Medical Staff

Getting Realistic About Time Management

Medical Staff Affairs Monthly, January 20, 2006

Dear Colleague,

I hope your New Year is off to a great start! Many of us have tucked away among our New Year resolutions a determination to manage our time more effectively in the months ahead. I was therefore partly relieved to read in an article several weeks ago that I'm not alone in promising myself that I will have more available time in the future than I have had in the past. According to a number of studies recently published in the Journal of Experimental Psychology, people invariably predict that they will have more spare time on the same day next week, or next month, than they had on that day.

Indeed, when asked to estimate how much time and money they will have in the future, they consistently overestimate their time rather than their dollars. One consequence is that people are often willing to volunteer future time for tasks which may seem relatively trivial or less important than truly critical tasks which must be accomplished. To quote one article, "This psychological quirk seems to guarantee that people will always be pressed for time, willing to take on tasks not because they regard them as valuable, but just because the promised execution is far enough in the future."

This tendency can be particularly pernicious when manifest among those who volunteer to do medical staff work. Few new medical staff leaders really appreciate the demands this work will make on their time. Yet a failure to give adequate attention to the challenging problems plaguing hospital-physician relations can only result in additional future grief.

There are several tactics for addressing this human tendency. One is to have very clear job descriptions for each medical leadership role which includes an articulation of expected time commitments necessary to perform the job adequately. Another tactic is the use of an experienced mentor at the beginning of a new leader's term. Such experienced physicians can provide guidance around time management and realistic insight into the time commitment that will be required by the new leader. If the leader is receiving a hospital stipend, then it is important that time sheets be kept documenting the hours spent on medical staff work. These should be reviewed periodically to see if the time devoted is becoming unrealistic for a practicing physician.

Last month the government announced that healthcare spending now consumes 16% of the GDP. This percentage has been growing inexorably for decades. So has the time it takes to manage ever more complex physician-hospital affairs. If your hospital does not yet have a Vice President of Medical Affairs, it is time to consider one. Volunteer community physicians simply can't devote the necessary time that will be needed in the future to solve healthcare's pressing concerns. Many institutions put a toe in this water by employing an interim VPMA to pave the way for a more permanent hire.

We have had great success placing expert physician executives in such circumstances. These are individuals who can devote the time to bring hospitals and physicians together. There is no more important task as the healthcare world continues to change unrelentingly. And a good VPMA can not only give necessary time, but can also speak the critical language of medical professionals.

Many times administrators can't bridge the gulf between themselves and their medical staff because they don't make a sincere effort to understand physician concerns. These hospital managers remind me of Mark Twain's attitude when he said "In Paris they simply stared when I spoke to them in French; I never did succeed in making those idiots understand their language."

As we forge ahead to face the challenges of 2006, let's all be realistic about what we can achieve with our own time and with the time of others. If we do, we just might find greater success in achieving our goals.

Best Regards,

Todd Sagin, MD, JD
Vice President and Medical Director
The Greeley Company

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