Seven Habits for Reducing Work After Clinic

Sumana Reddy, MD; FAAFP, Peter Rippey, MD, CAQSM; Arnold Cuenca, DO, CAQSM, FAAFP; Sumi Sexton, MD; Troy Fiesinger, MD, FAAFP; Kenneth G. Adler, MD, MMM; Brandi White


Fam Pract Manag. 2019;26(3):10-16. 

In This Article

Help Each Other

Having too much work after clinic is often a sign of a system or process problem, or perhaps even a workload problem (see "A word about panel size"). But sometimes, it is a sign of a struggling physician who needs help. For example, let's say there are four physicians in a clinic, each with roughly the same number and same mix of patients. One physician is habitually struggling with work after clinic and is behind on charting while the other physicians are generally on top of this work. The physician's lateness is problematic for the practice because it can affect billing and reimbursement as well as create liability issues if the physician can't remember details when documenting many days after the visit.

If you see a physician struggling (or if this physician is you), the best approach involves empathy, mentoring, and accountability. The practice may need to set standards for when charts are expected to be closed – and enforce those standards. At the same time, a manager or colleague should work with the physician to figure out what's going on, what his or her barriers are, and how to get back on track. Maybe the physician needs to have some time blocked out on the schedule to catch up on charting. Maybe the physician needs some EHR training or an MA to help with in-room documentation. Or maybe the physician just needs some coaching because he or she is trying to do too much in the exam room (for example, trying to address everything on the patient's agenda, over-documenting, and not delegating tasks such as patient education). The barriers and solutions are going to be personal because we are all programmed differently, but most physicians will need some help figuring things out. Don't let a colleague struggle alone, and don't make the mistake of simply applying more pressure on an already pressured physician. There are a lot of good physicians who just need a nudge and some objective help to get past their barriers to better performance.