Australian GPs spend only 79% of working time on direct patient care, and administrative dissatisfaction rose from 60% to 70% between 2023 and 2024. Practice owners also carry compliance, HR, accreditation and strategic load. A workable system uses Covey's urgent/important matrix, protects time for Quadrant 2 strategic work, and delegates routine administration to practice managers and nurses.
Australian GPs lose roughly a fifth of their working week to non-billable administrative tasks, and the RACGP reports that dissatisfaction with the administrative burden rose from 60% to 70% between 2023 and 2024. For practice owners who also carry compliance, HR, accreditation and strategic responsibilities, the problem compounds. This post sets out a practical time management system grounded in Stephen Covey's urgent/important matrix, adapted for general practice and supported by peer-reviewed evidence from physician-specific research (Gordon and Borkan, 2014) and Australian workload data. It covers how to distinguish between urgency and importance on a clinical day, how to protect time for strategic work and which tools and habits make a difference in practice.
The problem with numbers
The RACGP Health of the Nation 2024 report found that only 79% of a GP's working time goes to direct patient care. Indirect clinical work (results, referrals, correspondence) and management tasks consume the rest. MABEL longitudinal survey data show GPs spend 5.1 hours per week on non-billable activities (Bayram et al., 2021). Henderson et al. (2016) in the Medical Journal of Australia calculated the annual opportunity cost of this unpaid work at $10,526-$23,008 per GP.
Practice owners carry a heavier load than many other GPs. In addition to patient care, they manage Medicare billing compliance across time-tiered MBS items, RACGP accreditation cycles, Practice Incentives Program reporting, My Health Record obligations, CPD requirements, and staff management. The RACGP found that 69% of GPs report burnout, and 80% of practice owners express concern about their practice's viability (RACGP, 2024). Average FTE per GP has fallen from 0.79 in 2018 to 0.74 in 2023, so GPs are doing the same volume of work in fewer hours.
The picture is the same internationally. In New Zealand, the RNZCGP's 2024 'Your Work Counts' diary study found that a 40-hour clinical week breaks down to 22 hours of contact time, 12 hours of non-contact clinical work and 6 hours split between training and management. Every hour of face-to-face time generates at least 30 minutes of follow-up work. In Canada, the 2026 CMA/CFIB report found that family physicians spend 9.9 hours weekly on administrative tasks, and eliminating unnecessary administration could free capacity equal to 9,093 full-time physicians, roughly 9% of Canada's active medical workforce.
The compass and the clock
Much of time management comes down to the balance between the compass and the clock.
The compass is about what you decide to do.
The clock is about how and when you do it. The 'what' is about effectiveness. The 'how' is about being organised.
Stephen Covey's time management matrix, built on the Eisenhower principle, sorts tasks along two axes: urgency and importance. This produces four quadrants.
Quadrant 1 (urgent and important) is the crisis zone: the acutely unwell patient, the staff no-show, the accreditation deadline.
Quadrant 2 (important but not urgent) is the productivity zone: strategic planning, financial literacy, team development, systems improvement and governance training.
Quadrant 3 (urgent but not important) is the deception zone: it screams for attention but adds little value: routine emails, some phone calls, low-priority interruptions.
Quadrant 4 (not urgent, not important) is waste: time you can usually reclaim by recognising you don't need to spend it.
This is not generic self-help. Gordon and Borkan (2014) reviewed 5,624 studies and found only 15 that provided time management techniques for physicians. They adapted Covey's matrix for clinical work, noting that doctors find it hard to label any task as 'not important' and proposing modified language (important/less important, urgent/less urgent). Their finding: urgent patient care systematically displaces important-but-not-urgent work, which is the work central to career development and practice improvement.
Behavioural research supports this. Zhu, Yang and Hsee (2018) documented what they call the 'mere urgency effect' across five experiments: people prioritise time-sensitive tasks over tasks with greater rewards. Those who are busy, time-conscious and schedule-driven, a profile that fits most practice owners, are most susceptible.
In practice, I use three quadrants rather than four. I find no need for Quadrant 4 other than to recognise that I don't need to do whatever falls there. I set aside fixed time to deal with Quadrant 3 items, say an hour for emails and return calls twice a day, and I focus the rest of my energy on keeping Quadrant 2 protected and Quadrant 1 manageable.
