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You have an impressive to-do list, but you're still not getting things done. Wonder why?

Fam Pract Manag. 2001;8(4):60

Traditional wisdom about setting priorities promises you higher productivity and a greater sense of accomplishment. All you have to do is write out a to-do list, prioritize it by order of importance and urgency (using the ubiquitous “A,” “B” and “C” labels) and then tackle it, right? Then why, after nearly two years, is that same “C” item still on your to-do list? And why, after a busy day of administrative duties, seeing patients, responding to requests and making it on time to your son or daughter's ball game, do you still find yourself saying, “I didn't get anything done today”?

There are two reasons. One may be that your priorities changed during the day, but for good reason. No, you didn't accomplish “A,” “B” or “C” on your to-do list, but you did respond appropriately to the curveballs thrown at you today. Give yourself a break and a pat on the back.

The other reason may be that you have fallen into the “ACT then THINK” method of setting priorities. It is common to default to this approach when multiple tasks and requests on your time overwhelm you. In some cases, you may ACT then THINK out of habit – one you haven't yet decided to break. To help you break these old patterns, understand these five common priority-setting traps and how you can avoid them.

1. Whatever hits first

Do you “choose” your priorities simply by responding to things as they happen? If so, your priorities are really choosing you. For example, your phone rings with a request for information on one of your patients. You stop what you're doing to hunt down the needed information when your nurse pops in and asks that you call Mrs. Thompson right away. So, you put the first request aside and call Mrs. Thompson. Sound familiar? Think about how this general lack of control over your day contributes to your stress level. You need to clarify your priorities by determining each task's importance and level of urgency (i.e., THINK then ACT). This means negotiating with people to respond in a time frame that's convenient to you and agreeable to them.

2. Path of least resistance

When was the last time you heard yourself say, “It's just easier to do it myself”? This is not always an incorrect assumption, but if you're saying it too often, you're probably not giving your staff enough credit or you have the wrong person in charge – or maybe you're simply following the path of least resistance. Ask yourself these questions: Am I trying to avoid conflict? Does the task at hand require a medical degree? Do I need to invest time or money to train someone to take on some of the lower-priority tasks I am currently performing? Honest answers will help you determine what alternative action you need to take. Decide and do it now.

3. Squeaky wheel

In most offices, it is not hard to identify who the squeaky wheels are. Their requests are always urgent and they are very successful at getting you to respond according to their time frame. But do their requests really demand your immediate attention? If not, give them a specific time or date when they can expect you to respond. They may squeak a little more initially, but eventually they'll get your message and your priorities will remain your priorities, not theirs.

4. Default

“It doesn't look like anyone is really going to start working on this report. I guess I'll do it.” These words should send up a bright red flag. Much like setting your priorities by the “path of least resistance,” setting your priorities by default guarantees that truly important tasks will be put on the back burner. To prevent this, before taking on that report, ask yourself when the report is due and whether it's really your responsibility. If it isn't, determine who is responsible and ask them to give you periodic updates on their progress.

5. Inspiration

If you wait until you're “inspired” to respond to something like your Medicare carrier's request for documentation to support a claim, it probably isn't going to happen, even if the task is a high priority. Instead, remind yourself that responding might clear the way for easier billing and fewer hassles for you and your staff. High-priority items won't always be the easiest or most pleasant tasks on your list, but dig in and do them anyway, and you'll be glad you did.

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Copyright © 2001 by the American Academy of Family Physicians.

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