1.  The telephone is an optional life support device.
Identify when you will be available to return calls and keep to that schedule. Teach your receptionist to say, "That sounds like a case the doctor needs to see. Please come in right away and we will admit your pet into our emergency day care program.", or, "Dr. _____ reserves from 1:00 to 2:00 p.m. every day for returning client calls. What number can she/he reach you at during that time?"

2.  All choices have consequences, regardless of which one is selected.
List and prioritize your weekly activities into three categories:

a.  Must do: Those critical items, client requirements, deadlines, key to success, or advancement opportunities.

b.  Should do: Those of medium value, improvement of performance, not essential to survival.

c.  Nice to do: Those that are interesting, fun, and personally rewarding, but easily postponed, rescheduled, or eliminated.
When you look at the consequences, today's "B" may be tomorrow's "A," and today's "A" may become tomorrow's "C" if the deadline passes.

3.  Most crisis situations can be renegotiated.
Deadlines are generally human-made and arbitrary, based on agreements made before the disasters set into the daily schedule. Resources can be reallocated to reduce impact. Substitutes are available, to include colleagues
Most important, you may be able to narrow the scope of the demand, meet the critical element(s), and/or provide alternatives for the balance of the situation that do not require immediate reaction.

4.  Mail, like telephone calls, won't go away, but can be managed.
All unsolicited mail should be opened by staff members and placed into at least two piles: "information only" and "action." Good staff members will ensure the "lost cause" pile is eliminated before anyone else has to touch the two piles. They will also route the elements that require staff input before the boss has to read it. Information-only mail should never be read when the practice is operating. It is not that important.

5.  A place for everything and everything in its place.
Each key management team member needs at least five categories in his/her personal file drawer (this includes the boss):

a.  Ideas: Things to investigate further at a later date, usually to improve the operations.

b.  Projects: Details about ongoing projects, kept individually by project.

c.  Instant Tasks: Little jobs that need doing, when you have a few minutes.

d.  Self-development: Folders in this area include training, books, articles, etc.

e.  Background Information: Separate folders by topic for later reference, including statistics, trends, examples, quotations.
Hint: Color coding these major categories would be helpful to most, as would a monthly screening time to ensure folders are kept current.
Necessity: Each staff member needs a personal mailbox or accessible storage space for personal things, as well as practice distribution.

6.  Frequently ask, "What is the best use of my time right now?"
The inability to say "NO" is the major cause of doing the wrong thing at the wrong time. Learn alternatives to saying "NO" that fit into your life style, such as:

a.  "I can take care of that right now, but what I'm doing right now will be delayed. Is your request that important?" OR

b.  "I'm sorry I don't have the time right now. May I call you when my schedule clears?" OR

c.  "I'll be happy to do that, but with the rest of the jobs I'm doing, I won't be able to get back to you until...." OR

d.  "I appreciate you asking me, but I am over committed. Have you considered asking _____?"
Hint: When procrastination occurs, because of boring, difficult, and unpleasant activities, consider a proactive training and delegation program for someone on the staff.

7.  Do it!
Keep a daily time log for a typical two-week period, whatever "typical" is. Record activities by ten-minute intervals. Be specific. Identify who visited and record duration and topics of conversation. Be honest, you are the only person who accesses this information. Write a brief comment after each activity, to include the impact of interruptions and importance to your personal schedule. At the end of each day, summarize your feelings about the day in general: typical, busier, slower. Add the time, by day, in each category or major activity and show totals. At the end of the two weeks, identify those activities that can be delegated and train people to do them effectively.

Tests of Time

The above time log will provide some of the answers, but you need to ask the right questions first. There are four "test questions" that seem useful when assessing any time log information:

The test of necessity: Was the activity necessary for the person, for the practice, for success? How will the results be used tomorrow?

The test of appropriateness: Did the right person have enough authority to do the right job in a competent manner? Was someone working below or above his/her appropriate skill level?

The test of efficiency: For the tasks remaining, are you doing what is most effective for the practice? Is there a better way, a person with more aptitude or interest, or is there a technology replacement that will allow the veterinarian or staff to touch more clients or patients?

The test of continuous quality improvement: The continuous need to empower every person to improve his/her work environment, his/her client service, or his/her personal pride in performance must override the "tradition" of habits. Because it was a good system yesterday does not always mean it needs to be maintained for tomorrow!

Grading The Tests

After evaluating the seven principles and applying the above tests, there are only three ways to make better use of the available time. In any given period of your life, you can only:

 Discontinue low priority tasks or activities.

 Find someone else to take some of your work.

 Be more efficient at what you do.

Time, like money, goes further when we have less of it. It is the busy person who finds additional time to pursue excellence. In the final evaluation, remember the words of Mae West, "He who hesitates is last!"

The Final Words on Systems and Schedules

The day is controlled by planning, and every Plan A requires a Plan B. The phrase we like to use is "ARF"(absolute rigid flexibility!)

Some practices develop a market niche by offering "walk-ins welcomed anytime" and adapt the dual room schedule concept to walk-in and drop-off traffic. Others mix the appointments with a walk-in service to meet both demands. The secret is to know your community and establish the target market you want to serve before making the major system or scheduling change decisions. Test any plan for fit, and in the case of high-density scheduling, that means the outpatient doctor, nurse, and receptionist team work the high-density schedule for four straight-hours, then come off-line, sit down in a quiet spot, and evaluate the results with the practice manager as mediator. The two key evaluation questions for this triad are "What went right that we want to continue?" and "What do we need to change and/or improve to make it work better next time?

Leveraging the doctor's time by empowering the practice staff sounds like a trite phrase, unless zoning of the hospital is really a commitment to the nursing and client relations staff that they will be trusted to stay client-centered. The doctor-centered veterinary practice must give way to the patient advocates on the staff, and allow them to stay client-centered. When doctors "line out (block off)" valuable schedule time on the appointment log as non-available, they are being self-centered, which is worse than doctor-centered. These systems will not work with a doctor who demands to be treated as a prima donna, or who wants to be the center-stage star, which is usually only in his/her own mind. It requires a professional staff who accepts that the most two important assets in any veterinary practice are: 1) the staff, and 2) the clients. Protect the most important practice assets, every day, in every way: nurture your staff, remain client-centered, and always be caring patient advocates!