A lazy person works twice as hard
The old Scottish saying, “a lazy person works twice as hard” seems counter-intuitive, yet I’ve found it repeatedly true in my practice.
How many problems have an easy solution which, when done up front with a little bit of work, can save countless hours in the future? Often what holds us back from taking the initiative is time pressure - the feeling that we are already so busy, it wouldn’t be possible to invest the time to improve our processes.
The fallacy here, however, lies in the fact that part of what keeps us so strapped for time is the poverty of our processes themselves.
As James Clear illustrates in his book, Atomic Habits, “you not rise to the level of your goals; you fall to the level of your systems.” To promote more efficient patient care and clinic flow, we must set ourselves up for success by optimizing the steps required to progress through each patient visit. One important method to consider is creating a system for any work you do repeatedly, especially when a shortcut already exists.
For years, I have searched orders of ophthalmic medications I prescribe every day in the order tab in Epic, selecting the desired medication and manually inputting the eye laterality, frequency, and number of refills. Throughout the duration of my time in practice, I have known that I can favorite orders with these specifications preset for much quicker ordering from a personalized order set, but the task felt daunting.
Similarly, I type out the drop name and administration instructions for the medications I prescribe in the after visit summary to assure patient understanding and promote accurate compliance with the prescribed treatment plan. While I have a few saved dot phrases that include regimens I use, there are many medications I prescribe regularly where I type out the medication name, bottle cap color, and dosing instructions repeatedly throughout the week.
Albert Einstein famously remarked that “insanity is doing the same thing over and over and expecting different results.” In the world of efficiency, I would argue that insanity is also doing the same thing over and over when a faster way exists.
Although I had imagined that building these systems of medication order favorites and treatment instruction dot phrases would be a costly investment of time, it took less than an hour to create both for the most common twenty or so medications I prescribe. Even if it only saves a few minutes per clinic day, that investment would be repaid in full within a month’s time. Moreover, any time during the encounter spent looking at the screen, typing less, and interacting with the patient more fosters our physician-patient relationship, lessens our perceived burden of documentation, and allows us to move more quickly from patient to patient, keeping our clinics following.
Dan Martell, author of Buy Back Your Time, argues that “if you find yourself doing something more than twice, create a system for it.” In clinical practice, these systems range from electronic medical record shortcuts like favorite order presets and dot phrases, to workup and testing algorithms for patients based on their chief complaint, and organized pre- and post-operative instructions for surgical patients. Not only does systemizing these processes save time, it increases the likelihood that patients and staff are on the same page as the physician, and can allow for offloading tasks from the physician to supporting staff who can follow a clearly delineated protocol.
What work are you repeating over and over throughout your clinic week that could benefit from a systemized shortcut?
Although taking the time to build in systems takes initiative, the lazy path leads to doing the work twice (and in many cases, much more often than that).