Four strategies to build a hassle-free practice

Physicians can implement these workflow strategies at their practices to put the focus back on patient care and to better delegate care functions to clinical staff.


Physicians are beset by challenges that take their attention away from patient care.

But physicians can implement workflow strategies at their practice that put the focus back on patient care, better delegate care functions to clinical staff, and ensure physicians work at the top of their license, said Frederick E. Turton, MD, MBA, MACP, an internal medicine physician with Emory Healthcare, who spoke at the American College of Physicians (ACP) 2014 conference in Orlando, Florida. “Hassles will always be with us. We can manage hassles by managing our time,” Turton said.

These strategies can help practices reduce hassles:

1. Define workflows

Every clinical and non-clinical staff member should have well-defined roles in the workflow, Turton said. This allows the physician to devise protocols that staff members should adhere to. “This is about taking decision-making out of doctor’s hands, and placing it in the hands of a protocol,” Turton said.

2. Avoid batching

Turton defined “batching” as all of the things that need to get done that get stacked and put off until later: Unfinished charting, unanswered messages, lab values, imaging results, mail, the phone queue, and appointment queue. “When you stack something you reduce quality and increase the costs,” Turton said.

3. Delegate to your team

Delegation is about ensuring that the physician can work at the top of their license. Turton said it’s about “allowing the least trained-but still qualified-person do the work.”

There are a few ways to do this. First, practices should have a prescription refill protocol, under which refill inquiries are routed to a certified staff member and most refills are authorized without the physician.

Second, Turton said his practice in Atlanta, Georgia, improved adherence to diabetes markers by having medical assistants (MAs) conduct the basic interview with the patients and perform A1c tests and foot exams based on a protocol designed by the physician. That has allowed the practice to improve greatly on hitting its diabetes markers, Turton said.

4. Prepare now for ICD-10

The switch to the International Classification of Diseases-10th Revision (ICD-10) has been delayed, but start getting ready now to avoid problems later, said Robert Gluckman, MD, FACP, chief medical officer of Providence Health Plans and ACP treasurer. Not being ready when the transition occurs means not being paid for the care you provide.

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