While most doctors are very good at providing good quality medical care, most of them organise their clinics very inefficiently. Patient flow is disorganised; patients are made to wait for hours on end; phone calls are not returned; and medical records are hard to track down. This creates a lot of unhappiness and frustration - for both patients and doctors. The reason is historical. Doctors are never taught practise management skills in medical college; and some never pick these up. When they start practise as solo practitioners, they single-handedly run the clinic. In the early days, this is fine, because there are few patients, and the doctor can do everything himself. However, as he starts becoming busier, he starts having to hire staff to help him manage his clinic. Unfortunately, most clinic staff is untrained and because they are part-time, they are not very motivated in learning the complex skills involved in running a clinic. Also, the doctor is not very good at teaching them, because he does everything by " the seat of his pants". As time goes by, his attitudes harden,and he continues using the same old archaic inefficient systems, because these are the ones he has been using his entire life. Unfortunately, as his practise becomes busier, his "systems" can no longer cope, and most busy doctors today run clinics which are extremely inefficient, because they don't know how to fix the problem. They continue to get away with this inefficiency because they are the "experts" in the field, and patients are willing to put up with lots of incoveniences to see them - but this is a problem which causes a lot of stress for both doctors and their patients. Conscientious doctors are unhappy that they have to make their patients wait for so long, but they don't know what to do about this. Others take a perverse pride in how long their patients are willing to wait to see them - and boast about how hard they work long hours into the night ! Unfortunately, being busy is not the same as being efficient or effective !