The Executive Suite: A surgeon's* perfect day

Neil Baum, MD

It’s unlikely that doctors will ever have a truly perfect day, but if we did, it might begin and end like this:

5:00 A.M. wake up

5:15-5:30 meditating\mindfulness

5:30-5:50 Cardio workout

6:30 Healthy breakfast-quinoa, walnuts, flax seeds and seasonal berries

7:00 Arrive at hospital and go to the operating room to meet patient and family and answer any questions that they may have

7:30 Make incision for the first case

9:00 Close incision and go to surgeon’s lounge and check Email. Respond to a complementary letter from a deceased patient’s family thanking you for the outstanding care you provided their family member

Complete any open electronic records

9:30 Start the second case which ends at 11:00

11:15-11:45 Make rounds on three patients in the hospital

12:00 Meet office manager and practice’s managing partner to discuss five metrics that are reviewed monthly. You learn that production is increasing by 4%, new patients have increased by 6%, and the number of office and operating room procedures are also increasing, accounts receivables are steadily decreasing. No show rate averages two patients a week.

1:00 Start afternoon clinic to see 20 scheduled patients including 3 new patients: one referred by a medical colleague, another from a satisfied patient, and the last new patient is referred from the Internet

2:30-2:45 Open slot filled with a patient requesting a same-day appointment

3:45 See the last patient on time

4:00 – 4:30 Return phone calls and emails

4:30-5:15 Contact five telemedicine patients scheduled by the nurse\medical assistant

5:30 A telemedicine meeting with this morning’s post-operative patient and one patient in the hospital

6:00 home for dinner!

9:30 to 10:00 start a restful, stress-free sleep!

The potential result of having an ideal day: You feel a sense of accomplishment and satisfaction and you have put burnout on the back burner!

*Spoiler alert: This article was created with a surgeon’s schedule but could have easily been adapted to any practicing physician.

I acknowledge that this is an idealized version of what might occur in a surgeon's practice and would put doctors back in control and reduce the stress and potential burnout. Every day won’t be perfect but if you focus on giving patients a positive experience and respecting their time, we just might have that idealized day that we all dreamed about and as a result, we can put burnout to bed.

If I had to select one element that would contribute to this ideal medical practice, it would be making an effort to seeing patients on time.

As a physician, we have been given a pass and not been penalized for not being on time. We have excuses such as “tied up” in the operating room, seeing a patient in the ER, and an emergency occurred in the office. But let’s be honest, we have the ability to have greater respect for patients’ time. Making patients wait sends the message that the doctor's time is more important than patients’ time. If you’ve worked in the healthcare field for quite a while, you’ve probably heard the term “healthcare consumerism.” While the term encompasses many different things, the big idea is that patients expect their healthcare experience to be more like a customer service experience such as they experience at the dentist, the eye doctor, and even the hairdresser!

An egregious example: Patients are waiting in the reception area and a pharmaceutical representative enters and walks up to the receptionist and hands over his business card. The representative sits down for less than a minute and is ushered into the inner sanctum of the office. What message are you telegraphing to your patients who have been waiting for more than thirty minutes to see the doctor? It is a negative message that may result in patients canceling their appointment and seeing another surgeon. This problem can be easily solved by making appointments for the pharmaceutical representative which does not conflict with the scheduled time you are seeing patients.

This retail mindset means patients are no longer willing to put up with long wait times at the doctor’s office—just as they wouldn’t wait for a half-hour for the accountant, stockbroker, or even to buy tickets to a movie.

Reasons for shifting patient attitudes

The truth is that patients have never enjoyed long wait times in the physician’s office. For decades, patients simply accepted it as the norm. While some offices have always attempted to streamline processes, we all know that practices and hospitals have a reputation for scheduling appointments that rarely begin on time.

So, what’s different now? Patients have become empowered to take control of the situation. They know that there are other options out there. Now patients are deciding to choose another doctor's office. Also, with just a few clicks, they can go online and rate their experience and as a result, other patients may not decide to call for an appointment if you have a reputation for making patients wait an excessive amount of time.

Wouldn’t it be great if a doctor or hospital’s reputation was based solely on their professional merits? Of course, you strive to provide the best level of healthcare you can. But in this day and age, that’s not enough to earn a strong patient referral.

And patient referrals are not just limited to someone’s family and friends.Healthcare facilities with long wait times tend to receive poorer reviews than those with shorter waits. The highest reviewed practices had average wait times of 13 minutes or less, while those receiving low ratings had wait times greater than 34 minutes.

Bottom line: We entered the medical profession to treat patients and not paper (EMRs). The grueling process to become a doctor becomes worth it when a doctor can improve the quality of life for another human being. Please let me hear your thoughts about how you have reached or tried to reach your ideal day.