Medical Education

Patient Flow and the Broken Record Method to Get Home Sooner

4 Mins read



patient flow broken record and physician stress

In this article I will show you how a “broken record” can help you
~~ create immediate improvements in patient flow
~~ lower your physician stress levels
~~ and get home sooner at the end of every office day.

It starts with this question …

Do you ever feel like a broken record in the office?

You know the old vinyl albums we played back in the day on a phonograph with a needle. Sometimes they would skip and play the same thing over and over. Do you ever feel like that in your office week?

You are either saying the same thing over and over again to your patients OR
Entering the same thing into the medical record multiple times in your day ?

Every time you get stuck in this cycle your patient flow comes to a complete halt. The whole office is waiting on you to move on and you are stuck … just like the needle on that old vinyl record.

Not only that, this “broken record” repetition can be a major source of physician stress — because what you are doing probably does not require the skills and experience of a physician at all. You didn’t become a doctor for this.

Rather than clench your jaw and growl the next time you feel like a broken record … let me encourage you to do something else instead.

SMILE. Here’s why …

This broken record is a red flag that marks the quickest ways to improve your patient flow and optimize your office day. When you deal with broken record behaviors properly you will automatically improve patient flow, dramatically lower your physician stress levels and get home sooner on every day you are in the office.

You transform the broken record into better patient flow by automating and/or delegating the repeated activity. In my work with over stressed doctors, we have found the broken record typically occurs in two areas.

=> Patient education

=> Documentation

1) The Patient Education Broken Record


This occurs when you have a small number of diagnoses that make up a significant portion of your practice. You find yourself interrupting your patient flow to educate the patient on what to do and/or what to expect with this problem … over and over and over again. It is a classic broken record AND completely unnecessary.

Three Solution Options:

a) Make a handout with the broken record information on it. Put some of your personality and your specific tips and tools in there. Print it on colored paper so that your instructions stand out from the sheaf of other white papers our patients take home from every office visit … most of which have to do with insurance or billing.

b) Delegate this patient education to a staff member. You train them on what to say and how to say it – perhaps with a handout as in step #1. Once you have seen the patient and made the diagnosis and it is clear that this patient education topic is the next step … call your patient educator into the exam room and kick patient flow back into gear by moving on to the next patient.

c) High Tech: Shoot a video of you doing your broken record patient education. Load your patient education videos onto and iPad or Laptop or your own YouTube channel. When the patient education is the next step in the patient flow, hand the patient the video player and start the video for them. Tell your nurse they are watching the video and to check in with the patient in a couple minutes while you move on to the next room. You may want a handout to go with these videos as well.

2) The Documentation Broken Record

This is when you find yourself typing the same note over and over into your EMR in free text. Usually doctors who do this pride themselves for the quality of their documentation, are the partner who stays the latest in the office to finish up charts and tell me they “hate templates”. Realize that broken record documentation is a choice you make that impacts your physician stress levels, messes up your patient flow and blocks you from spending more time with your family and life outside of medicine.

You must become a power user of your particular EMR or you will continue to be a slave to it.

When I ask further questions about why they “hate templates”, over stressed doctors will tell me what they hate are the templates preloaded into your EMR.

Of course you hate these … they aren’t YOUR TEMPLATES. In order to stop the documentation broken record you must learn to use the shortcuts in your EMR and take some time to customize them and make them work for you in your individual practice.

The Solution:

Pick a broken record encounter that comes immediately to mind.

Sit down with the person in your group or representative of your EMR vendor who has the reputation of being the best Power User around. Tell them you want to build a custom template and have them show you how it is done. Then set yourself up a template that is something you would be proud to see in your chart notes. Make this baby yours and yours alone and set it up so it takes just a keystroke or mouse click to drop it into your chart note.

This may take a couple hours to set up initially and I have seen it turn a 5 minute typing exercise you do 12 times a week into a single keystroke for each of those patients.

What is at stake here?

Think about just a single broken record encounter you see multiple times a week . That one diagnosis where you end up saying the same thing over and over to the patient AND documenting the same thing over and over and all the ways it disrupts patient flow.

With the one-two punch of patient handout and a documentation template you can kick start patient flow again and save 5-10 minutes per patient … WITHOUT sacrificing a lick of patient satisfaction or quality of care. Multiply that times 3-4 times a day and it becomes clear that you will dramatically improve patient flow, lower your physician stress and get home earlier once you take these broken records on in your office.

PLEASE LEAVE A COMMENT and tell us the first broken record encounter you will be taking on to improve patient flow and lower the physician stress in your practice.

Here’s another patient flow video lesson

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