The premise that we can manage time is silly. It keeps on ticking, just like a Timex® watch, regardless of what we attempt to do with it. What we need to manage is ourselves and better schedule the sequence of events. We need to take control of our lives and our daily activities. Whether a multi-doctor practice, or a busy one-doctor practice, the mt³ principles discussed here apply equally. This will be the concept discussed below.

People do have individual energy cycles, regardless of what the practice needs. Some people are most effective in the mornings, some are afternoon people, and a few are night folk. The majority of Americans have their prime energy time in the morning, a low slump at lunch time, a moderate energy boost mid-afternoon, and another slump about supper time. A good practice manager will utilize each staff member during his/her specific prime times for highly productive tasks and save the routine tasks for the individual's slump time. But again, the purpose of this is inward looking, so we will not expand on this perspective of time utilization.

One of the "most unique" concepts we introduce into multi-veterinarian practices, and one of the most exciting for practitioners, is that a work cycle is two weeks, not one week. This is important because it allows a three-day weekend once every two weeks for each veterinarian. Here is an example for a typical "open three evenings" small animal practice:

This schedule assumes we use multi-tasking training techniques in scheduling, as shown in the subsequent examples, so it reduces the overlap between the veterinarians on Monday, Tuesday, and Thursday evenings, considering Thursday afternoon from 1:00 to 3:00 should be reserved for training and staff meetings. A "mt³ schedule", using two or more consultation rooms per doctor, scheduled out of sync, usually allows a full day's caseload to be seen in the four morning hours. An increased workload, especially if the morning outpatient "day care" admissions, usually expected to be about forty percent, are seen by the same team later in the afternoon, when the morning outpatient doctor becomes the inpatient team doctor.

The second benefit is when veterinarians are on a clinical performance percentage compensation of eighteen to twenty-two percent, with the owner at twenty-three to twenty-five percent. The two associates seldom compete for clients, due to the lack of overlap. In the previous sample plan, note the evening shift starts "after lunch", an important psychological advantage. The single Wednesday off is preceded by a short day and followed by an evening shift that allows a "longer break" than a single day off. The other way to look at the schedule is that each veterinarian works two days, then is off a day, works for three days, then off another day (but on-call), then he/she works four days and is off for three days. No more five or six-day weeks!

An alternative two-doctor schedule is possible, one that is unbalanced, but provides for the young doctor (DVM-2 below) to get four party nights a week, with three days off, and the previous, worn-out, and stressed lone-doctor (DVM-1 below) a weekly three-day weekend.

We explain to the new doctor that Monday and Wednesday are great days off, since kids are not in the Mall, on the ski slope, playing in the fishing rivers, or crowding the beaches. Also, by delaying Tuesday and Thursday start time, late nights are also easy to have. In fact, Friday is the only day that the new doctor does not have yesterday or tomorrow off, so it is a "very friendly" schedule. The fact that the past lone-doctor goes from six days a week to having a three-day weekend every week, when we add an associate, we seldom hear any complaint. In rare cases, the original doctor feels guilty, and wants to split the evening hours with the new doctor.

This is not fair, since those newly extended hours are usually new client access time, and pet parents coming in during those new hours should be allowed to bond with the new doctor first. In reality, the new doctor has higher productivity times (evenings and Saturdays), without the previous lone-doctor on-site, so the production pay is greatly enhanced.

Life is equitable, not fair! - Tom Cat's first rule of scheduling

If we look at the impact of a third veterinarian in this schedule, let's assume an owner has built this practice with blood, sweat, and tears, not to mention family sacrifice and fiscal hardships. The owner has invested a lot more in the practice than the associates and can have an alternative schedule, still with three-day weekends, since some Mondays will be business needs:

As you can see, the owner is "optional" for full coverage, but provides the double coverage for an aggressive inpatient and surgery program, without sacrificing the outpatient program. The other important factor to note is the associates get the "densities," those times with higher client counts, evenings and weekends, allowing them the most advantageous times to increase their productivity percentages.

When we address the paraprofessional staffing for either option, empower the nurse technicians and client relations specialists to develop their own schedules to ensure adequate coverage, just provide the specific needs such as:

 Target full-time hours at thirty-two to thirty-six scheduled hours per week, to allow for the "need" to finish up without causing overtime.

 On surgery days, we need a "clean" IPNT, as well as the OPNT. If there is an IPNT doing dentals or abscesses, that person cannot be the "clean technician", supporting the surgical suite. But the laboratory technician could be the "clean technician."

 Client relations staff know when client densities occur. Use split-shift scheduling to ensure client-centered service, including coordination with the OPNTs to assist client flow and client relations back-up. If there is a skilled telephone client relations specialist, there is usually only a two-staff member requirement for receiving/discharging clients/patients, especially if invoicing and collections are being made in the consultation room by the outpatient staff.

 We need at least one OPNT per two consult rooms to support the client relations specialists and consultation rooms, when there are appointment times scheduled.

 In cases were doctors cannot write well, we may have a nurse transcriptionist in each consult room, also to hold animals and record what the doctor and client are saying.

 The OPNT assistant is also the pharmacy floater, ready to count pills or hold animals.

 Schedules with the names and times are provided to the practice manager the Thursday before the work week. Don't expect others to cover your areas of responsibility unless you coordinate it yourself.

These scheduling concepts have been provided as an example of an implemented "time management" system for mental hygiene, as well as client service support. These ideas are only the implementation of some basic principles of time control, which are discussed below.