MODULES
Time Management
PA Profession
Health Care System
Business Knowledge & Skills
Legislative and Politicial Process
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TIME MANAGEMENT
"Using time effectively involves making choices that produce positive results, increase good feelings and reduce the potential for stress." - American Institute for Preventive Medicine Systematic Stress Management
This module is designed with the busy practitioner in mind. As leaders, we must all learn how to manage our time wisely. Our volunteer efforts do not occur in a vacuum. We have work, school, family, and recreation activities in which we participate. So how do we do it? How can we achieve a work/life balance and still have time for the other things in our lives? Take a few minutes to review the objectives below and see how effectively you can manage your time. Review your goals and prioritize your roles and responsibilities.Tools
"It is better to say this one thing I do, then to say these 40 things I dabble in." - Washington Gladden
Procrastination
"Hard work often pays off over time, but laziness always pays off now." - Despair.com
Procrastination is at the core of poor time management. Procrastination is defined as: the intentional postponement of a task because it appears unpleasant. Most people procrastinate to some degree - but some are so chronically affected by procrastination that it disrupts their careers and thwarts even their best efforts. The key to controlling and ultimately combating this destructive habit is to understand how and why it happens (even to the best of us) and to take a few simple steps to better manage your time and outcomes.
- Recognize self-defeating problems such as; fear and anxiety, difficulty concentrating, poor time management, indecisiveness, and perfectionism.
- Identify your own goals, strengths, weaknesses, values, and priorities.
- Compare your actions with the values you feel you have. Are your values consistent with your actions?
- Discipline yourself to use time wisely: Set priorities.
- Study in small blocks instead of long time periods. For example, you will accomplish more if you study/work in 60 minute blocks and take frequent 10 minute breaks in between, than if you study/work for 2-3 hours straight, with no breaks. Reward yourself after you complete a task.
- Motivate yourself to study: Dwell on success, not on failure. Try to study in small groups. Break large assignments into small tasks. Keep a reminder schedule and checklist.
- Set realistic goals.
Modify your environment: Eliminate or minimize noise/ distraction. Ensure adequate lighting. Have necessary equipment at hand. Don't waste time going back and forth to get things. Don't get too comfortable! A desk and straight-backed chair are usually best. Be neat! Take a few minutes to straighten your desk. This can help to reduce day-dreaming.
The other part of the solution can be as simple as applying this rule of thumb: If you're not working (directly or indirectly) to progress toward your top priority projects, you're probably procrastinating. And, when you're doing something important, such as working on your top-priority project or task, and something urgent comes up, recognize that this will take time away from this important work. To do this, it is imperative to understand the difference between urgency and importance. This is where activity logs come in. You may be surprised at how you are spending your time. Memory is a very poor guide when it comes to remembering where your time goes.
How to Use an Activity Log:
Activity logs help you to analyze how you actually spend your time. The first time you use an activity log you may be shocked to see the amount of time that you waste! It can be too easy to forget time spent reading junk mail, talking to colleagues, making coffee, eating lunch, etc. You may also be unaware that your energy levels may vary through the day. In fact, most people function at different levels of effectiveness at different times. Your effectiveness may vary depending on the amount of sugar in your blood, the length of time since you last took a break, routine distractions, stress, discomfort, or a range of other factors. There is also some good evidence that you have daily rhythms of alertness and energy.
Download Activity Log Template
Time Management Solutions
Action Plans
An Action Plan is a list of tasks that you have to carry out to achieve an objective. It differs from a To Do List in that it focuses on the achievement of a single goal. Whenever you want to achieve something, draw up an action plan. This allows you to concentrate on the stages of that achievement, and monitor your progress towards it. To draw up an Action Plan, simply list the tasks that you need to carry out to achieve your goal. This is simple, but still very useful! To use your action plan, simply carry out each task in the list! You can add subcategories for each action item in order to carry out the goal. For example, if you choose to set a goal of "earn my MBA," then under that goal may include action items associated with loan information, part-time work options, and employer education reimbursement information. This is beneficial in two ways. It allows you to achieve small goals and be able to mark them off your list, a feeling of accomplishment, and two, gives you an idea when you make the task as to how hard it is, or how long it may take.
