How to manage your time in private practice

We only have 168 hours in a week.

How we utilize this time will determine how successful we can be in private practice. I will first give you my experience managing my time as an obstetrician and gynaecologist and then give you some advice as to how you could maximize your time to achieve your goals in life.

At the beginning…

When I started private practice in 1994, I had a lot of time on my hands. I probably wasted much of it. I spent some of that precious time polishing my Mandarin even though, now thinking back, I could have done a lot more. I also strove to improve my laparoscopic surgical skills. I learned all about assisted reproductive techniques and started the IVF centre in Mahkota. I also completed a Masters Degree in Reproductive Medicine. However, most times, I probably sat around chatting with colleagues in the doctor’s lounge. Time wasted is forever lost.

Moving forward 27 years, now I have to be in many places at one time when I am at work. I need to be in my clinic to see patients; rush to the labour room to deliver babies; perform IVF procedures like egg collection or embryo transfer; perform surgeries in the operating theatre and soon perform HIFU in the HIFU centre. The frustration of being an obstetrician is that I never know when a patient will come in labour. I have to drop everything to conduct the delivery. Sometimes this happens while I am operating and when this occurs I have to ask a colleague to help me with the delivery. Performing surgery especially complex laparoscopic surgeries while having a patient in labour can be very stressful. The pregnant patients may not be  happy and I am not able to operate in peace.

When busy- what to do?

One way I have successfully managed to be in different places at one time is because I work in one hospital. My clinic is on the first floor of the building. The operating theatre is on the same floor of my clinic. The labour room is one floor above me ie. on the second floor and the IVF centre is on the third floor. The HIFU centre will be on the 5th floor and I will have to climb 4 floors from my clinic to reach it. However, because all are within walking or running distance from my clinic, I can do more with my time compared to many of my colleagues who work in different parts of the city.

One problem being an obstetrician is that I am unable to predict when a patient will come in labour. Some days may be very quiet and on other days there may be may patients in labour. As such on a a busy morning, I can start oocyte recovery at 7.30am followed by seeing a few patients in the clinic and then start an operation at 8.45am. Then, after the first operation I can do another oocyte recovery. While waiting for the next case to be prepared, I can see a few more patients in the clinic. I then perform my second surgery. After that I can do another oocyte recovery and a few embryo transfers. I can sometimes also manage to conduct a delivery in between.

When well planned, I can pack a great deal of work from 7.30am to 1 pm. This will never be possible if my work is all over the town. I maximize my time for the work I do.

So what advice can I give you?

1. When you start private practice, you will have a lot of time on your hands. Utilize this time wisely. Do not waste it by chatting with colleagues all the time. Focus on the future of your practice and do the things that can improve this.

2. Where you choose to work will help you manage your time. If you choose to work in only one place, just like I have, you can optimize your time. However, the disadvantage is that your whole life is committed to one place only. If you have chosen to work in 2 or 3 different places you will need to plan your time wisely so that you are not wasting time in traffic or waiting for your turn to do a procedure.

3. Choose what you want to do. I think the most difficult thing to do is to decide what not to do. Many of us are trained in many aspects of our specialty and to forgo some of these skills can be difficult. I will give you an example. At one time I, I wanted to stop delivering babies. However, I realized I could not do so because of the worry that I will loose the skill of managing pregnancy and delivery, a skill that most obstetricians take a long time to acquire.

4. Consider blocking a half day in a week to manage non clinical stuff such as medical reports, bills, taxation, administrative work and so on.

5. If you are becoming too busy, consider having a secretary to manage and plan your diary. You may even want to consider taking an assistant. However this may incur additional cost.

6. Invest in planning your time. You need to plan your time everyday or every week so that at the end of the week, you are happy that you have achieved something and have not wasted your time. Many of us are so busy being busy that we don’t plan our time wisely.

19/3/2021

Acknowledgement

I would like to thank Dr. Gunasegaran PT Rajan for reading through this manuscript and giving good suggestions.

I would like to thank my wife Sarojini for editing this manuscript.