Focus on Physicians:
Insights, Ideas, and Strategies
When Work Follows You Home: The Hidden Cost of “Work-Life Integration”
With the rise of EHRs and telemedicine, the term "work-life integration" rapidly has become an administrative buzzword. However, for physicians who are expected to be always on duty, this approach can paradoxically increase stress and decrease balance.
In this article, I’ll explore why work-life integration might not be the promised panacea for getting it all done.
An earlier version of this article appeared on this website in August, 2024
Unless you’ve been in practice for decades, you may not remember a time when work didn’t follow you home. EHRs, patient portals, and telemedicine are part of the everyday fabric of medical practice. Over time, these tools, first touted as efficiency builders, have changed not only how care is delivered, but also where work lives, increasingly extending into the time and space that once allowed for rest and recovery.
The Myth of Seamless Integration
Against this backdrop, “work-life integration” has been offered as a solution. Rather than separating work from personal life, the generally well-meaning idea is to blend the two to create flexibility and make it easier to manage competing demands.
In theory, it sounds reasonable. But in practice, it often means something else entirely.
For physicians, integration rarely looks like meaningful flexibility. More commonly, it translates to constant accessibility. This often means responding to patient messages, completing documentation, and managing administrative tasks outside of scheduled work hours, or even on vacation.
As a result, work doesn’t simply shift location. It expands. And over time, that expansion has become normalized and often expected.
The Professional Cost of Always Being “On”
The concept of work-life integration encourages multitasking, which science has shown to be a misnomer.
Multitasking in fact isn’t true parallel processing. In reality it’s rapid task-switching. And that comes at a well-defined cost:
increased cognitive load
decreased focus
reduced accuracy
fatigue
This common scenario is a set up for:
Impaired decision-making
But beyond that, there’s a deeper cost. When you are continuously stretched, your capacity for empathy, curiosity, and engagement begins to narrow. Work begins to feel more transactional and less sustainable. And everyone, from your patients, to your loved ones and family, and yourself, suffers.
The Illusion of Flexibility
Personal time exists for a reason. By definition, it makes room for the parts of your life that cannot be fulfilled at work. Ironically, work-life integration is often marketed as freedom. But let’s be honest about how it plays out. You’re probably not bringing your toddler or your elderly mother to your office. And you’re not taking a walk with your EHR.
Personal time is where you:
connect with family
rest and recover
move your body
nurture your spirituality
engage in relationships and activities that require your full attention
These are not things that can be meaningfully “integrated” with clinical work.
More often, the flow is one-directional. Work spills into life, shrinking and fragmenting the limited space that remains.
And over time, something subtle but important happens: You are no longer fully present anywhere.
A More Honest Path Forward
If we want physicians to thrive, we need to move beyond language that sounds good but doesn’t hold up in practice.
For healthcare systems, this means:
reducing unnecessary administrative burden
minimizing “click work”
allowing support staff to manage appropriate tasks
creating environments where focus, not fragmentation, is supported
For physicians, it means reclaiming boundaries: protecting your attention, your energy, and your capacity to think clearly, and to care.
The Bottom Line
The concept of “work-life integration” is not inherently harmful. But it often becomes a justification for constant availability, and that is not sustainable. When work is everywhere, it becomes difficult to be fully present anywhere.
To sustain balance, you need a center of gravity. That comes from creating the conditions for both your work and your personal life to fully exist, so that your time, energy, and attention are not continuously claimed by one at the expense of the other.
Remember that balance is not just about managing your work; it’s also about nurturing and protecting what gives your life meaning and joy.
If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.
If you’d like to learn more about my coaching practice, you can schedule a complimentary introductory meeting by clicking the link below.
How to Manage Interruptions and Limit Attention Residue: A Guide for Physicians
Attention residue happens when you switch tasks, but a part of your mind remains stuck on the previous task. The little breadcrumbs that remain can significantly decrease your cognitive performance and make it harder to focus. And once you’re interrupted, no matter whether the issue was urgent or trivial, it’s easy to switch over into another unrelated brain drain, such as checking your email or social media, rather than returning to the task at hand.
In this article, we’ll explore strategies that you can use to retake control of your mental focus, manage interruptions, and minimize attention residue in your daily practice.
