seconds to write these words on every patient...
  14. 14. You will spend 3 hours each year writing “No Scleral Icterus.”
  15. 15. Is this really the best way to spend your time?
  16. 16. Principles of Productivity
  17. 17. Reflective Questions
  18. 18. Who is the best person to perform a task?
  19. 19. Probably not you. (Don’t be offended.)
  20. 20. How much is your time worth?
  21. 21. Example: $150,000 per year / 60 hours per week * 50 weeks per year = $50 / hour. A useful oversimplification.
  22. 22. (Writing “No Scleral Icterus” is costing you $150 a year.)
  23. 23. 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.
  24. 24. Create filters or rules so you never see tasks that you should never perform.
  25. 25. HDR Image: Fireworks Over Lake Austin, Stuck in Customs, Flickr
  26. 26. What should you do?
  27. 27. (One option.)
  28. 28. A Better Option Become comfortable with “to do lists”: Write them Rewrite them Cross items off Review them often
  29. 29. To Do Lists Organize different lists by location Office Hospital Phone Errands Home
  30. 30. Group similar tasks together to save time lost in “task switching.”
  31. 31. Keep a “mission critical” list of tasks that must be performed that day.
  32. 32. The 80-20 Rule: 80% of the effects come from 20% of the causes.
  33. 33. Concentrate on your most important tasks.
  34. 34. When should you perform a task?
  35. 35. If it’s simple and quick, do it now.
  36. 36. 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.
  37. 37. Parkinson’s Law: “Work expands to fill the time available.”
  38. 38. Where should a task be performed?
  39. 39. 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.
  40. 40. Why perform a task?
  41. 41. Rediscover your motivation.
  42. 42. Why? Why are you performing this task? Why are you doing it this way? Why are you practicing medicine?
  43. 43. Ideas
  44. 44. Most doctors’ desks are organizational disasters.
  45. 45. The solution? Inboxes. (You went to medical school for this?)
  46. 46. Inboxes 101 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.
  47. 47. HDR Image: Hong Kong, Stuck in Customs, Flickr
  48. 48. An Open Secret: Most doctors never learn how to document properly.
  49. 49. Many doctors live with constant anxiety that they are over-coding or under-coding.
  50. 50. The Solution: Craft Individualized Note Templates New 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.
  51. 51. The Hospital Routine Image: Fractal Hospital, Gualtiero, Flickr
  52. 52. Group Your Tasks Check Labs Examine Patients Write Notes
  53. 53. 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.
  54. 54. Grouping Tasks Strategy 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).
  55. 55. Learn Efficiently
  56. 56. Choose one textbook for your specialty and read a few pages every day.
  57. 57. Keep a list of clinical questions. Regularly look up the answers and cross them off your list.
  58. 58. Fill an iPod with medical lectures and podcasts. Listen while you commute.
  59. 59. 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]
  60. 60. Refresh Your Information Sources Medical Blogs Google Scholar Google Book Search Google Alerts & Google News UpToDate
  61. 61. For More Information on Life Hacks for Doctors www.efficientmd.com wiki.efficientmd.com casesblog.blogspot.com
  62. 62. Thanks.
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