PRACTICE PEARLS

Holidays are a common time for physicians to take scheduled time off, and practices should encourage it as an important component in maintaining well-being. However, practices also have to ensure that patients have sufficient access to care and that holiday time off is distributed fairly. Our large primary care practice developed a structured approach that incorporates clinicians' holiday preferences while maintaining adequate access, thereby supporting physician well-being and reducing the strain of holiday coverage. Here's how it works:

• Prioritize patient care. Determine the minimum number of clinicians needed per session to maintain adequate patient access and to cover staffing and overhead costs.
• Survey clinicians annually about their preferred holiday weeks. Distribute the survey several months before the upcoming calendar year, ideally in the summer. This provides sufficient time to adjust schedules and staffing, with limited disruption to already-scheduled patient visits.
• Clearly define holiday weeks. Each physician should have the opportunity to take time off during two holiday weeks, in addition to either Thanksgiving or Christmas (see below). Holiday weeks should include national holidays as well as local school breaks (excluding summer break), as these are popular times for vacation requests.
• Alternative Thanksgiving and Christmas weeks. Because these are the most commonly requested weeks for time off, have clinicians alternate them each year.
• Be transparent. Track and share previous holiday time-off data when distributing the survey. Give priority to those who have not recently taken a specific holiday week.
• Have a plan for managing in-basket responsibilities via cross-coverage among colleagues and let patients know they should expect longer response times for non-urgent messages.

Daily huddles can be a quick and powerful way to ensure efficiency, teamwork, and patient-centered care. In my practice, these morning gatherings have become essential. This four-step framework ensures our entire team is ready for the day.

1. Prepare ahead of time. Each team member reviews the schedule and comes prepared to comment on patients' needs, such as preventive screenings, refills, lab work, or even outstanding balances. This ensures nothing falls through the cracks.
2. Meet at the same time and place. The huddle is carried out on schedule in the designated location every morning, even if one team member is unavailable.
3. Share updates. Making announcements or communicating workflow changes for the day in the presence of the entire team reduces confusion and allows for discussion.
4. End with purpose. Closing with a unifying thought — a prayer, quote, or reflection — helps the team start the day connected and focused.