An earlier version of this article appeared on this website in July, 2024
It’s not just your imagination. It really is more challenging than ever to maintain your mental focus at work.
💉 EHR alerts
💉 Phone notifications
💉 Interruptions from staff
💉 Attention sapping apps
All of these and more conspire to make staying focused a daily struggle for many physicians, regardless of specialty.
Repeated interruptions and the lingering effects of shifting attention, known as attention residue, can severely hamper not only your effectiveness and productivity, but also your personal well-being.
Resolving the current state of disorder in healthcare will require systemic change, including a fundamental shift in the functionality of many EHRs. But protecting your headspace now is a critical skill that can help you stay above the fray.
In this article, we’ll explore strategies that you can use to retake control of your mental focus, manage interruptions, and minimize attention residue in your daily life and practice.
Understanding Attention Residue
Attention residue happens when you switch tasks, but a part of your mind remains stuck on the previous task.
The little breadcrumbs that remain can jumble up your thoughts and make it harder to focus. And once you’re interrupted, no matter whether the issue was urgent or trivial, it’s easy to drift over into another unrelated brain drain, such as checking your email or social media, rather than returning to the task at hand.
Realistically, interruptions have always been part of life in most medical settings. But the challenge has intensified due to
💉 EHR systems that promise constant accessibility
💉 Increasing patient complexity
💉 Expanding administrative burdens
💉 Widespread staff reductions
💉 Growing supervisory responsibilities for non-physician staff
Except for the small but growing number of forward-thinking healthcare systems, the current environment is a near-perfect recipe for attention residue.
This isn’t just theoretical. Studies show that interruptions from a broad range of sources may happen more than every 6 minutes in busy medical environments like the Emergency Department. It’s no surprise that these repeated interruptions can seriously degrade your ability to remain focused and aware.
How to Reclaim Your Mental Focus
Ideally, healthcare leaders will recognize the need for systems and workflows that reduce unnecessary interruptions. Some organizations are already making meaningful progress in this area. But even under the best of circumstances, interruptions are going to happen. Here are a few ways that you can limit the mental drain.
Prioritize and Plan
This can be a difficult step for physicians, since we don’t always have control over the way the day might go. But simply outlining your top priorities can help by giving you a focus and a “north star” for the day.
Start by outlining your top priorities. Whenever possible, focus on these high-impact tasks when your mental energy is at its peak. For many people, that is the first thing in the morning.
Use tools like the Eisenhower Matrix (also known as the Time-Priority Matrix) to strategize your urgent and important tasks, and mitigate those less important time-wasters.
Time Blocking
Consider setting aside specific time blocks for different types of tasks. For example, set aside uninterrupted time to study for your boards, or for administrative work. If you have some control over your schedule at work, scheduling similar patient visits can be helpful, so that your mental flow is less likely to be interrupted.
Communicate your schedule and your plan to create these focused blocks of time to your team (or your family) to minimize unnecessary interruptions. Getting buy-in from your schedulers and administrative staff can help to make time blocking work for you.
Mindfulness and Meditation
Mindfulness is more than a catch-phrase. Techniques like deep breathing, meditation, or yoga can sharpen your ability to focus and help regulate stress. These are tools that can help you to strengthen your cognitive resilience in the face of a demanding clinical environment.
Meditation in particular has been found to be helpful in improving attention, focus, and memory and reducing stress. Just like medication or physical therapy, consistency matters. In one study, it took 8 weeks of regular practice before the impact of meditation was clear.
Taking a mindful pause before and after each patient, study, or procedure is a great way to mentally reset. In many cases, even this very brief break can improve your efficiency and help you to regain a sense of control.
Limit Multitasking
Multitasking was once considered a badge of honor, and something to aspire to. But now we know that when people multitask, they often make more mistakes.
Research shows that multitasking also leads to longer completion times and greater mental fatigue. This is especially true when both (or more) tasks require cognitive effort rather than simple rote actions. In reality, tackling one task at a time is usually faster and far more effective.
So what’s the alternative? When you're faced with a task that’s too large to complete in a single sitting, try breaking it down into smaller, more manageable steps. Each sub-task becomes its own achievable goal, which can help reduce overwhelm and maintain your momentum. Writing these steps out and checking them off as you go can boost motivation and give you a sense of progress, even during busy or fragmented days.
