Apply the Four Ds and Free Time to Focus on Critical Aspects of Your Practice

You want to use your work time systematically, but HOW? The four Ds–delete, delegate, defer, or design out–free you to focus on more important activities.

How do you “find” the time every day to devote to your most important activities, what I call A-, B-, and C-level work? Well, focus first on your D-level activities.

Now that may seem counterintuitive, but in fact, this is the best place to start. Not only do you, by definition, tend to spend a lot of time on the D-level stuff, but it’s the easiest place to make changes because the consequences of dropping those activities are small.

So start by listing all the D-level activities you do every week. They might include:

• Scheduling patients
• Fixing the Wi-Fi in your office
• Writing low-level email messages
• Scanning documents into your electronic filing system

From there, we recommend keeping a time log for a week or two so you can spot all the time wasted on low-value D-level work. Once you’ve identified all those D-level activities, then apply the following “Four Ds” to get them off your plate:

The Four Ds

1. Delete it. Some D-level activities just plain shouldn’t be done by anyone. Look at each action item and ask yourself what the consequences would be if no one did it. If the items are small, then consider crossing them off your list altogether.
2. Delegate it. Maybe it’s a task that needs to get done but not necessarily by you. Hand it off to your assistant, a staff member, or a vendor. Anytime you can delegate a D-level activity to someone, you free up both your time and your focus to do more valuable work.
3. Defer it. Maybe this task needs to be done, and done by you, but does it need happen right now? Sometimes delaying the action is the smartest choice.
4. Design it out. If you find yourself handling a recurring D-level activity over and over, instead of doing it, improve the process or system to keep the task from coming up in the first place.

Take the example of a renowned laser eyelid and facial plastic surgeon. Considering the number of procedures this doctor performs each year, he used to spend hundreds of hours giving preoperative instructions and explanations to his patients. Then one day he “designed it out.” That means he produced a simple, clear, and detailed video that he shows to patients. It features all the preoperative education and instructions that he used to say over and over and over. After his patients watch this video, he comes back into the exam room and answers any questions they have. This saves him hours each month and even gives his patients a better experience.

Examples of Designing It Out

Other examples of designing it out include redesigning your new-patient paperwork and instructions so they’re easy for patients to understand and complete. That translates into fewer questions for your staff to answer.

Or you might pre-empt the five most common new-patient questions by giving them a “quick start” booklet that proactively answers those questions.

Or you might post an educational video for your patients online or play it in the office for patients.

You get the idea.

Designing out a recurring activity is the very essence of building a systems-reliant Level Three practice. It simplifies processes and empowers your team to get consistently great results with less and less reliance on you, the owner. Free Up Your Time!

By applying all four Ds–Deleting, Delegating, Deferring, and Designing Out–you’re likely to free up at least two hours (or many, many more) every week. It’s time you can reinvest in critical higher-level activities.

Good luck in growing your practice.

You can access our Time Value Matrix tool in our free Medical Practice Success Toolkit.