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Set some expectations around portal messages. I personally would 100% rather send a portal message than field a phone call, but they should be brief and to the point and not be visits in email form. Do not let your staff send you messages like “Mr Jones called and wants to discuss his medication”—they need to get more detail than that.

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Set expectations regarding controlled substances with your patients. After my first shady patient experience, I learned to be upfront with my rules. No early refills, no replacement of lost medicines, prescription has to come from me or a covering doc or I’ll stop writing for it. I rarely start chronic narcotics, and if I choose to continue them from a previous doc, then I’m not going up on what they already have - they’ll have to find a pain doc to do that.

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Make everyone work to the top of their degree, including yourself. Learn which tasks can be delegated, even the simple things. For example, for things that need my signature, I’ve asked them to put the date so I don’t have to. When you’re signing 10+ things at the end of the day, it makes a difference.

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20 is doable, 25 is a lot (unless you are including a few virtual appts in each half day). Try your best to run on time, and train your patients to come 15 minutes before their appt time. In my clinic, my patients know that if they come late, and the patients in the lobby are all early, the on time patients get seen first. Late patients are told they can be seen at the end of clinic or if there is an opening/no show, or they can reschedule to another day. Most ppl reschedule. There are exceptions to the rule obviously (very elderly, more acute issues, a patient that I really need to see, etc).

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Try to handle your inbox/labs/messages with any in between patients/downtime you have. Make a habit, because the inbox is the big killer. If it piles up, it just becomes daunting. Do a few messages here, a few there, a few refills, labs, etc etc throughout the day.

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