As you knock out these smaller to-dos, you’ll build a sense of accomplishment. That feeling of progress can help quiet the mental clutter and reduce the attention residue that builds up when unfinished work lingers in the background.
Set Boundaries
Not only are they annoying, but interruptions increase the likelihood of errors, directly impacting patient safety. What’s more, these unwanted intrusions also impact your own mental well-being and your relationships by triggering heightened levels of anxiety and annoyance. That’s why setting boundaries is a crucial skill.
Whenever possible, set clear boundaries around your availability with colleagues, staff, and patients. Visual cues such as a closed door or a sign that reads “Do Not Disturb Unless Urgent” can signal your need for focused time without seeming unapproachable. And if you’re in the operating room or in a procedure, be sure that the parameters for interruptions are very clear.
When you're engaged in cognitively demanding work like surgery or a procedure, reviewing charts, developing treatment plans, or reading studies, it’s a good idea to minimize social or nonessential conversation. Let your colleagues know when you're in a focused work mode so they understand that any delay in response is intentional, not personal. Over time, this kind of clear communication builds mutual respect and helps foster a team culture that supports protected time for high-concentration tasks.
It can also be helpful to set expectations with patients and staff that non-urgent in-box messages will only be addressed during or after certain hours of the day.
Reclaiming Your Focus
Maintaining mental focus requires practical, intentional strategies and consistent follow-through. By experimenting with the time-tested approaches I’ve offered above, you’ll strengthen your ability to concentrate, reduce attention residue, and better manage the inevitable interruptions in your day.
If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.
If you’d like to learn more about my coaching practice, you can schedule a complimentary introductory meeting by clicking the link below.
What if You Don’t Know What You Want Next: A Physician’s Guide to Finding Direction
Like many doctors, there may come a time when you feel a need for change and a yearning for something different. Maybe you feel stuck, unfulfilled, or underappreciated. Or perhaps you simply crave a change of scenery.
In this article, I’ll give you some strategies that will help you to gain clarity and direction when you’re not sure what you want next.
An earlier version of this article appeared on this website in March 2024.
As a physician, you've poured years of your life into your profession. You spend the better part of your waking hours staying current on the latest research, honing your skills, serving your patients with compassion and care, and being a supportive teammate to your colleagues and staff.
But, like many doctors, there may come a time in your professional trajectory when you feel a need for change and a yearning for something different. Maybe you feel stuck, unfulfilled, or underappreciated. Or perhaps you simply crave a change of scenery.
In this article, I’ll give you some strategies that will help you to gain clarity and direction when you’re not sure what you want next.
Why Uncertainty Feels So Hard
Even when your current trajectory feels all wrong, it may be difficult to envision what change should or could look like. From medical school to residency and beyond, your path up to this point has probably been clearly marked. As you reached one milestone, the next was likely in view. That’s one reason that making your own way can feel like such a steep climb.
There’s a certain comfort and predictability in following the well-worn trail, no matter how strenuous. For many people that is the right choice. But at some point you may find yourself longing to choose your own direction, or set your own pace. Whether you're considering changing the way you practice, adjusting your working hours, exploring opportunities outside of clinical medicine, or even contemplating retirement, the uncertainty can be daunting.
It’s very easy to get stuck at this point, instead of recognizing that this period of unease is often the first step in a new direction.
Seven Strategies to Move Forward
Although it’s important to think things through, I’m a firm believer in the adage that action creates clarity. Action however, does not have to mean commitment or a big shift. Sometimes that can even be dangerous, especially when you haven’t planned for the obstacles ahead. Giving yourself time and space to actively explore what is possible can make your next steps more clear.
If you’re feeling like you’ve come to a standstill, here are some ideas that can help pull you out of the rut and find some serious traction that will move you forward.
🥾Reconnect with Your Core Values
Take some time to reflect on what truly matters to you, both personally and professionally. What are your core values? What values do you want your career and life to reflect?
Understanding what drives you and what you hope to achieve can provide valuable insight into the direction you should take. If you’re unclear on how to express your personal values, my Values Workbook can help.
