How to Minimize Interruptions

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Haybrant

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I think we would all agree that one of the more annoying parts of the Rad Onc life is the # of interruptions in a day. Some days it is non-stop, I would guess >50-75 interruptions (therapist, dosimetrist, physics, nursing, front desk, AA etc...) To me this causes a huge quality of life decrement. Is it to the same degree for other physicians as well? Do you have strategies on how to limit this?

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It can get bad here in FL, esp during peak snow season.

I remind myself that I enjoy the work and that I get killed during the week to enjoy (relatively) stress-free evenings and weekends.

It's all about perspective.

Beyond that, I use email and text a lot to communicate with staff and referrings. Keeps me glued to phone and desktop but minimizes actual interruptions in terms of answering phone calls that come to the front desk
 
I highly recommend designing a "non-clinical day" (or a half of a day), and locking you office door/turning off cell phone for it.

I think we would all agree that one of the more annoying parts of the Rad Onc life is the # of interruptions in a day. Some days it is non-stop, I would guess >50-75 interruptions (therapist, dosimetrist, physics, nursing, front desk, AA etc...) To me this causes a huge quality of life decrement. Is it to the same degree for other physicians as well? Do you have strategies on how to limit this?
 
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Hire a midlevel.

Otherwise, it's part of the job.

Patient X's cone beam looks off, can you look at it? Patient Y has diarrhea, can you see him? SBRT about to start, can you get to the linac? Sign off on the IMRT QA for this guy. Sign off on the plan for that guy. Dr. Z has a patient here he wants you to see right now. Please sign these tube feed/home care/speech therapy/hospice orders. That PET/IMRT you ordered needs a peer-to-peer. Administrator A/B/C/D/E is here, do you have a minute to talk? The new med onc candidate wants to meet you. Time for tumor board!

I mean it's an unending barrage of minor nuisances. But you have to put it all in perspective. We are well compensated to do it, and most of these issues take 30 seconds to rectify and don't require much effort at all. It's not like someone's AAA burst on the floor and you need to leave clinic to get to the OR for a 5 hour surgery... right now. Just learn to love it.
 
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It could be the private practice mindset, but when I'm in clinic, busy as hell and people are coming up to me all the time to ask about our patients we're treating, I actually like the feeling. I like the feeling of being busy, of the clinic really humming, of things happening. FAR worse to me than being interrupted all the time is when I have nothing to do. Far worse. Sure, it takes practice to be able to work with such a constant stream of interruptions, but outside of midlevel support, that's the gig.

One thing that has been helpful to me has been getting the clinic all on board with "Dr. OTN will respond to me/my request when he is ready." I'm sure it's annoying to staff, but it helps me make sure I'm getting done what needs to happen when it needs to happen.
 
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I turn my telephone off occasionaly. I cannot always do that, apparently. But when I know some good residents are reachable, I do that.

Usual cases when I turn my telephone off:
- important meetings with senior staff in echelons way above my head
- challenging discussions with patients (breaking bad news, considering switch of treatment to palliative / best supportive care)
 
I turn my telephone off occasionaly. I cannot always do that, apparently. But when I know some good residents are reachable, I do that.

Usual cases when I turn my telephone off:
- important meetings with senior staff in echelons way above my head
- challenging discussions with patients (breaking bad news, considering switch of treatment to palliative / best supportive care)

Mosaiq allows you to send tasks to each other and as far as I know Aria supports this (even better?). I highly recommend a system like this.
 
At one of the clinics i work at, there is a set hour each day on the physicians schedule to work in dosimetry on contours/planning - no clinic patients/weeklys during that time... if not much to do in dosi that day, leaves some down time or time for catching up on dictations
 
- challenging discussions with patients (breaking bad news, considering switch of treatment to palliative / best supportive care)

This is the problem I have. I am often the first doc the patients see after the pathology comes back from glioma surgery, and I have to break it to them that they have a glioblastoma or something similarly devastating. Yet at times I have either staff knocking on my clinic room door or my phone ringing every 2 minutes about some thing or another.

I had a conversation one day where literally every other sentence was interrupted for several minutes as I was trying to explain the situation to a 30something year old guy with a high grade multifocal brainstem/basal ganglia glioma. This is to me the most frustrating thing in my job, and I can't understand how my patients put up with me.

I wish I had a solution to this. I mean I'm in academics, but the reality is that even in academics I'm interrupted constantly and there can be serious pressure to see patients and deal with issues quickly. I'm often the covering doc or the only doc in clinic that day, so I can't turn my phone off or tell people not to bother me. It's nice having a resident, but you don't have a resident all the time and there's only so much a resident can deal with.
 
Does this seem to be getting worse? At least for me it is- I cant remember it being such an issue 5 years ago.
 
I just got a smart watch and am testing the waters using it as a pager system. To me, will be less intrusive to my door being knocked or phone ringing. Just a small step, but perhaps it will help

I agree, this is the most annoying part of my job!

Another step my partner and I are taking is an assigned day for all CBCT's, so we'll switch off and get bugged a lot on those days but less on the others..

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Great post, I thought it was just me. Even worse while covering for one, sonetimes two other docs at times. I am literally “pinned” down in the clinic or going back and forth to a machine, etc.

I may not be able to take many breaks during the day, but at the end of the day, it’s still better than most other fields.
 
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