Best Laid Plans Work

Work Stuff Follow Up & A Fun Surprise

October 19, 2022

Follow Up, Part 1

Clinic days! I mentioned yesterday that my clinical days are currently M / T / Friday and next year they will be M / W / F.

I totally get the appeal of ‘batching’ them more, as in a Wed-Fri or Mon-Wed schedule.

But I don’t think it will work for me. 2 (and a half) reasons:

1- Patient messages and lab results. What I do is very . . . longitudinal. Yes, I see a patient on a given day. But I have to follow up results on said patient, and that usually does not involve bringing them in for a follow up visit — it involves a patient message over the portal or sometimes a phone call for a more detailed result. (Note: I have started to use telehealth visits as a way to actually get ‘credit’ for more involved conversations. But the way our templates are structured so far out, it’s not as easy as you might think to fit this in.)

The idea of arriving every Monday (or Wednesday) to ~5 days of accumulated results (and patients nervously waiting for answers to their questions!) gives me hives. I just don’t want to practice that way! And patients these days expect a faster response time than 5 days. IF I had a dedicated NP or PA to manage this, it would be amazing. But I don’t see that happening any time soon!

2- Rest. Working in the clinic is such a different energy that I LOVE the idea of having podcast work days as ‘rest’ between the clinic schedule. I want to at least experience this for a while before deciding it’s worth giving up!

1/2 – (this is 1/2, because it might be more malleable than I think, but I haven’t delved into it) — I don’t really have complete control over the days – it is partially based on when there is space and staff in the office, as we have multiple providers there on different days. I work out of one office and don’t currently go to satellites but a lot of others do. (Of note, I am not against going to satellites but my patient panel is based at the main office and I don’t know how a move would go over). Monday and Friday are usually quieter days from the perspective of who else is there, so it’s good to do patient care those days.

Follow Up, Part 2

One listener suggested I plan out PL days wayyyyy in advance. Yes! I love this idea, and I do actually do it (I’ve already submitted through most of 2023). However, what I have generally submitted are the days I know I will want to be off — the kids’ spring break, a booked trip, etc.

Sometimes you have an idea that doesn’t have 6 months of lead time though, and it can be hard to move patents that have appointments booked months in advance — for example, I have patients on my schedule for April + May already. Not b/c I am soooo popular but because I’m in a popular specialty in our area and there are not enough pediatric endocrinologists to meet the local demand. My colleagues’ schedules are similar.

Anyway, the answer occurred to me as a result of this comment – I need to add some random days in regular intervals, like once every 1-2 months at least. This way if something comes up, I can swap out the days and have a place to PUT the patents that would be moved. And if something doesn’t come up — well, why not use PL time if I have it?!

SOOOO, I did it – picked one random each day in May, June, and July! And I will keep doing this going forward until my cushion gets small enough that I don’t want to deplete it too much. But probably a 6-8 day cushion is all I need now that I am part time (48 – 64 hrs).

Follow Up, Part 3

Only tangentially related, but — I am having a good day today and am just happy I took the plunge I did, as much as I know there will be adjustment pains. I know it will take time to anchor down the ‘right’ new routines, and I am ready and willing to experiment!

1:1 kid dinner date #3/3 in the past month – this time to Sakura Ramen because A is obsessed with bubble tea. (Side note, I tasted it and OMGGGG how much sugar is in that? Actually I don’t want to know)


Fun surprise: thank you NYT!

What a huge thrill it was to receive a mention in this NYT article: 6 Podcasts to Get You Organized!!! It was a total surprise and seriously felt like such an honor. I was having an insanely busy clinic day and this was just such a crazy and unexpected boost! ALSO, huge thank you to those of you who alerted me — I actually had no idea until I clicked through!

Hopefully some more listeners will find BLP as a result, I truly enjoy doing both shows and the more interaction there is, the better! (So keep those Planner Peace and Planning-Adjacent Questions coming!)