🥾Inventory Your Strengths and Interests
Think about what energizes you in your current work. Which skills do you enjoy using most? Are there interests outside of medicine that you’d like to explore more deeply?
Sometimes asking yourself “What lights me up?” is enough to spark new ideas. Don’t be afraid to consider possibilities that may not obviously relate to the practice of medicine. At this point in the process, curious inquiry does not mean commitment.
Mind mapping or journaling can often help connect your passions with new possibilities.
🥾Seek Guidance and Perspective
Reach out to mentors and trusted colleagues. Each one of us has our own story, but a mentor can give you valuable insight and may even open doors to new opportunities.
You might also choose to work with a coach. A coach will give you a safe space to explore and reflect, and the process can provide valuable insights that can help you get out of your own way. While a coach will not tell you what to do next, coaching will support you as you uncover your own answers.
🥾Explore and Experiment
If you're unsure of the direction you want to take, allow yourself to try out new experiences. Attend a conference, volunteer for something meaningful to you, take a course, or explore an interest that excites you. These experiences don’t have to directly connect to medicine. Exploration itself often reveals what truly resonates.
🥾Stay Flexible
Your path doesn't have to follow a straight line. It's okay to pivot or investigate new opportunities at any stage of your life. Be true to yourself, but keep in mind that it’s always a good idea not to burn any bridges along the way.
When you embrace flexibility, you’ll often find unexpected and even surprising opportunities.
🥾Take Small Steps
Thinking about a major change can feel overwhelming, especially for physicians. More than most other professions, we often feel defined by the work that we do.
You don't have to have all the answers right away. Break down your goals into smaller, manageable steps, and focus on consistent and purposeful action. If your goals change through the process, all the better.
🥾 Practice Self-Compassion
Be kind to yourself as you navigate change. It's normal to feel uncertain or indecisive during big transitions. Practice self-compassion and remind yourself that it's okay not to have all the answers.
Moving Ahead
As a physician, you already embody resilience, dedication, and resourcefulness. Those same qualities will serve you as you explore what comes next. By aligning with your values, experimenting with new possibilities, and giving yourself grace in the process, you’ll create space for clarity, renewal, and purposeful action.
If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.
And if you’d like to schedule a complimentary introductory meeting with me, click the link below.
Maximize Your Time: Essential Toolkit for Physician Time Management
Physicians aren’t magicians, but the demands of the job often make it feel like you’re expected to conjure time out of thin air. When every minute of your day feels like it belongs to someone else, managing your own time isn’t a luxury. It’s essential. Yet time management is rarely taught in medical training, leaving many of us to figure it out the hard way.
During my years as a busy cardiologist, I became fascinated by productivity strategies. I learned from the best in the field, and I discovered that with the right tools, I could work more efficiently and create space for what mattered most outside of my practice.
As a physician coach, I enjoy sharing these simple techniques and insights with my clients. For some, they can be transformative. By optimizing your personal time, you may find that the more rigid pressures of work feel like less of a burden.
An earlier version of this article appeared on this website in December, 2023
Physicians aren’t magicians, but the demands of the job often make it feel like you’re expected to conjure time out of thin air. It’s not your imagination. A recent study found that in order for a primary care physician to provide guideline-recommended care and communication, they would have to work nearly 27 hours every single day.
With burnout impacting more than half of US physicians, much of it related to these unrealistic demands, some healthcare systems and many medical associations are beginning to take note. System-wide commitments to streamline tasks and automate simple processes are beginning to take hold. But true reform is likely to be several years away.
In the meantime, when every minute of your day feels like it belongs to someone else, managing your own time isn’t a luxury. It’s essential. Yet time management is rarely taught in medical training, leaving many of us to figure it out the hard way.
During my years as a busy cardiologist, I became fascinated by productivity strategies. I learned from the best in the field, and I discovered that with the right tools, I could work more efficiently and create space for what mattered most outside of my practice. That included time with friends and family, creative pursuits, and re-energizing with physical pursuits like riding my horse and practicing yoga. That extra space in my life helped me to stay energized and focused so I could keep showing up fully for my patients.
As a physician coach, I enjoy sharing these simple techniques and insights with my clients. For some, they can be transformative. By optimizing your personal time, you may find that the more rigid pressures of work feel like less of a burden.
