Ophthalmologists, like many other physicians, are increasingly facing burnout. This trend is particularly evident among those completing residency and fellowship programs, who often seek different practice environments and better work-life balance.
The goal is to work smarter, not harder—and that requires a commitment to efficiency and embracing change. Accepting the need for incremental improvements can boost productivity and reduce burnout. Revisiting tried-and-true methods, along with thinking both inside and outside the box, can make a significant difference.
Start Clinic on Time
The top rule of efficiency is to start on time. This may seem obvious, but if you struggle to stay on schedule and feel burnt out by the end of the day, make it a habit to arrive at the clinic early and be prepared to start on time.
Your staff will be ready when you are, as you set the expectations. If you want to stay on schedule and reduce your daily stress, ensure that you are not causing delays. Have your office manager or technicians log your arrival times, recording any days you are late and the reasons for it. Just as you expect your staff to be punctual, you should hold yourself accountable, too: Your patient schedule will suffer if you are consistently late.
Minimize Rescheduling
It’s essential to minimize patient rescheduling to keep your schedule running smoothly. Frequent changes can frustrate patients and erode their trust in your clinic’s reliability. Additionally, rescheduling places an extra burden on your staff, detracting from their ability to perform other tasks.
In my operational assessments of eyecare clinics, I often find that physicians frequently reschedule—sometimes even at the last minute—and may require patients to reschedule 2 to 3 times. While some conflicts, such as illness, are unavoidable, it is important to work with your family and practice leadership to ensure that your schedules are blocked off well in advance.
Proactive planning, such as anticipating potential conflicts and communicating necessary changes early, can minimize the need for rescheduling. Encouraging a culture of commitment to scheduled appointments among all staff members, supported by clear policies and expectations, will further enhance your clinic’s efficiency.
Create an Effective Support Team
Building an effective team around you is crucial for optimizing your practice. Partnering with “physician extenders” like optometrists (ODs), physician assistants (PAs), technicians, scribes, and surgical counselors can enhance your clinic’s efficiency and patient care.
I once mentioned to an ophthalmic CEO that I would have my team investigate something for me, and he laughed, saying, “Your team? That would be nice!” Many physicians may not realize the importance of creating effective teams around them, and that’s the problem. You cannot do this alone.
Examine your provider schedules to ensure that patients are assigned to the appropriate specialists. For instance, a patient with mild-to-moderate dry eye symptoms who is referred to a cornea specialist may be better served by a general MD or an OD who performs dry eye evaluations.
By leveraging your team’s skills and expertise, you can ensure patients receive the most appropriate care while optimizing your clinic’s workflow and reducing the burden on individual providers.
Leverage the Scribe Position
To improve both efficiency and patient care, make the most of your scribes. They can be invaluable in several key areas. First, have your scribe document patient conversations by following your dictation, creating a comprehensive record of each visit and treatment plan. Ensure your scribe is trained in coding examinations to maintain accurate medical records and capture all necessary information for billing and insurance purposes.
Your scribe should keep pace with you, arriving promptly in the exam room to document slit lamp and fundus examinations accurately. The scribe can also assist in patient education, reinforcing your advice and ensuring patients understand their treatment plans. It’s crucial for your scribe to enter the next exam room with you to hear the entire examination and document it accurately, reducing the risk of errors.
Additionally, many electronic health records (EHR) companies are developing virtual scribe technology, which can greatly assist with documenting patient visits (see “AI in Ophthalmology,” p. 7). AI scribing may allow you to reduce the number of employees needed in your clinic or allow your staff to focus on other administrative tasks, such as prescription refills and writing professional letters to referring doctors.
Align Tech Protocols for Cross-Training
To boost your clinic’s efficiency and flexibility, doctors within each specialty must align their protocols. Standardized protocols ensure consistent patient care and make technician training less complicated. When everyone follows the same procedures, it’s easier to cross-train staff, allowing them to adapt to different doctors’ preferences and cover absences more effectively. Consistent protocols also help ensure high-quality patient care, regardless of the doctor or technician involved. This consistency helps build patient trust and satisfaction.
Encouraging collaboration and communication among doctors to develop these protocols fosters a cohesive and supportive work environment while reducing physician burnout. When your clinic runs smoothly with aligned protocols, it minimizes the chaos and stress, leading to a more satisfying and less exhausting workday.
Fully Stock Exam Rooms
Another effective strategy to increase efficiency is ensuring all exam rooms are fully stocked with the necessary equipment and supplies. Technicians often spend 4 to 6 minutes retrieving items. While this might not seem like much, it adds up quickly when it happens 2 to 3 times a day. By fully stocking your exam rooms, you can save approximately 2,500 minutes per year per technician in unproductive time. Developing a system where staff ensure everything is in place can significantly improve productivity and prevent frustrating delays in patient care.
Invest in Equipment
The right equipment can simplify your workflow. One impactful strategy is to add a second monitor to each exam room (or even a large screen TV on the wall) to display scans while keeping the EHR on the computer screen for your scribe to take notes. Physicians often wait 10 to 30 seconds for patient scans to open. While collaborating with IT vendors is crucial to minimizing network delays, installing a second, large-screen monitor allows the scribe to access the tests quickly. This setup lets you view and show the scan to the patient without delays or interrupting the scribe’s workflow. This small change can save between 2.5 and 8.5 hours per year, allowing you to use that time more effectively. Given its potential to enhance efficiency, investing in 24-inch monitors that cost a few hundred dollars each is a worthwhile strategy.
Invest in Training
Effective employee training is transformative for reducing burnout and simplifying your responsibilities. Hiring an outside expert for training can significantly enhance efficiency and accountability. This expert can certify your technicians in essential skills, ensuring everyone is well-trained and capable. Although there is an initial cost (see sidebar, “Return on Investment for Technician Training”), ongoing and reliable education is invaluable. Regular training for technicians, along with continued leadership training for clinical managers, keeps your team energized and prepared to assist you.
Key areas to focus on include training technicians to take a thorough patient history and perform refractometry appropriately. Educating staff on when to carry out specific tests can also speed up assessments. Investing in comprehensive training creates a more efficient, patient-centered environment that benefits you and your patients.
Track Clinical KPIs
To maximize workflows without feeling overwhelmed, focus on a few key metrics. For physicians aiming to enhance efficiency and reduce burnout, I recommend tracking total collections per FTE provider, total number of doctor days, encounters per FTE provider, and net collections per visit. These straightforward metrics provide a clear perspective on your clinic’s efficiency.
Review your numbers from the past year and set goals for the next 12 months. Comparing your performance to industry benchmarks can also offer valuable insights. By concentrating on these specific metrics, you can quickly identify areas for improvement, enhancing overall efficiency. This targeted approach streamlines goal-setting and accountability each month, making your life easier and your practice more effective.
Bringing It All Together
Addressing burnout and enhancing efficiency in your ophthalmology practice requires a multifaceted approach. By implementing the strategies I’ve discussed here, you can work smarter, not harder—ultimately enhancing both your professional satisfaction and your patient care. OM
