On Meetings and Efficiency: Dermato-philosophy

Dermatologists are known to be among the most efficient clinicians, often seeing scores of patients per day.¹ In a usual visit, dermatologists are frequently able to accomplish the following in a matter of minutes: meet patients, establish a rapport, make diagnoses, describe disease processes, develop and explain treatment approaches, and when necessary, perform small procedures. It is perhaps unsurprising then that, as a group, dermatologists are highly focused on efficiency and productivity, even outside of the clinic. One area that deserves a high degree of scrutiny is meetings. With the increasing bureaucratic burdens in medicine, meetings—and here we refer to the administrative type rather than an educational conference—have become a fixture of modern life for clinicians, a far cry from the nostalgic vision of a rustic doctor working alone after hanging out a shingle.² Team meetings, committee-meetings, hospital-mandated meetings, research meetings, educational meetings—meetings are unavoidable regardless of one’s role and focus in health care.

Many have expressed a generalized antagonistic attitude toward meetings, and physicians are likely no different.³ In this brief article, we aim to outline best practices and principles for maximizing efficiency in meetings from a dermatology perspective. The goal is not to criticize well-intentioned efforts but to revisit the purpose of meetings and to offer constructive and practical suggestions to improve meeting efficiency. Ahead, we share personal experiences, anecdotes, and a variety of opinions, supplemented with external evidence from the literature, where available.

Culture of meetings

There is a general culture of meetings, particularly in the corporate world, that has been discussed and parodied extensively. From coffee mugs that proclaim, “This meeting could have been an email,” to the pithy and hilarious quote from author Dave Barry: “If you had to identify, in one word, the reason why the human race has not achieved, and never will achieve, its full potential, that word would be ‘meetings.’”

It is clear that meetings have long been a contentious subject, and complaints are often voiced when a meeting feels ineffective or purposeless or when the goal could have been accomplished by other, more efficient means.⁴ Hunt Johnsen, a designer/builder in Encinitas, CA, once said: “Never lift what you can slide, never slide what you can roll, never roll what you can get someone else to move for you.” One could riff off of that saying: “Never meet in person when you can video chat, never video chat when you can call, never have a meeting when you can communicate just as efficiently asynchronously.”

Prevent superfluous meetings

A recent study conducted by Rogelberg et al measured a variety of factors related to meetings and highlighted the significant costs and amount of strain that unnecessary meetings placed on companies’ financials and their employees.⁵ Conclusions from this study were clear: unnecessary meetings are costly. In addition to the direct, measurable costs, intangible costs were also taken into consideration. The study found that 86% of employees felt they worked more effectively when they had longer periods of time uninterrupted by meetings. This alludes to the concept of the “maker’s schedule and the manager’s schedule,” beautifully articulated by Paul Graham.

The concept of a maker’s schedule versus a manager’s schedule argues that there are two broad types of schedules that are largely incompatible. The manager’s schedule is optimized for those managing people and teams and is embodied in the traditional appointment book, with each day cut into numerous short, meeting-length intervals. In contrast, the maker’s schedule reflects a creator’s needs, like carpenters, writers, artists, or programmers, and is characterized by longer, uninterrupted periods. These extended periods of time allow for greater focus and productivity. Even a quick meeting in the middle of one of these longer intervals can disrupt flow, and it can take significant time to restore a highly productive state once interrupted. It is possible that, if managers organized meetings with an understanding of this concept, there would be fewer, less costly meetings. Dermatologists dip into both of these schedule types, with patient care very much on a manager’s schedule but things like finishing notes, writing scholarly papers, or preparing for a presentation very much in line with a maker’s schedule.

There are, however, other ways to prevent superfluous meetings. Nir Eyal, the author of the book Indistractable, addresses this by stating the following: “One of the easiest ways to prevent superfluous meetings is to require two things of anyone who calls one. First, meeting organizers must circulate an agenda of what problem will be discussed. No agenda, no meeting. Second, they must give their best shot at a solution in the form of a brief, written digest. The digest need not be more than a page or two discussing the problem, their reasoning, and their recommendation.” Keeping in mind that the primary objective of most meetings should be to gain consensus around a decision and take action around this consensus, organizers can use these two requirements, along with the concept behind the maker’s and the manager’s schedule, to decide whether or not a meeting should be held.