Start a Bullet Journal
A bullet journal is one of my favorite time savers. This analog notebook is far more than a traditional planner. It’s a personalized system that blends task management, reflection, and goal tracking. Here’s how it can work for you.
✅Customizable Layout: Design your bullet journal to fit your needs, whether that’s jotting daily to-dos, tracking long-term projects, or creating space for self-reflection. Don’t worry about making it look pretty, unless that’s something you enjoy. Mine is simple: a basic checklist and scattered notes throughout the day. No artistry required.
✅Mindfulness Practice: The act of writing by hand boosts memory and mindfulness. It can also help you to prioritize tasks. I like to take 10 minutes every evening to set up my plans for the next day. Even if I don’t check off every box, simply writing them down creates an intention and makes it more likely that I’ll eventually follow through.
✅Bonus Tip: Use color coding for the win. Assign different colors to specific types of tasks or appointments—like blue for meetings, green for personal time, and red for urgent deadlines. It’s a quick way to visually organize your schedule and makes it easier to remember what’s important at a glance.
If you want a deeper dive into bullet journaling, check out The Bullet Journal Method, by Ryder Carroll. There’s no rush to get through it. For me, ten minutes a day was enough to build lasting momentum.
Commute with Audiobooks
Multitasking is generally overrated. That’s because most people tend to do both things halfway. And multitasking can make you more vulnerable to distractions. But listening to a good podcast or audiobook on your commute or while exercising can be a great way to safely and efficiently feed two birds at the same time. That could be CME, a good story, or personal development.
Here’s a brief list of some of my favorite productivity audiobooks:
✅Four Thousand Weeks by Oliver Burkeman is a thought-provoking exploration of time, productivity, and the modern obsession with getting everything done. Rather than offering hacks to do more, Burkeman challenges us to embrace the limitations of the human lifespan, roughly 4,000 weeks, and focus on what truly matters. It’s a refreshing, philosophical take on time management that encourages purpose over perfection and presence over productivity.
✅Atomic Habits by James Clear focuses on the development of small, incremental habits to achieve significant life changes. The book emphasizes the compound effects of your small daily decisions and the importance of establishing systems rather than focusing solely on goals.
✅Stolen Focus by Johann Hari delves into the modern crisis of attention, exploring how various factors in our environment and daily lives erode our ability to concentrate. Hari argues that the decrease in attention spans is not an individual failing, but rather a systemic issue influenced by technology, diet, sleep patterns, and societal structures. Although Hari advises systemic change, simply being aware of these forces can help you to push back.
✅Deep Work: Rules for Focused Success in a Distracted World by Cal Newport advocates for a practice of deep, focused work as opposed to the more common shallow, multitasking approach. The book offers practical advice on how to cultivate a deep work habit, minimize distractions, and maximize your cognitive capabilities. Although the ideas in the book are not always applicable to the reality of a physician’s practice, you will come away with a greater understanding of the importance of focus and the negative impact of constant distractions.
Recharge with App-Based Yoga and Fitness
Taking care of your physical and mental well-being is one of the most powerful ways to clear your head, enhancing your ability to manage time. As a registered yoga teacher, I’m a big fan of online yoga classes—not just for the practice itself, but for the flexibility they offer.
✅Flexibility: Yoga apps let you practice at your convenience, fitting sessions into a busy schedule. . Whether you have 10 minutes or a full hour, there’s something that fits your schedule. I like DownDog, AloMoves, and YogaWorks. All three also offer options besides yoga, including strength training and meditation. And some offer live options as well.
✅Stress Relief: : Yoga, like many forms of movement, is a way to reset both body and mind. If you're just starting out, or if your time is limited, keep it simple. Commit to just 10 minutes twice a week and build from there. Sometimes the hardest part is simply beginning.
✅One quick tip: If you’re new to yoga, Pilates, weight training, or any other form of movement, consider a few in-person sessions or private lessons. Learning the basics from a skilled teacher helps prevent injury, boosts confidence, and makes the experience more enjoyable.
Save Time with a Time Tracking App
Understanding where your time goes is the first step to better time management. My favorite easy-to-use option is Toggl. Time tracking apps can help you to:
✅Identify Time Drains: Tracking your time online can help you spot activities that sneakily eat up more time than you realize. That doesn’t mean you need to give up email or social media altogether—but when you see where your time is going, it becomes easier to make intentional choices that align with your priorities and values.