ABC's of Time Management: divide planned tasks into three groups
A. Critical: must be successfully completed to succeed (strategic planning, interviewing and selecting people, managing people, launching a new project, market share increase)
B. Important: must be 80% completed as a group to succeed (similar to group A depending on the defined goals and objectives)
C. Useful: not necessary (reading magazines, attending seminars, doing the work of staff, opening mail and organizing, writing management articles)
Prioritize Tasks
Prioritizing is the answer to time management problems - not computers, efficiency experts, or matrix scheduling. You do not need to do work faster or to eliminate gaps in productivity to make better use of your time. You need to spend more time on the right things - C. Ray Johnson
Setting Goals Effectively
If you don't know where you are going,you might wind up someplace else. - Yogi Berra
Broad guidelines apply to setting effective goals:
- Positive Statement: express your goals positively: "Execute this technique well" is a much better goal than "don't make this stupid mistake."
- Be Precise: if you set a precise goal, putting in dates, times, and amounts so that achievement can be measured, then you know the exact goal to be achieved, and can take complete satisfaction from having completely achieved it.
- Set Priorities: where you have several goals, give each a priority. This helps you to avoid feeling overwhelmed by too many goals, and helps to direct your attention to the most important ones.
- Write goals down to avoid confusion and give them more force.
- Keep Operational Goals Small: Keep the goals you are working towards immediately (i.e., in this session) small and achievable. If a goal is too large, then it can seem that you are not making progress towards it. Keeping goals small and incremental gives more opportunities for reward. Today's goals should be derived from larger goals.
Set performance, not outcome goals This is very important. You should take care to set goals over which you have as much control as possible - there is nothing as dispiriting as failing to achieve a personal goal for reasons beyond your control such as bad business environments, poor judging, bad weather, injury, or just plain bad luck. Goals based on outcomes are extremely vulnerable to failure because of things beyond your control. If you base your goals on personal performance or skills or knowledge to be acquired, then you can keep control over the achievement of your goals and draw satisfaction from them. For example, you might achieve a personal best time in a race, but still be disqualified as a result of a poor judging decision. If you had set an outcome goal of being in the top three, then this will be a defeat. If you set a performance goal of achieving a particular time, then you will have achieved the goal and can draw satisfaction and self-confidence from its achievement. Another flaw is where outcome goals are based on the rewards of achieving something, whether these are financial or are based on the recognition of colleagues. In early stages these will be highly motivating factors. However, as they are achieved the benefits of further achievement at the same level reduce. You will become progressively less motivated.
Set Specific Goals: If you achieve all conditions of a measurable goal, then you can be confident and comfortable in its achievement. If you consistently fail to meet a measurable goal, then you can adjust it or analyze the reason for failure and take appropriate action to improve skills.
Set Realistic Goals: Goals may be set unrealistically high for the following reasons:
- Other people: Other people (parents, media, society) can set unrealistic goals for you, based on what they want. Often this will be done in ignorance of your goals, desires, and ambitions.
- Insufficient information: If you do not have a clear, realistic understanding of what you are trying to achieve and of the skills and knowledge to be mastered, it is difficult to set effective and realistic goals.
- Always expecting your best performance: Many people base their goals on their best performance, however long ago that was. This ignores the inevitable backsliding that can occur for good reasons, and ignores the factors that led to that best performance. It is better to set goals that raise your average performance and make it more consistent.
- Lack of respect for self: If you do not respect your right to rest, relaxation, and pleasure in life, then you risk burnout.
Setting Goals Too Low Alternatively goals can be set too low because of:
- Fear of failure: If you are frightened of failure you will not take the risks needed for optimum performance. As you apply goal setting and see the achievement of goals, your self- confidence should increase, helping you to take bigger risks. Know that failure is a positive thing: it shows you areas where you can improve your skills and performance.
- Taking it too easy: It is easy to take the reasons for not setting goals unrealistically high as an excuse to set them too low. If you're not prepared to stretch yourself and work hard, then you are extremely unlikely to achieve anything of any real worth. You should set goals so that they are slightly out of your immediate grasp, but not so far that there is no hope of achieving them: no-one will put serious effort into achieving a goal that they believe is unrealistic. However, remember that the belief that a goal is unrealistic may be incorrect. Such a belief can be changed by effective use of imagery. Personal factors such as tiredness, other commitments, and the need for rest, etc. should be taken into account when goals are set.