Action Items

One common complaint about meetings is the feeling that nothing was accomplished. Therefore, when there is a requirement to hold a meeting, organizers should decide what needs to be done during and after the meeting and develop a plan based on these decisions. This means that an agenda should be accompanied by an action item list. An action item is a discrete task that a team or individual must accomplish during and/or after the meeting. Therefore, all items planned during the meeting should be completed by the end of the meeting, and the tasks that arise from meetings should be documented for easy follow-up and tracking. As teams or individuals complete the tasks, they should be recorded as being completed, then removed from the list of outstanding action items. A sample action item list is shown in Figure 1.

Figure 1: Sample action item list

Live, Video, Telephone, or All Alone

Regardless of the decision to hold a meeting or the content discussed in the meeting, a separate consideration should be the setting of the meeting. After several years of foregoing travel and holding meetings virtually due to the pandemic, many individuals have felt that their previous travel for meetings was simply not worth the time, expense, and effort. Thus, when planning a meeting, certain factors should be considered to decide whether the meeting should be held in person or virtually.

Although most travel restrictions and social distancing requirements have been lifted, the shift toward online meetings has maintained much of its momentum. In fact, it has been predicted that 40% to 60% of long-distance business travel will permanently cease.⁶ While this shift in long-distance travel may negatively impact multiple industries, including air travel, hotels, and restaurants, a variety of other factors are at play. One of these factors, and a compelling reason to continue limiting the need for travel, is the environmental impact. Commercial air travel is responsible for about 3% to 4% of total US greenhouse gas emissions. Moreover, low-density, first-class travel can result in as much as four times the emissions as compared to coach passengers. Environmentalist and author Paul Hawken calls flying long distances for business meetings “a catastrophically monumental waste of resources.” Furthermore, local travel in cars to meetings unnecessarily held in person results in additional emissions while also contributing to traffic. Even hyper-local meetings have a cost: having to close out what you are working on, pack up your things, and head down to a meeting in the same office is still more invasive and time consuming than just logging in via computer or picking up the phone. Lastly, in-person meetings may make it difficult for people with disabilities or other specific needs to attend and participate.

Along with the environmental cost, other factors, including time, financials, and the emotional toll of travel, should be considered. When deciding to hold a meeting in person, organizers must weigh and justify these costs with the potential benefits of in-person meetings. These benefits include the ability to provide a stimulating or inspirational environment, the ability to pair a tour or another experiential component to the location, additional activities or networking opportunities outside of the meeting venue, or a substantial need for focused, concentrated efforts or privacy.^7,8

One possible way to maximize the efficiency of meetings is to encourage hybrid meetings. These meetings offer the best of both worlds, combining the advantages of in-person meetings with virtual participation. Although hybrid meetings come with their own set of challenges, their flexibility, cost-effectiveness, and ability to include remote participants make them highly beneficial.

Making the Most of Meetings

While meetings are a common component of many individuals’ lives, they are often considered unproductive or a waste of time. In this article we discuss common problems of meetings and offer perspectives and actions that can be used to address these problems. This is summarized by a flow sheet seen in Figure 2. To reduce superfluous meetings, organizers should consider the concept of the maker’s and manager’s schedules and the associated costs. Organizers should also make an agenda prior to the meeting to ensure the agenda merits calling a meeting. When a meeting is held, organizers should ensure productivity of the meeting. Lastly, organizers should weigh the costs and benefits of in-person meetings to decide upon the setting of a meeting.

Figure 2: Flowchart designed to be used when planning a meeting

1. Feldman SR, Fleischer AB, Jr, Young AC, Williford PM. Time-efficiency of nondermatologists compared with dermatologists in the care of skin disease. 1999;:

2. bson CC, Resneck JS Jr, Kimball AB. Generational differences in practice patterns of dermatologists in the United States: implications for workforce planning. 2004;:

3. ell DN, Feldman SR and Huang WW-T. The most common causes of burnout among US academic dermatologists based on a survey study. 2019;:

4. c AS. Don’t waste my time! A guide to common sense meetings. 2004;:

5. lberg S. Report_The Cost of Unnecessary Meeting Attendance.pdf.

6. anza B. Updated Study Estimates Up To 40% Of Airline Business Travel May Not Return.

7. VA

8. VA