✅Create Structured Work Intervals: I especially like the Pomodoro Technique. It goes like this: Work for 25 minutes, then take a 5-minute break. This structured and repeatable process can enhance focus and prevent burnout. You can also use time tracking to break larger projects (as well as tasks like charting) into smaller intervals. That way you’ll maintain your focus and create a more manageable and efficient process.
✅Batch Your Tasks: By committing to focus on one type of task at a time, your efficiency will surge. For example, use a dedicated block of time for phone calls, charting, or emails. You’ll find that when you’re not skipping from one modality to another, you’re able to get more done, even if all you have is 10 minutes.
Click on “Do Not Disturb” Mode
Your attention is one of your most valuable resources. Pre-scheduling Do Not Disturb mode on your phone, computer, or both can protect your focus during critical windows of the day. Of course, being unavailable isn’t always practical, so be strategic in how you use this function. Here’s how it can help:
✅Fewer Interruptions: Silencing notifications during focus blocks helps reduce distractions and boost efficiency.
✅Protects Your Boundaries: Sending calls to voicemail or messages to “later” mode gives you breathing room for deep work, rest, or patient care.
✅Easy to Set Up: Most smartphones and operating systems allow you to automate DND based on time, location, or calendar events.
Pro tip: Let colleagues or assistants know when you’ll be in DND mode, so they can support your boundaries rather than bypass them.
Free Yourself with App Limits
Many apps, especially social media, are designed to control your attention. When you set a time limit (available in your phone’s settings), you can begin to take charge of this most valuable resource. Here’s why it works:
✅Raises Awareness: You may not realize how often you scroll until you get a daily report or hit a time limit.
✅Encourages Intentional Use: Setting a 15-minute cap on apps like Instagram, TikTok, or news sites helps you check in without falling down a rabbit hole.
✅Built Into Your Phone: Most smartphones include screen time settings where you can create limits for individual apps or categories (like entertainment or social media).
Take One Simple Step
You don’t need to overhaul your entire routine in order to optimize your time. Instead, pick and choose what works best for you, or let these ideas spark some options of your own. The important thing is to commit to making at least one change. When you invest a little time and energy to get started, you may be surprised by how much you get back.
What time management tricks and tools have you found that keep you organized and on task? Drop me a line. I’d love to hear from you!
DISCLAIMER: As an Amazon Associate I may earn from qualifying purchases, which means that if you click on one of the product links, I’ll receive a small commission. This helps support the website, for which I am grateful! Please do your own research before making any important decisions.
If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.
And if you’d like to schedule a complimentary introductory meeting with me, click the link below.
Creating Boundaries and Reclaiming Values: My Podcast Appearance on Dr. Bill Lombardi’s Journey to Better
I recently had the great privilege to be invited back to trail-blazing cardiologist Dr. Bill Lombardi's Journey to Better podcast. This is truly one of the best physician-focused podcasts out there.
Bill is a fantastic and thought-provoking interviewer! We discussed a wide range of issues facing physicians today, including the importance of setting boundaries, the crucial role of effective and engaged leadership, and how coaching can work for physicians dealing with challenges of transitions, time management, and leadership opportunities.
I recently had the great privilege to be invited back to trail-blazing cardiologist Dr. Bill Lombardi's Journey to Better podcast. This is truly one of the best physician-focused podcasts out there.
Bill is a fantastic and thought-provoking interviewer! We discussed a wide range of issues facing physicians today, including
⚕️The importance of setting boundaries
⚕️How to integrate the experience of the arts into medical practice
⚕️The crucial role of effective and engaged leadership
⚕️Why defining your personal values can help you to make better decisions for yourself and your practice
⚕️How coaching can work for physicians dealing with challenges of transitions, time management, and leadership opportunities.
You can find our conversation wherever you get your podcasts, including Spotify and Apple Podcasts, or take a listen below. And if you want to listen to my first podcast appearance on the show, you can find it here.
