Time Management for physicians

Let's face it and set the facts here. We will never be able to catch up on every single task we need to accomplish. plans don't always go as planned. Life .. just happens.

But what we can do is at-least try to lessen the wasted time, and regain some control on our passing days.

Lost time is never found again.

(Benjamin Franklin)

For healthcare workers in general, it is becoming much harder to keep up and maintain a good work-life balance. Increasing demands, complexities, limited resources, and inability to cope are increasingly major challenges contributing to professional burnout, increased depression rates and suicide.

Many medical publications have recognized and established the prevalence of burnout and depression and increased demands from healthcare professionals, but only few addressed how to improve, and effective strategies to improve efficiency and effectivity.

If you find yourself in the midst of overwhelm (like I used to) .. lets try together to establish a helpful practical framework to begin with.

first and most importantly .. Slow down and take an honest look on what are you trying to achieve, what are you sacrificing, are your goals worth the sacrifices you are giving?

Only if you have done this reflection and kept honest with yourself .. you will be able to organize and prioritize your life goals.

Identify your personal goals and objectives:

• Set your short (1- 2 year ) and long term (5-10 years) goals. your short term goals should be your path toward achieving your long-term goals.

• Once you have an idea on what you want to achieve, write them. This will lead you to identify you coming actions and push you to start planning.

• Keep monitoring and revising your goals repeatedly.

Once you know your goals, Set your priorities:

• be realistic and honest to balance your responsibilities and expectations.

• Learn how to balance your never ending responsibilities by using the Covey's time management matrix technique.

Focus Matrix is an example of a productivity app. that can help you prioritize and manage your tasks.

Plan and organize your tasks and activities:

• find the 10% solution: Break your big tasks into small steps. make small adjustments to gain mini achievements to keep you going.

• Develop a weekly, daily and monthly plans.

Time blocking, or time mapping concept is a very effective method that allows you to be in control of your day ahead. There are many ways to use time blocking, you can try and adjust it according to your needs. I find it difficult to completely time block all my days for every waking hour.

In my situation, there are always unexpected things you have to take care of every day. I've learned from my work in the ED to be chaotically organized. I have

blocks of routine, where everything else is flexible around it, and be very open to the idea of changing your expectations and just go with the flow.

So the way I use time blocking is more flexible than other strictly tight, must adhere to schedules.

• Identify your next week's general framework, your most important project that you need to work on, important meetings to prepare for, kids special school activities you need to prepare for etc.

• The point of this method is not that you will strictly adhere 100% to this planned schedule, but at-least that you looked ahead of time to how does your week look or how much need to be done, so you'd be aware of any wasted time or extra free time you might have, or recognize the need to catch up in limited time if necessary.

• identify your big routine work (clinic, class, picking up kids) and block that time on your calendar. be realistic, be aware of commute time, lunch time, interruptions etc.

• Identify a short list of tasks to be done for that day (5 max for example).if it happened you have more free time you can add extra tasks accordingly, but don't get into the habit where you over cram your day and end up postponing your tasks.

• allocate time blocks for every task, usually scattered around my big routine work for that day. Add small tasks as buffers between big tasks.

• Don't assign multiple high priority projects all over the day. Specially if you are working a long routine day.

• Identify your most productive time and block it to your highest priority tasks if possible where your energy is the highest. (early riser vs night owl)

• set a physical space where you can work with less distractions or interruptions, if possible. ( eg.writing your manuscript in a busy emergency department will probably not end as a very productive session)

• Set your lowest energy time to complete less urgent tasks like answering emails.

• Answering non urgent emails should be set a limited time per day, not to exceed 4 times a day (unless its an urgent email that requires your attention)

• Alternate between your highest and less priority tasks over the day.

• Set a reasonable period of time to complete a measurable component of the task.

• if you need to work big time blocks, make sure to chunk them into brief sessions with breaks in between, to gain maximum benefits and be able to get into your flow smoothly

• I use Session app on my computer and I feel its absolutely essential to have some sort of a timer. Any timer to apply the pomodoro technique is sufficient.

• I also like to keep some sort of quantification to my productivity. I don't over track every single activity I do, but I try to identify certain trends in my daily routines to be able to tweak them and find a sweet spot for maximum energy, flow and productivity. Session also allows me to keep this measurement.

• There are more robust time tracking methods, if you are more interested to take it to the next level Hours, Forest, Clockify etc.

• All those weekly and daily plans should be guiding you in a clear path toward achieving your long term goals.

• Planning your day ahead will help you to reduce wasted times in non urgent tasks, keep you in better control and awareness of your calendar, ensure you avoid distractions and plan for a personal break and off time for yourself to be able to recharge.

Be aware of your distractors:

• Observe and eliminate interruptions around you if you can. if you are unable to work in your office because of constant colleagues or urgent patient's matter interruptions, don't plan your important work in that time.

• you can also use the physical space to minimize the interruptions, for example .. close your office door for a certain period of time, if this is feasible. Determine certain office hours if you are in academic setting.

• Use a close by library or coffee space of your preference to work is another example of recognizing the optimal physical space to work in.

• Recognize the less optimal options to work on the less urgent tasks that does not require high energy or concentration .. while commuting, waiting areas, etc.

• Always anticipate un expected events even in your free blocks of time, where you need to adjust your schedule continuously, like an urgent meeting, changed deadline of a project.

• How ever your schedule, always expect 25 - 70% of unexpected events in your free time. This expectation of emergencies will save you frustration and failed plans.

Finally, Time management is a skill if learned, can increase your efficiency and satisfaction, can help you achieve more goals, reduce stress and improve your life work and personal harmony.

Until we can manage time, we can manage nothing else.

( Peter drucker)

For further reading:

• Personal Productivity: How to work effectively and calmly in the midst of chaos

• Recapturing time: a practical approach to time management for physicians

• The Pomodro Method of time blocking

• How to Time block

• First things first, Stephen Covey.

• Getting Out from Under, Stephanie Winston.

• 168 hours: you have more time than you think, laura Vanderkam.

• Deep Work: Rules for focused success in a distracted world, Cal Newport.