Secrets To Stress Relief In A Busy Practice

By Kristin K. Titko, DPM

If there is one thing that I have learned in the past eight years that I did not know in my first six years of practice, it is this: work does not have to be full tilt stress. In the past two years, I have nearly perfected this motto. While I am certain there is still room for improvement, I would like to share some of the changes that allow me to maintain my level of desired profit while minimizing the stress along the way.

Let me first warn you that some of what I want to share may be controversial. Some ideas stray far from the commonly accepted ideas of many specialists. They may not all pertain to you. They may not all pertain to your office but I encourage you to read the following with an open mind.

During the first six years of practice, my daily routine was to wake before sunrise, eat a granola bar for breakfast, work through most of lunch and often scarf down half of a fast food burger and a couple of French fries. I would get home from work too tired to eat. For dinner, I would eat a pint of ice cream — an entire pint every weekday for dinner and nothing else.

At the age of 31, I looked healthy enough from the outside but one evening I came home from work, walked up one flight of stairs and was breathing so hard I could not catch my breath. I stopped right then and there. I called a friend of mine who knew something about fitness and began a physical fitness program.

Since then, I work out regularly, watch my diet carefully and drink plenty of water. The change this has made for my daily stress levels cannot be overstated. I believe that a healthy diet and regular exercise can help your mind and your body tolerate more of what your day gives you.

In keeping with a healthier lifestyle, I have also come to learn that making time for vacations will decrease stress levels and increase profitability. I have learned to arrange my schedule in a way that works for me and allows for frequent vacations. It never fails that upon returning to the office after a few days away, I am refreshed, revived and more relaxed. This allows me to return to the office with a clear head, a bigger smile, more patience with my patients and more friendliness for my staff. When these factors are present, one can expect efficiency to increase (thus increasing profitability) and patient compliance to increase (thus decreasing patient-induced stresses).

Knowing Staff Capabilities: Keys To Streamlining Your Office Environment
In a profession in which staff turnover is usually high, the staff whom I have working with me are crucial to facilitating office efficiency and less stress for me. During my first two years in practice, I went through more medical assistants than a graduating class size of a typical medical dental assistant school. Only in retrospect can I truly see how stressful that was on me and my practice.

Now that I have a staff of people whom I consider to be some of the best medical assistants in the world, I remember daily to thank them, guide them gently, praise them openly and treat them fairly. The working relationship I have with all of them is one of mutual respect and this shows throughout our days at work. Patients can sense this teamwork. This easygoing, lighthearted, professional aura helps put patients at ease and eliminates many potential stressful situations.

My staff assists me with answering many of the patients’ questions (only after I have directed them with proper information). They assist patients in the treatment rooms with their shoes, their personal belongings and many of their fears and concerns.

My electronic medical records system allows my assistants to enter some information into the computerized chart note while I am in the treatment room rendering care so much of the note is completed before the patient leaves the room. This cuts down on the amount of time I spend charting. All I have to do is check the chart for accuracy, add my exam information, add a few extra points and the note is done. This means you do not have to spend time on charts after hours. That alone is the epitome of simplicity and efficiency that makes my office less stressful and more profitable for me.

Should You Decrease Your Patient Load?
I believe that my residency offered some of the best training available for its time. I love to do surgery. I used to live to do surgery. Now my life is geared toward less stress for me and less stress for me means less surgery. I used to do hospital surgery five days a week and often on Saturdays.

Now I do surgery one-half day a week. I refer many of my patients to one of my younger, more aggressive, more eager associates for surgery when surgery is indicated. I have found success in using conservative therapies to address many conditions, conditions that could only be handled surgically according to my training. This not only cuts down on late night/early morning phone calls but also on my scheduled “post-op visits.” These newly available time slots are now open for more profitable visits.

New patients of course can be some of the most profitable for any specialist. I receive more calls from potential new patients (by way of patient and physician referrals, public speaking engagements, etc.) than my schedule has been able to accommodate well for years. When a potential patient calls, you should see the patient that same day. In order to create more time for new patients without overbooking my schedule (which is what I had been doing for years), I needed to open more time on my books.

I hired a podiatrist who was looking for more work to do. I have transferred all of my routine foot care to her with the understanding that if the patient develops a different problem, she sends the patient back to me to address that problem while she continues the patient’s routine care. Patients love the extra time she spends with them and they appreciate knowing that I have not “kicked them out of my practice” and that I am right here for them if they need me again. This has allowed me to increase my profitability without having to work longer hours.

Getting The Most Out Of Ancillary Referrals
We all struggle with new ways to make a profit. There is nothing wrong with wanting to make a better financial living. Many of us are offering physical therapy, vascular testing, DME dispensing, nerve conduction studies, etc., in our practices. I see nothing wrong with this. In fact, these are likely great ideas and I am missing a big boat.

However, I see many of the new ideas as increased stressors: more office space, more staff, more costs, more billing issues, more insurance auditing opportunities, etc. I enjoy the many reciprocal relationships with vascular doctors, neurologists, physical therapists, orthotists, etc. If I can keep things simpler in my office, my efficiency increases, my stress decreases and my profitability continues to increase. That for me is the equation that currently keeps my life more balanced.

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