All day, technology dings and beeps, phones buzz, staff members need just a moment of your time, and personal issues linger in the back of your mind. With all of the interruptions and potential distractions that occur throughout a day, how do rheumatologists stay focused on patient encounters and work responsibilities?
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“Arriving at work early to address any outstanding messages or overnight concerns helps me start the day ahead of things,” says Margaret Tsai, MD, rheumatologist, Cleveland Clinic Foundation, Lorain, Ohio. “Then, when patients arrive, I can fully focus on them.”
Dr. Tsai’s office staff takes and triages all of her messages, eliminating the constant flow of messages that may interrupt patient visits. She has educated staff on the appropriate levels of urgency for patient concerns, which helps them notify her appropriately via text, phone or email.
For urgent and time-sensitive issues, such as a patient being sent to the emergency department or needing to be seen immediately or another provider calling, staff will knock on the exam room door or send her a text message. “The office staff assists me in addressing urgent patient issues in between patient office visits,” she says.
For less urgent matters, such as requests for medication refills and medication questions, staff members email her.
Elena Schiopu, MD, associate professor, University of Michigan, Ann Arbor, says it’s important to keep her smartphone in her pocket on silent. As a mother of three young children, she doesn’t want to miss a call from her children’s school about illness or injury. “To make sure I don’t miss a message, I’ll briefly look at [my phone] when the patient moves from the chair to the table, while also observing the patient’s movement pattern,” she says. “I have to look at my pager when it beeps, so I don’t miss a patient emergency.” Whenever an interruption occurs, she apologizes to the patient and tries to resume the interaction with the patient as quickly as possible.
Other disruptions may occur when personal issues mentally distract you.
“When I’m going through a difficult time, I’ll briefly stop in front of the patient exam room door before entering, take a big breath in and force my face into a wide smile to uplift my spirits,” Dr. Schiopu says. Maintaining this positive attitude during patient encounters helps sharpen her focus.
“It is a conscious effort. When a patient asks about my family, I’ll smile and say, ‘Thank you for asking. Everyone is doing great’—even if that’s not the case. Divulging details about a family issue is a slippery slope and [may] take time away from the patient’s time. Therefore, I turn the conversation back to them.”
Dr. Tsai says having supportive family and friends is key to providing the best care possible to her patients. “Sharing and relaxing with family and friends ease stress,” she says. “Having this support outside work also helps prevent burnout.”
Dr. Schiopu identifies several strategies that help her maintain peak performance levels. “Getting a good night’s sleep is very important, as is staying well hydrated and having a healthy snack in between seeing patients,” Dr. Schiopu says. “I always wear comfortable shoes, [because] I run around quite a bit.”
“Maintaining a healthy diet and regular sleep routine are non-negotiable,” Dr. Tsai says. She adds that quality time with family and friends has been critical in helping her recharge for work. “Scheduling weekly fun time, such as kayaking, hiking, volunteering or exercising, has kept me healthy and happy, and able to work to my full potential.”
Dr. Schiopu says, “Giving back to the rheumatology field by mentoring and volunteering helps me feel like I’m making a difference, which lifts my spirits and helps me stay positive.” This helps her reach her optimum performance levels.
Dr. Tsai’s employer has started requiring a mandatory yearly wellness day off for employees to ensure they address wellness—which Dr. Tsai commends. The intent is for the employee to focus on addressing personal wellness away from the office, enabling them to schedule doctors’ appointments and exercise.
Another tip: Dr. Schiopu recommends inserting clinic breaks into the schedule by alternating established patients who may take less time, with newer or more complex patients who may have a lot of questions. “This typically ensures that patient appointments stay on time and that I can have occasional breaks,” she says.
Dr. Schiopu also advises taking at least two weeks of vacation at a time to truly disconnect from the demands of a busy clinic. Plus, spend at least one night a week with your spouse and devote some weekends to family time. During conferences, plan time to do something you’ll enjoy, such as shopping or visiting a museum.
Making a conscious effort to avoid distractions, not dwell on personal matters and keep your mind and body at peak performance should help you remain sharp and ready for whatever comes your way during the workday.
Karen Appold is a medical writer in Pennsylvania.