The Dysfunctional Medical Practice – Part V of a Five Part Series

This is the last installment in our five-part series about the Dysfunctional Medical Practice. So far, we’ve seen that chaos can reign when there is lack of leadership, when office processes break down or are nonexistent, and when people are allowed to develop habits that impede smooth operations. The process of effecting change in a challenged environment requires buy-in from all the constituents (in this case, even the physician’s family) and the change must be led by a skilled and objective expert.

Our tardy, chatty, disorganized physician client didn’t change overnight, but he realized that his behaviors were the lynchpin to the problems. One issue that exacerbated the chaos was his tardiness in reviewing documents. Because he required charts to be pulled for all documents, he became overwhelmed when he couldn’t find his desk or credenza, and had to navigate through carts, piled high with work. Some short-term solutions included distinguishing between routine, maintenance meds and other prescriptions, foregoing charts on routine results (screened by a trained individual), enlisting the assistance of the practice-extender (PA or ARNP), and creating bite-size pockets of work to sign.

When last we saw this client, his office was a better-oiled machine. He experienced more satisfaction with his work, and was able to spend more quality time with his family; staff tenure increased, as did morale, due to organization which led to a normal work-day and less stress; patients experienced greater satisfaction as they re-established trust in their clinician, felt cared for and valued; and finally, quality of care improved.

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