Bike Shedding for Physicians: Avoiding Trivial Time Wasters
Your time is precious. You have a demanding and consuming professional life. In all likelihood, you're juggling multiple priorities at any given time. Sometimes the most trivial issues seem to claim the most attention. But as a physician, it's important to be able to focus on the things that really matter, and to avoid getting dragged down into the weeds.
It’s useful to consider the phenomenon known as bike shedding. In a nutshell, bike shedding is a term used to describe the tendency to spend disproportionate amounts of time and energy on relatively minor issues, while neglecting more important but complex concerns.
An earlier version of this article appeared on this website in August, 2023
Your time is a precious commodity, but if you’re like many physicians, you give it away freely. In all likelihood, you're juggling multiple priorities at any given time, trying to get it all done while striving to stay on schedule and keep your patient satisfaction scores high.
Sometimes it’s the most trivial issues that seem to claim the most attention. But as a physician, the work you do has value, and your best work often takes time. Protecting your attention is critical. That’s why it's important to be able to focus on the things that really matter, and avoid getting dragged down into the weeds.
In thinking about the way you use your time, it can be helpful to consider the phenomenon known as bike shedding. The concept isn’t new, but it may be unfamiliar if you don’t hang out with business gurus. The term was coined by C. Northcote Parkinson, a British management expert and naval historian, in the 1950s. In introducing the idea of bike shedding, he described a committee meeting that is called to discuss a specific financial agenda. On the agenda is:
a nuclear power plant costing tens of millions of dollars
a bike shed for the plant costing a few hundred dollars
a coffee budget amounting to about twenty-five bucks
The nuclear power plant is way out of anyone’s comfort zone, and no one wants to look ignorant or ask too many questions. So they quickly approve the budget and proceed to focus on the more familiar topic of the bike shed. After extensive discussion, argument, and finally compromise and agreement, they complete the deliberations over the bike shed with a feeling of satisfaction. They round out the meeting with an hour-long debate over the coffee budget, a topic on which they all have a strong opinion.
How Doctors Fall Victim to Bike Shedding
In a nutshell, bike shedding is a term used to describe the tendency to spend disproportionate amounts of time and energy on relatively minor issues, while neglecting more important but complex concerns. If you’ve spent any time in hospital committee meetings, you can probably relate to this phenomenon. Issues such as EHR functionality and staff management can sometimes fall into this category.
But bike shedding can also happen in your personal life. For example, you might spend hours researching the perfect running shoes, instead of focusing on your training plan. Or you might spend days agonizing over the color scheme of your living room, while putting aside more important but complicated family issues at home.
It’s natural to want to escape from stressful decisions by focusing on things that don’t really matter. And the importance of taking time to step away from the chaos of the day cannot be overstated. But spending that precious time perseverating over things that are not meaningful can be counterproductive.
The bigger problems are still looming. What’s worse, these are the issues that tend to build up steam the longer they are ignored. Eventually you may find that you are pushed or dragged into action, whether you feel ready or not.
From Spinning Wheels to Forward Motion
So how to shift gears and get back on the road? Here are some tips to help you identify and avoid bike shedding, whether at work or at home:
Identify your priorities
🚳What's most important to you? Once you know your priorities, you can make decisions more easily and avoid getting bogged down in trivial matters and unnecessary conflicts.
Delegate
🚳If you can delegate tasks, do it. Delegation is important both at home and at work. This will free up your time so you can focus on the things that matter most
Remember the big picture
🚳When you're feeling overwhelmed, take a step back. What are your long-term professional goals? What do you want to achieve in your personal life? How can you break that down into achievable steps? Keeping your goals in mind will help you to stay focused on the important things.
Set boundaries
🚳It's important to set boundaries so that you spend your time purposefully. This could mean saying no to extra work commitments with little upside so that you can make time for yourself and your loved ones. Or it could mean giving up your spot on the neighborhood committee that causes you stress and lost sleep, when you’d really rather be gardening.
It’s natural to default to bike shedding. It’s a way of avoiding stress and putting off difficult questions. But it's something that you can learn to recognize, navigate, and redirect.
If you find yourself getting caught up in bike shedding, tap the brakes and ask yourself if it's really worth your time and energy. If not, let it go and move on.
