Open all hours

Credit: © iStockphoto/Thinkstock

Today running a dental practice is a time consuming process. There are increasing demands placed upon the principal and team coming from all directions. We have a constantly evolving Care Quality Commission (CQC), HTM 01-05 and practice inspections for those who hold an NHS contract. This, combined with a busy home life in an age of always being available via mobile phone, email or social networks, can quickly become overwhelming.

I can personally attest to this, recently balancing managing a practice with coping with an ever-increasing workload at The Dental VA where I am responsible for CQC compliance and management systems. Having robust systems in place are essential for the smooth running of any business, but for me another factor was thrown into the mix: having a baby. The demands of a newborn combined with chronic sleep deprivation caused me to visit some time management principles to enable the smooth running of the business whilst freeing the maximum time for home life without those niggling thoughts such as 'did x turn off the compressor Friday night?'.

It is of course a misnomer to suppose we can manage time; it is ourselves we must manage. We all have 24 hours a day to get through that ever-expanding list we carry in our head - or for those of us organised enough, on a piece of paper ... these days the smart phone works best for me. In this modern age of PDAs, high powered computers with sophisticated software and smart phones you would expect all organisation and planning to be easy. This has not proven to be the case; in fact, it would seem things have become harder to manage. A major factor in this is that technology, rather than freeing us, has made us potentially available '24/7'.

There are a number of suggested methods for time management and much like dentistry itself it is seldom 'one size fits all'. It may be that one system works for you better than another or that some form of hybrid solution is best.

Eat a frog

One system many people use is a simple list of jobs which we work through during the day. The danger with this is there is a tendency to put off the jobs we dread doing and busily cross off the other tasks which are of little real importance. Brian Tracy wrote a book entitled Eat that frog - playing on the Mark Twain quote: 'Eat a live frog every morning, and nothing worse will happen to you the rest of the day'.

We all would rather book the Christmas party venue than phone the irate patient and deal with his complaint. So by 'eating the frog' or in this case making the difficult call, the most important thing on the list is done whilst removing the feeling of dread, making the day more productive and enjoyable. Peter Turla said: 'If a consequence of doing nothing is nothing - then do nothing'.

Work by consequence

So what are the most important tasks? Sometimes this is obvious but often it isn't. One helpful thought process is work by consequence. What would be the biggest consequence of doing or not doing something in a timely manner? Once you have prioritised the tasks you can allocate 'A' for most important 'B' for the next and so on. The Pareto principle, also known as the 80:20 rule, suggests 80% of your tasks will be done in 20% of your time and perhaps more relevantly 80% of your productivity will come from 20% of your activity. Of course these percentages are not written in stone but it does emphasise the need to accurately prioritise.

'Do not confuse motion and progress. A rocking horse keeps moving but doesn't make any progress.' - Alfred A. Montapert

The demands of a newborn combined with chronic sleep deprivation caused me to visit some time management principles to enable the smooth running of the business.

What's important may still seem a little vague and Stephen Covey suggests another method in order to prioritise in his book The seven habits of highly effective people. Covey suggests dividing tasks as important/unimportant and urgent/non-urgent. Even American President Eisenhower is said to have used this method, being quoted as saying: 'What is important is seldom urgent and what is urgent is seldom important' (Table 1).

Table 1 Prioritising tasks
Full size table

The suggestion is that you spend as much time in quadrant two as possible. This involves planning, looking after your long term mental, physical and spiritual health and building relationships with friends and family. Some time inevitably will be spent in Quadrant 1, but with planning in Quadrant 2 there should be less crisis in Quadrant 1. Again some interruptions will be made to your working day and put you in Quadrant 3 so protecting this time and not allowing yourself to become distracted is important. Quadrant 4 is things that steal time from being productive. Again it is too simplistic to suggest never spending any time in this quadrant - watching Homeland the mini-series is neither important nor urgent but it is your downtime. It is when you are spending too much time in Quadrant 4 at the expense of more important things that it becomes an issue.

It is not just at work we need to focus on what is important; home life can easily take a back seat to work. We all have a finite amount of time and being efficient at work can mean finishing at lunch time and going home on time. Glen Du-Pont from the Dawson Centre for advanced dental studies suggests 'If it is important schedule it'. This can mean scheduling family time so that time is protected and is not lost to something trivial.

'I am too busy mopping the floor to turn off the tap.' - Author unknown

Monitoring systems

Weekly meetings are also useful but only if started with a clear agenda and finished with a list of what was decided and who is doing what by when.

I find systems are important and once set up just need to be monitored. For example: dental recalls need to be done every month. Set a reminder on your phone, diary or software management system. Recalls are only really effective if they are followed up, for instance two weeks later, to see how many of the patients contacted in month x have actually booked their appointment. I personally do send out a second reminder in that same month for the patients who haven't yet contacted us.

When I started at my practice there were pages and pages of patients with outstanding treatment plans. I've set up a system to contact all patients with an outstanding treatment plan once a month. By following that system we have only a few outstanding treatment plans a month and we now have a full diary, happy patients and a reduced number of emergency appointments.

Weekly meetings are also useful but only if started with a clear agenda and finished with a list of what was decided and who is doing what by when. At these meetings work can be delegated; we all have our strengths and there is nothing wrong with the appropriate delegation of tasks to team members.

There is no one definitive solution to time (or self) management. Most of us feel we have too little time to do everything we need to do. In much the same way a log of spending helps identify where you are wasting money, a time log can show where you are wasting a lot of time. Like a diet analysis sheet the patient fills out it is only of use if honest and accurate. Once you can see where you are wasting time you can steal this time for more productive and enjoyable things. After all, time is the most valuable commodity we have.boxed-text