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It's pretty straightforward - if you don't have a separate timekeeper, the referee does it. They've been using a stopping clock in NFHS games with no problem for literally decades now, where although there is normally an official timekeeper, the NFHS rules also state that:
Not close to the same thought. In NFHS we stop time for goals, cautions, and injuries, which is manageable. We don't stop every time the ball goes out of play--and I can't imagine trying to do that while reffing. If IFAB/FIFA want to capture all that time, it is completely manageable within the existing Laws: all they have to do is tell the Rs and 4O that is the expectation and they 4O is responsible for accurately timing stoppage from injuries, goals, misconduct. The fact that isn't the instruction makes it pretty clear that the powers that be see the cure as worse than the disease.
I do think other areas of enforcement would also have an impact. The rule change I would make is the sanction for the GK IFK infractions. Part of why refs are very reluctant to call these is the resulting IFK that comes about, which is always a cluster %#&$. Change the restart on GK IFK infractions to a CK (or borrow from field hockey and make it a "short corner" from the PA/GL intersection. That is still bad for the defending team, but not the same chaos as the IFK. And tell R's to call it--give a warning at 6 seconds and call it three seconds later if the GK is still holding the ball. As we saw with PKs, the players will adapt. After the first season it will almost never get called.
I also wouldn't mind borrowing from basketball on restarts--delay your own restart, and its a turnover to the other team. Yup, that GK becomes a CK. I think GKs are going to be less interested in risking that result than a meaningless caution, but it still isn't so draconian that it can't be called.
A bit radical, but I think less radical in effect than a stop clock, which I think would radically change the flow of the game.