- Determining what you value
- Setting time to do what you value
- Doing what you intend to do in the time set aside
- Minimizing distractions through confidence in your systems
It is important to be deliberate about time management, given that time is our most precious commodity. We should set communication boundaries, including setting expectations around texting, email, EPIC messages, and calling patients. Having said that, we must also arrange communication to happen within the context where it can be acted on, as well as making room during the day to think and find flow.
With regards to calendar management, it is essential to block consecutive hours of time on your calendar, and to instruct your administrative assistant to book standing and non-urgent meetings outside of blocked time. Task management is also important – constantly revisiting your list of things to do wastes energy and focus. Each task should be addressed once:
- Do it (less than 2 minutes)
- Delegate it
- Defer it
- Delete it
Dr. Plimack also spent some time discussing the management of emails, emphasizing that emails should be either (i) filtered, (ii) deleted, (iii) completed quickly, (iv) filed, or (v) filed as a task. Ultimately, our email inbox should not be our “to do list”, and we should strive to see the bottom of our inbox. Regarding task management, Dr. Plimack notes that tasks should be moved to another bucket, and then that bucket should be sorted (she uses Evernote).
Managing time in clinic should be set up for success and includes several aspects of clinical care. Our advanced practice providers should be independent practitioners, since they are experts in our patients’ care and an integral part of our patients’ team. Additionally, we should be focused on delegating tasks to our nursing team. This may entail chemotherapy teaching, getting signatures on consents after our conversations, completing a review of systems, checking orders, and following up on the schedule.
In EPIC, documentation should be templated as much as possible, and we should also be using smart phrases whenever possible. For managing clinical trials in the clinic, Dr. Plimack notes that there should be template specific documentation for each trial, which completes the note quickly, and reminds you of the key eligibility of each trial. These templates also describe the study to the patient (with the key elements), and include the standard of care alternatives. Dr. Plimack also uses a two step process for informed consent: Step 1 – have a patient sign an ICF at the visit (signing just says “I understand”, it is not a commitment, but it does secure a spot and allows for quick scheduling), and Step 2 – requirement of the patient to confirm their intent to enroll the next day with the clinical research coordinator/clinical research nurse.
For new patients, we should prepare for their visit ahead of time and also use templates for notes. Additionally, using your nursing team allows you to learn a patient’s goals of care (versus a second opinion), raises awareness to a patient’s main concerns, and gathers a review of systems. By structuring your talking points with the patient, this saves questions for the end, and it may also be beneficial to start the visit with an overview of what you have learned by reading through the patient’s chart, rather than having the approach of the patient telling you their story (there are pros and cons to each approach). When highlighting patient instructions in the note, this is perfect for developing templates of these conversations. This may include:
- Template language for each clinical trial
- Template care goal discussions and hospice discussions
- Template common treatment conversations, but keeping these short and specific to the patient
- A summary of prior treatment (duration, reason stopped)
- A description of new results (labs, scans)
- Succinct documentation of your decision-making and plan, as well as the conversation with the patient and family
- Allows an outside reader to understand key elements of this patient’s care
- Contain the elements needed for billing
Dr. Plimack concluded her presentation discussing a brief guide to organizing your work life by highlighting several helpful tools:
- Evernote and Microsoft To Do for tasks
- SimplyFile for email
- Google Notes for short to do lists
- LastPass for passwords
Presented by: Elizabeth R. Plimack, MD, MS, Fox Chase Cancer Center, Philadelphia, PA
Written by: Zachary Klaassen, MD, MSc – Urologic Oncologist, Associate Professor of Urology, Georgia Cancer Center, Wellstar MCG Health, @zklaassen_md on Twitter during the 2025 GU Oncology Early Career Thought Leaders Conference, Philadelphia, PA, Thurs, Mar 6 – Sat, Mar 8, 2025.