Now review the goals you have set, and then measure them against the points above. Adjust them to meet the recommendations and then review them. You should now be able to see the importance of setting goals effectively.
When you are thinking about how to achieve goals, asking the following questions can help you to focus on the sub-goals that lead to their achievement:
- What skills do I need to achieve this?
- What information and knowledge do I need?
- What help, assistance, or collaboration do I need?
- What resources do I need?
- What can block progress?
- Am I making any assumptions?
- Is there a better way of doing things?
PA PROFESSION
The best way to find out more about the PA profession is to speak with a PA. PAs have a high level of job satisfaction and, in general, love to talk about their work and their profession. This module provides a brief overview of the PA profession, including definition, history, demographics, employment, roles, and trends. The American Academy of Physician Assistants (AAPA) Web site provides introductory information on all these topics for the general public. Detailed data are available to AAPA members on the Web site.
Tools
The PA profession was developed in response to a shortage of primary care physicians, particularly in rural and medically underserved urban communities. In the 1960s, medics and corpsmen were returning from military duty in Viet Nam with a wealth of knowledge and experience, but without credentials to apply their skills in the civilian health care system. This pool of military veterans was tapped for the first PA Program at Duke University in 1965, which was developed by Dr. Eugene Stead. He is considered the "founding father" of the PA profession.
Physician assistants are health care professionals licensed to practice medicine with physician supervision. PAs employed by the federal government are credentialed to practice. As part of their comprehensive responsibilities, PAs conduct physical exams, diagnose and treat illnesses, order and interpret tests, counsel on preventive health care, assist in surgery, and in virtually all states can write prescriptions. Within the physician-PA relationship, physician assistants exercise autonomy in medical decision making and provide a broad range of diagnostic and therapeutic services. A PA's practice may also include education, research, and administrative services.
PAs are trained in intensive education programs accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) . Because of the close working relationship the PAs have with physicians, PAs are educated in the medical model designed to complement physician training. Upon graduation, physician assistants take a national certification examination developed by the National Commission on Certification of PAs in conjunction with the National Board of Medical Examiners. To maintain their national certification, PAs must log 100 hours of continuing medical education every two years and sit for a recertification every six years. Graduation from an accredited physician assistant program and passage of the national certifying exam are required for state licensure.
The profession has evolved since those early days. We now have 70,000 PAs eligible to practice. PAs practice in every setting and every medical and surgical specialty. According to the AAPA 2006 Census, 38% of PAs work in primary care and 16% are employed in counties that are designated non-metropolitan. PAs have prescription privileges in all 50 states. We now see PA programs developing internationally. With professional titles and curricula that are appropriate to their nation's health care needs, PA educational programs are developing or underway in Canada, the Netherlands, and in other countries of Europe, Asia and Africa .
Resources (PDF)
HEALTH CARE SYSTEM
The popular press abounds with information on health care delivery, and no doubt your clinical experience has brought you many examples of the strengths and weaknesses of the system. This module provides a set of resources to familiarize the learner with key concepts related to the health care delivery system in the United States. The drawer includes a brief introduction to issues related to the health care delivery system, organization and financing, reimbursement issues for PAs, and liability issues for PAs. Through this overview, coupled with further reading, we hope you will become more familiar with the United States health care delivery system and how it affects the way that PAs deliver health care.
Tools
The U.S. health care delivery system can be viewed on multiple levels, including economic, political, social policy, and public health perspectives. Much has been written about the need for health care reform. The recent Congressional battle over Medicare reimbursement for medication for the elderly serves as an example of the interaction of constituents, legislators, lobbyists, and advocacy groups (e.g., AARP).
From the point of view of a PA entering practice or changing practice settings, a variety of aspects of the health care system may be important. For example, a PA in an ambulatory setting needs to know about the dominant health care insurance plans and drug formularies which cover the patients in that practice. Hospital-based PAs also need to know how their services can be reimbursed, particularly if the PA needs to provide data on their cost-effectiveness and productivity.
Further study of the U.S. health care delivery system can be done through CME events, journal reading, interviewing experts, and utilizing the excellent resources of the AAPA. As PAs (and as patients), we all have experiences with the system - some good and some unpleasant.
PAs who choose to become involved in efforts to change the health care system are faced with a daunting task. Some people say that there is no "system," and that U.S. health care should undergo significant reform in order to adequately serve all of the American public.
