Before you pack your Toothbrush.

Whether you are going on an annual holiday with family, or to an educational event in another city, sometimes the prospect of taking time out of clinic can fill one with dread. How do we learn to enjoy time away from seeing patients, without fearing that it’s all going to get into a terrible mess by the time we are back at work?

At Private Practice Ninja we believe in working hard and playing hard.

Start as you mean to go on. In an ideal world, you will be thinking in a proactive rather than reactive way.

Here are our Private Practice Ninja tips to put into practice, two weeks before you go away on leave…

Try putting a ‘just to let you know we’re going on annual leave’ in your email signature (and that of your med sec).

Perhaps something in red or even italicised, giving everyone the heads up that you are going to be away overseas soon. It helps to send the message to patients and clinicians that they need to get those requests in promptly if they want it actioning before you go on holiday.

Take ten minutes to reflect back on what was happening in your clinical appointments diary, the last time you went away.

How many new patients did you see that week, and how many of those new patients had their follow-up appointment in the same week? If they weren’t followed up before you went away, have a little look through your emails and find out how much time did you then have to spend, in communication with or about that patient while you are away? Chances are you didn’t make a clean break and you were still clearing up questions and queries in the back of an Addison Lee cab, on the way to the airport.

Your aim is to put them all to bed before you go away.

The Ninja way: Any new patients booked in on the final week ideally need a follow-up scheduling later that week, if they are going to require any investigations and blood’s that simply can’t wait until you get back.
Only dire emergencies that can’t be referred on to elsewhere e.g. to another colleague or ‘buddy’ are allowed to disobey this rule.

If your local hospital or diagnostics centre has limited availability for investigations, try negotiating to hold an imaging time slot or two with them, as in all likelihood they are going to be needed for that last minute patient. It’s rare that such a slot goes unused if it’s not required. A little sleuthing from your secretary will go a long way in this matter.

  Ask your med sec to pre-empt the fact that you are going away with your patients so that their expectations can be managed.

Why is this all important?


There is nothing that builds resentment more than if you can’t relax on a trip away because you are still expected to: phone patients, look up an MRI scan results or generally answer one of those dreary emails asking “can you recommend something for my five-year history of lateral buttock pain?”

 Learn to manage your own expectations. Whether I’m at a conference, snorkelling on a Caribbean coastline or camping in the mud in the New Forest, when I’m away from clinic I know I’m not going to be able to completely disconnect for the entire duration of the trip. It’s just not possible.

So whilst you may be in the position to re-route your emails to your med sec, the chances are that won’t work entirely because there will always be clinical questions he or she can’t answer (plus that stray email from Majestic Wine asking where you wanted that ill-chosen Chateau Neuf du Naff to be delivered).

So what’s the best way to manage email requests when they come in?

Set up an ‘out of office’ that explicitly states in what way you will be able to respond to people.
This could be a brief sentence explaining that you are not going to have ready access to email and, that you are going to reply to everything on your return or, get back to urgent requests within twenty-four hours.

It’s very important that you put another contact detail in there as well so that in event of emergency they need to phone X, Y or Z person. This is where it’s really helpful to have a pre-prepared ‘buddy’ who agrees to cover truly urgent patient situations while you are away, however unlikely the need for that may be. Strike a reciprocal deal with your ‘buddy’, and that way you both to get to benefit.

Ring fence some time, so that you can indulge in a little bit of firefighting whilst you are away.

I typically choose to take a peek at around 4 pm every day for around ten to fifteen minutes. This is late enough in the day so that I feel like I’ve had some R ‘n R and haven’t had to endure the irritation of some silly request spoiling the best part of my day, but still leaving enough time before the end of office hours to deal with anything urgent that might require the assistance of an administrator back home.

Tell everybody this is what you will be doing and resentment won’t build, as you’ll be able to give them your undivided attention the rest of the time.

Stashing emails.

I make two new email files in my Outlook email account every time I go away – this will also appear on my iPhone, a ‘@@@holiday to action’ and ‘@@@holiday to file’ file.

This means that anytime one of those annoying little messages pops up into your phone, I can take a quick peek at it at 4 pm and zip it across to the appropriate file – which will appear at the top of my email list (courtesy of using ‘@@@’). This way it’s literally out of sight and out of mind, and I don’t have to rely on my inbox as a ‘To Do’ list or aide memoir.

Put some responsibility back into the hands of your patients.

If you know that you have got some particularly tricky character, set up a follow-up with them for as soon as you are back. Signpost instructions for patients, for when they absolutely should make contact with your secretary, and absolutely shouldn’t make contact with your secretary, (e.g. in the instance of symptoms suggestive of cauda equina, go to A & E instead).

Their issues will still be there on your return, but at least you would have safety netted any problems.

Block out an hour after a big trip, at the beginning of your first morning clinic, to deal with the backlog of emails before the onslaught of patients starts. That way you know you have everything tidy before that first patient walks into the room, and comments on how lovely your tan looks.
and finally….

Don’t forget to pack your toothbrush.

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Sometimes, we all need a little extra help in building our practices – from a business perspective, as well as a clinical one.

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