  • Reply Rebeca October 19, 2022 at 3:14 pm

    From a fellow bubble tea addict: I ask for mine with no sugar or with 30% sugar, a modification that many bubble tea shops will accommodate (along with preferred ice level).

    • Reply Sarah Hart-Unger October 19, 2022 at 3:20 pm

      okay that is VERY good to know. Maybe I’ll tell her to try 50% to start and we can go from there!!!

  • Reply Lisa of Lisa's Yarns October 19, 2022 at 4:33 pm

    I feel like the NYT mention is the universe’s way to showing you that you are making the right decision to drop to your new part-time schedule! ๐Ÿ™‚ I hope your downloads/subscriptions grow as a result!

    The patient messages/lab follow-ups sound challenging! So it makes sense to do a M-W-F schedule so you don’t get too behind on mychart messages/lab results/etc. I’m always amazed at how fast some of my providers respond to me. Like the family practice doctor I took Will to on Friday sent me a note through mychart on Saturday morning to comment on his RSV lab coming back positive on Friday night. We saw him because he had an opening so don’t have any sort of relationship with him. I had already read the lab reports when it came into mychart. My rheumatologist responds super fast, too.

    • Reply Sarah Hart-Unger October 19, 2022 at 4:35 pm

      Yes and I don’t want to leave my patients hanging for 5 days NOR do I want to walk in weekly to an exploding inbox! You get it ๐Ÿ™‚

  • Reply Kwan October 19, 2022 at 6:29 pm

    I also came on to tell you that you can request a lower percentage of sugar in your bubble tea! Full strength bubble tea would make me crazy!

  • Reply Coco October 19, 2022 at 6:43 pm

    congrats on getting mentioned by NYT, that’s HUGE!!!! isn’t it great that someone recognize your hard work that you would do anyway because you simply love it? it’s the cherry on the top.
    love the idea of dates with kids… how often do you do? who gets to pick?

  • Reply Linda October 19, 2022 at 8:01 pm

    I wonder if the author of the article is a fan who reads reads your blog.

  • Reply Florence October 19, 2022 at 11:07 pm

    Interesting that you get back to patients so quickly! I’m adult endo in Canada… unless there’s something urgent that requires a med change, most of my patients only get their results at the next appointment. Of course, we’re a bit different than peds as I feel there is less stress associated with our blood work…I feel a parent waiting for delayed/precocious puberty or growth delay workup is much more worried than the average adult endo patient. We also have really long waiting lists…”non urgent” things wait 2 years to be seen when they’re supposed to wait 1 year.

    • Reply Gillian October 20, 2022 at 9:10 am

      I am an adult endo in NYC and my patient want lab results super quickly, often much faster than I can get them out. It is an ongoing challenge to manage expectations around the speed of follow up. Obviously, this only applies to nonurgent issues.

  • Reply Elisabeth October 20, 2022 at 4:30 am

    Congrats on the NYT article mention. What a great boost for your day, but also longterm for your podcast, too!
    I have never had bubble tea, but it’s all the rage here, too!

  • Reply Coree October 20, 2022 at 5:48 am

    Oh gosh, that’s so sweet! It makes my teeth hurt. I always order the less sugar, I feel like there’s plenty in the boba balls. But they are my comfort treat when I’ve been teaching and have lost my voice.

  • Reply Amanda October 20, 2022 at 8:50 am

    Congrats on the NYTimes mention — that’s amazing!!! And yes to patients spread over the week — totally find that MUCH better for me and my patients!

  • Reply AW October 20, 2022 at 8:57 am

    I bet you are a super popular doctor too :).

  • Reply Diane October 20, 2022 at 12:58 pm

    Bubble tea is a sugar bomb but I love it- i donโ€™t drink coffee so Bubble tea is my indulgent drink of choice. Like mentioned above, I do no sugar in mine. The boba is actually stored in sugar water so I find that sweetens the drink plenty.

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