Where do you stand? What do you think works well for your patients? Not so well? What improvements would you like to see take place in the American health care system? If you think that change is needed, here are some opportunities to influence change:
- Vote for candidates who support positions that you agree with.
- Provide advice to candidates in order to influence their positions on health care.
- Advocate for patients and/or groups of patients who are disenfranchised by the current system.
- Provide quality health care to all patients, independent of their insurance (or lack of insurance).
BUSINESS KNOWLEDGE AND SKILLS
This module will introduce you to the knowledge and skills needed to develop a sense of comfort in the "Corporate World of Medicine." The "business" of medicine is an area that many PAs do not feel comfortable with, but is increasingly important to delivering effective health care.The drawer includes an outline of organizational theory, practice management, human resource management, business development and management, and marketing. We hope that working through this drawer will enhance your understanding of business skills in health care organizations.
Tools
The Definition of Organizational Theory
Organizational theory is the comprehensive evaluation of an organization no matter how large or small. All organizations function at a constant level with modification to meet the needs of the environment.
Components:
The Managerial Role - Perception and Motivation in Leadership
- Decision Making
- Social Structure
- Organization/Work Design
- Communication and Coordination
- Environment
- Innovations/Change
- Performance - Efficiency and Effectiveness
- Strategic Planning
- Future Challenges
The Definition of Practice Management
Practice management is the support and development of a "machine" to run the practice. The development and adaptation of this theory and concepts support the practice management environment practice. Management style is both administrative and clinical.
Components:
- Participatory
- Dictatorial
- Consultative
- Oblivious
- Size and Complexity
- Inter-Personal Relationships
- Accreditation
- Regulatory
The Definition of Human Resource Management
Human resource management is the acquisition, preparation, development, design, work measurement, and compensation of a group of individuals that function within a structured environment.
Components:
- Legal environment
- Governmental oversight
- Recruitment
- Training
- Retention
- Compensation
- Termination
- Collective Bargaining
The Definition of Business Development and Management
Business development and management is the fiscal environment and financial theory used to develop, support, understand, and grow an organization.
Components:
- Performance
- Budget Development
- Profit and Loss Statements
- General Ledger
- Cash Accounting
- Accrual Accounting
- Audits
- Organizational structures
- For-profit vs. Non-profit
The Definition of Marketing
Marketing is the overt action one takes to promote an organization or an individual for the good of that organization or individual. The purpose of promoting entity is for financial gain and/or a positive image presentation in a controlled environment.
Components:
- Public Relations
- Advertising
- Public Speaking
- Print Review
- Paid vs. Free Promotions
- Image Enhancements
- Organizational Enhancements
- Collaborative Work
LEGISLATIVE AND POLITICAL PROCESS
This module provides a set of resources to familiarize you with key concepts related to the legislative and political process (state and federal), as it relates to PAs. The module includes a brief discussion of the legislative and regulatory process, and of lobbying. We hope that this module will stimulate your interest in the legislative and political process as it affects patient care.
Tools
The ability of PAs to care for our patients is affected directly by legislative and regulatory issues. At the state level, a PA's ability to practice medicine and prescribe is determined by state laws and the regulations, usually promulgated by the State Medical Board, which govern PAs. At the federal level, reimbursement issues, e.g., related to Medicare and Medicaid, have profound influence the PA practice climate.
PAs need to possess knowledge of how laws are passed and how regulations are developed and revised, in order to influence the practice climate in their states. Lobbying is the process through which PAs can affect how laws are enacted and how regulations are developed. Lobbying can be a simple as making a phone call or writing an e-mail. Without effective lobbying through state chapters and through the AAPA, PAs would not be able to be as effective in providing care to our patients.
What you can do to influence the legislative and regulatory environment in which you practice: Become active in your constituent organization
- Each constituent organization of the AAPA (constituent chapter, specialty group, etc.) includes PAs who are knowledgeable about the political process. Join the organization and learn from these PAs.
- Attend AAPA regional and national conferences, all of which include presentations and/or training on the political process.
- Read AAPA News and legislative updates.
- Write a check to your constituent organization's Political Action Committee (PAC).
- Take the time to become informed and respond to requests to make phone calls, write letters, and visit legislators, when your legislative coordinator asks.
- Vote! Vote for local, state, and national candidates who will represent your point of view on health care and other issues that are important to you.
