Leave on Time Without Cutting Corners

For years, I was the last person to leave the clinic. The office lights were dimmed, except for my room. I was surrounded by silence. Working on the charts, as best as I could. “Just one more note,” I told myself – 50 minutes ago. Exhausted, drained, frustrated. I carried tremendous resentment. Joy in practicing medicine was stripped away. I cared deeply about my patients, about how I could provide them the best care I could, yet somewhere along the way, that started to cost me my life outside medicine.

Every physician is working extra hours beyond their last scheduled patients. That was what I kept telling myself for a long time. I believed that was the norm. Staying late means caring more – does it not? Over-documentation and over-functioning do not mean better care. Many inefficiencies are habits we form intentionally and unintentionally, and they are not necessities.

The real problem is that a sneaky character is in disguise, hiding in plain sight – perfectionism. It can show up as writing excessively detailed notes. Rechecking decisions unnecessarily. Or doing tasks others could handle. This is not a flaw. It is a pattern trained and drilled into high achievers. You were conditioned to get the perfect scores, the perfect records, and to appear perfect in any way possible throughout your training. What got you here is now keeping you stuck.

What most physicians are not taught is the concept of “good enough”. This is not an excuse to slack off. Documentation should be accurate, relevant and defensible, not exhaustive. Embrace clinically excellent, not perfect. Your note is not your legacy – how you care for your patients is. Good enough is not careless. Good enough is not lazy. It is intentional and focused, so you have more capacity to handle more clinically complex situations.

I invite you to examine your patient notes. A complete note is one that supports clinical reasoning and continuity of care. Gear your notes to be problem-focuses rather than narrative storytelling. Sure, the “history of present illness” part is somewhat of a storytelling section, yet you want to keep the story to be problem-focuses on how you can help the patient. Do a quick mental filter before you document – does this change care, clarify thinking or protect you medically? If it does not, then omit it.

Set decision boundaries. The more decisions you make, the more draining it is throughout the day. It is even more draining if you are constantly second-guessing yourself. Make it a habit to make decisions once, based on the available information. Life is full of uncertainty, especially in medicine. Learn to be comfortable in make decisions in uncertainty. Confidence grows with action and not over-analysis.

Delegate without guilt. Many physicians – including the past me – believe that doing things themselves will be faster. Delegation is not offloading. It is optimizing care. Let other team members handle what they can do, and you get to work on things only you can tackle. Team-based care improves both quality and efficiency. Be creative in delegating. Start small, for example, simple call back to patients about normal lab results or simple instructions to take over the counter medications. As you get more comfortable in delegating, increase to include more phone calls, more inbox management, documentation support and patient education.

Create a “closing routine”. Set a defined end-of-day workflow to signal completion. It may be wrapping up notes to a “good enough” standard. Or doing a final inbox check before logging out. Or planning your day and prioritizing for tomorrow. Remember that done is a decision and not a feeling. You get to decide when and what is considered done.

Let go of the guilt. Going from working extended hours (that you did not sign up for) to leaving on time can feel uncomfortable at first. Guilt is a sign of changing identity and not doing something wrong. The discomfort it is creating for you is a signal for you to get ready to embrace the new you – the physician who leaves work on time and be comfortable about it. You are modeling sustainability while not sacrificing care.

When you leave work on time, your evenings are reclaimed. You get to be more present with your family. You have a source of renewed energy for patients. When you set better boundaries, you become a better physician offering better care.

You do not need more hours – you cannot get more than twenty-four hours a day anyway. You need new rules. Give yourself the permission to do medicine differently. You can be both efficient and exceptional. What would change if you decided that today, your work was enough?

If you are ready to start leaving on time, do not wait for the perfect system. Start with one change tomorrow. Write your last note to a “good enough” standard. Make one decision without second-guessing yourself. Delegate one task you usually hold on to. You do not have to overhaul your entire workflow. You just have to stop doing everything 110%.