The point of spending time in Quadrant 2 is to reduce the amount of time you spend in Quadrant 1. If you invest in systems, training, delegation and planning, crises happen less often. If you don't, you're permanently reactive.
How to protect Quadrant 2 time
This is where the 'big rocks' concept comes in. You schedule your most important commitments into your calendar first, before the small tasks fill up the rest of the week. If you don't protect time for strategic priorities, they will not happen.
Spend an hour a week planning your week. Spend 15 minutes a day planning your day. Schedule strategic time in your calendar the same way you'd schedule a patient: it gets a time slot, a colour code and a reminder. Tasks without a set time fall off your radar.
Set goals and write them down, attach a deadline and break each goal into achievable pieces. Make them SMART: specific, measurable, achievable, realistic and time-bound.
When you look at each task, identify its significance (vital, important or optional) separately from its urgency. Urgency is different from importance, and the tyranny of urgency, those things that scream for attention but carry low significance, is the single biggest time thief in general practice.
Set aside strategic time for activities such as gaining financial literacy, acquiring legal and HR knowledge, reviewing practice KPIs, or building governance skills. These are Quadrant 2 work, and skipping them is how practices stay stuck in crisis mode.
The evidence for huddles and delegation
Two interventions have a strong evidence base for general practice.
Daily team huddles
Rodriguez et al. (2021) published a scoping review in the Journal of General Internal Medicine covering empirical research on huddles across clinical settings. The Institute for Healthcare Improvement studied 10 high-performing health systems and found standardised huddles were a feature of excellent management, with over 92% of identified problems resolved. A huddle takes 5 to 15 minutes before the first patient and covers staffing, the day's schedule, complex patients and care gaps.
Team-based delegation
A study of 27,836 family physicians published in JAAPA (Hooker et al., 2021) found that practices with nurse practitioners or physician assistants experienced increases in panel size of 259 to 410 patients per physician. In the Australian context, expanding practice nurse roles in chronic disease management, immunisations, wound care, health assessments and mental health care plans can free hours of GP time each week. Delegation means putting the right tasks with the right people.
Practical tools and habits
I've tried a lot of tools over the years. I've settled on Gmail and Google Calendar for scheduling with Google Tasks. Gmail has labels and colour-coded stars. I use red for urgent, blue for strategic, and green for the rest, including follow-up on delegated tasks. I use label rules in Gmail to categorise emails as they come in and also label them by action (e.g., agenda items, for specific people or meetings). It's relatively simple to set aside specific protected time to address these tasks.
I also group related agenda emails under a specific label, e.g., CEO or Manager Agenda, and address them all in a single meeting rather than handling them one at a time. At the meeting, it is easy to delegate the starred actions and change their star colour status to green, removing the star when they are complete.
One rule I follow: never book a meeting for more than 20 minutes. That leaves 10 minutes to write up actions and move on. Meetings expand to fill the time you give them.
Batch processing of administrative tasks, grouping similar work rather than handling it piecemeal, reduces the cognitive cost of switching between different types of work. Arndt et al. (2017) in the Annals of Family Medicine found that family physicians spend roughly 4.5 hours daily on electronic health record tasks plus 1.4 hours outside the clinic. Even recovering 14 minutes per day from billing and coding frees capacity for inbox management, team huddles or an extra appointment.
The practice manager role carries much of the load. The Australian Association of Practice Management represents over 2,800 managers, and a UK survey (2024 to 2025, n=174) found that 96.5% of GPs and practice managers agreed that practice managers affect patient outcomes. A good practice manager takes Quadrant 3 work off the GP's plate and creates the systems that keep Quadrant 2 priorities on track.
Start with values
Before any of this is useful, you need to know what you're managing time for. Covey's system requires you to step back from the day-to-day and consider the bigger picture of your life and your practice. Without clarity on your personal and business values, it's hard to decide what goes in Quadrant 2 and what doesn't.
Spend some time thinking about and writing down your personal and business values. The only way to manage your time is by deciding what you will not do. Everything else follows from that.