The challenges of preserving time for physicians

I recently took on a new job at my daughter’s swim meet: I was a timer. This meant that I stood at the edge of the pool with a stopwatch and recorded the minutes and seconds it took for the swimmer in my lane to complete their race. In this arena, seconds matter. We actually were timing down to hundredths of a second.

This caused me to reflect on the funny way time has of seeming both slow and fast.

During my clinic day, I feel in a constant rush. As I step into each exam room, I try to judge whether I’ll be able to complete the visit in my allotted time-usually not. I’m sensitive to patients having to wait in the exam room, and I’m sensitive to the patient I’m currently with when they bring out their laundry list; they may have been waiting weeks for this appointment. Chronically, I am juggling time. Should I take the extra two minutes to work on the note, get started with the next patient early, or answer a phone call?

At the end of my day, as the last patient leaves the office, I examine my unfinished charts, my full in-basket, while texting my husband to coordinate picks up and drops off for swim team, track, and piano lessons.

When I have administrative days, I am usually rushing from meeting to meeting. There is very little time sandwiched in between to even get from one conference room to the next. This causes a domino effect of meetings starting late, ending late, and then you are running late to the next meeting, which is OK because the meeting is starting late, and so on. I am in perpetual wonder about what I could actually accomplish if I had fewer meetings and more think time.

Then I think of the big time questions. How much time do I have left in my own life? Am I using the seconds, minutes, hours, days, and years as well as possible? No. Do I spend enough time with my family? No. Do I waste time? Yes. Why does time seem suspended when binge-watching Netflix?

As my patients grapple with life-altering diagnoses, they ask me questions. How much time do I have left? I don’t know. Do you think I should…go to Alaska…take my grandson fishing…continue to do my dance class? Yes, yes, and yes. I try to judge how much to press on end-of-life decisions. Is this “the” event or another recoverable illness?

In medicine, we often balance the seconds with the years. Seconds or even parts of seconds matter-during an intubation, when reading an EKG, etc. In the greater sense, years matter-preserving and protecting health so that each patient can live a full life. In between are days cut into 20-minute chunks of time, standard lengths that defy our patients who do not fit into neat, time-sensitive boxes.

Jennifer Frank, MD, is a family physician and physician leader in Northeastern Wisconsin and finds medicine still to be the best gig out there. Married with four kids, she is engaged in intensive study and pursuit of work-life balance.