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Time management is crucial in running an efficient business, especially an operation as complex as general practice. Dr Tillman Jacobi gives advice

Most GPs and their staff have problems managing time. Typical signs are:

·feeling overloaded, not in control and defensive about work

·always catching up rather than having energy to try new initiatives

·regularly working more than 50 hours a week

·confusing urgency and importance of tasks

·dealing with issues in an increasingly perfunctory way

·doing without regular holidays

·observing signs of stress in yourself ­ such as losing weight

·finding it impossible to say No or delegate

·feeling guilty about leisure time

·getting depressed and negative.

Time management starts with prioritising your activities. Discuss them with colleagues if you have reached the stage where you find prioritising difficult. It often helps to write things down. Make sure you distinguish between what is urgent and what is important. There is a difference.

It is time well spent to keep a careful record of what you do during a typical day. It should become obvious from this whether you are spending time on unnecessary activities.

Then make a list of activities that can be amalgamated, delegated or solved by improving your own skills (such as your reading speed or your typing abilities) or by intelligent use of technology (for instance setting up Word templates or using speech recognition software).

It may be that you are not particularly confident with computers. Learning to use them better would be time well spent.

It obviously makes sense to surround yourself with the best possible staff. Having low-grade staff is not conducive to delegation.

If something goes well, ask yourself how its principles can be applied to other tasks. Review and update short-cuts occasionally to check if they are still the best, fastest and safest ways of doing things.

Research in business has shown that as little as eight minutes of careful preparation in the morning may save up to a whole hour over the day. Of course, a significant proportion of work will remain uncertain until it shows up. But it can be useful to reduce obstructions by looking at critical tasks which, if not done at a certain time, may delay a whole sequence of other tasks.

Also, learn to say no where appropriate and learn when to abandon a task ­ completion is sometimes futile.

A common problem is starting projects at the wrong time. Ensure careful preparation and a sufficiently long, uninterrupted stretch at the right time of the day for you to start and finish complex business. Tackling any assignment in a bitty and unorganised way will take much longer overall and will also be stressful.

Avoid setting up long daily to-do lists. They can be demoralising if they are much more than you can achieve. Instead try a list of desired outcomes for one whole week ­ and each day pick the tasks you feel ready for.

Remember, though, that some are going to take longer than others and shouldn't be delayed until you have to rush them.

Whenever you put a new to-do item on a list, write four more pieces of information next to it:

·how urgent or important is it?

·can it be delegated or even abandoned?

·what consequences/use does the completion of the task have?

·how long do you expect the task to take? (Check this after completion.)

It often helps to look at the monetary value of your time in specific settings ­ for example in meetings or when teaching and during administration work.

Quite obviously some tasks are a lot more worth doing than others. Some things you have to do as a GP there is no getting away from. But when it comes to outside work, for example, make sure you are investing your time wisely.

Some useful tips

·Learn to say No ­ and delegate

·Surround yourself with good staff

·Improve your skills where appropriate (ie getting to grips with computers)

·Prioritise your day's tasks before starting

·Start projects at the right time ­ ie when you have some hope of finishing them

·Do a cost benefit analysis of your time

·Remember some tasks can legitimately be abandoned!

Tillman Jacobi is a GP in Wigginton, York

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