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Journaling Prompts for Physicians: Rediscovering Your Personal Life
Journaling has been called the “paper mirror.” It reflects back to you, the writer, what you might not see of yourself. Yet unlike a true mirror, this mirror is private and personal. Studies of journaling have reported evidence of improvement in both psychological and physical well-being.
In this article, I am offering prompts that will give you space to dive into your personal life, including your family, relationships, and personal projects.
In an earlier article, I explored the way that journaling can help you to reconnect with your inner wisdom, helping you to find a path forward when you feel stuck or uncertain. In that article, I delved deeper into the practical mindfulness of journaling, and the benefits of writing by hand, whether in a conventional notebook or a handwriting tablet .
Journaling has been called the “paper mirror.” It reflects back to you, the writer, what you might not see of yourself. Yet unlike a true mirror, the journal’s mirror is private and personal. Given this introspective aspect, it’s not surprising that studies of people engaged in journaling have reported evidence of improvement in both psychological and physical well-being.
Of course, journaling can also resurface unpleasant thoughts and memories. That’s not always bad. Some people find the safe space of their notebook to be a perfect container for catharsis. Getting the words out of your head and onto the page can be uncomfortable, but the process may allow you to let go of those thoughts and fears that are holding you back, freeing up mental space. If it feels right, you might even want to ceremonially destroy your journal once the “bad” stuff is out.
But if it feels overwhelming or resurfaces trauma that you’ve suppressed, then journaling may also be the nudge you need to begin working with a therapist who can help you process complex memories and emotions.
In this article, I am offering prompts that will give you space to dive into your life outside of work. Let them be a scaffolding that helps you to explore the ways that personal projects, family, and relationships might intersect in your life. By intentionally putting your thoughts on paper, you may uncover ideas for mindful action that begin to align these aspects of your life with your ideal self.
Exploring Family Through Journaling
How do I currently nurture my relationships with my family? What more could I do?
What values do I want to model for my family? How can I live those values more fully?
What are some of the most meaningful moments I’ve shared with my family recently? How can I create more moments like those?
If I could describe the ideal dynamic I want with my family in one sentence, what would it be?
Are there any unresolved tensions or conflicts in my family relationships? How might I approach them with compassion?
How does my professional life affect my family life, and are there changes I could make that might bring greater harmony?
What are some small ways I can show appreciation to my family this week?
Journaling to Strengthen Relationships
Which relationships in my life feel most nourishing? What makes them important to me? How can I deepen those connections?
Are there relationships that feel draining or misaligned with my values? What boundaries might I need to set?
What does a fulfilling relationship with a romantic partner look and feel like to me? How about a friend? How do my current relationships align with that vision? How can I create more of that?
When was the last time I expressed gratitude or love to someone important in my life? How did it feel?
Who do I turn to for support, and how can I show them appreciation for being there for me?
Are there people I’ve lost touch with who I’d like to reconnect with? What’s one small step I can take this week to reach out?
What qualities do I bring to my relationships that make them stronger? How can I lean into those strengths?
How can I better communicate my needs, desires, and feelings in my closest relationships?
Empowering Personal Projects
What personal project excites me the most right now? What about it feels important or meaningful to me?
Are there projects I’ve set aside that I would like to revisit? What’s holding me back?
How do my personal projects reflect who I am and who I want to become? Where might they lead me?
Is there a skill I’ve been meaning to learn, a book I want to read, a trip I want to take, or something else? What small step can I take this week to make progress on something that I care about?
If I had unlimited time and resources, what would I pursue? Why? How might that change my life?
How do my personal projects bring a sense of balance to my life, and how can I prioritize them more effectively?
What have I learned about myself through my personal projects? What strengths or interests have I uncovered?
Integrating Self, Family, and Community
How do my personal projects, family, and relationships influence each other? Are they in harmony or competition?
How might the personal projects that inspire me connect me more deeply with people who share my passions and values?
What would it look like to balance meaningful work, personal growth, and rich relationships all at once?
What’s one thing I can do this week to bring these aspects of myself into greater alignment?
How do I want the people closest to me to remember me, and what can I do now to honor that vision?
I hope this list has inspired you. In the next article in this series, I’ll provide you with a series of prompts that will help you go deeper into creating balance, fostering connections, reframing challenges, and envisioning the future.
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Using the Language of Art to Create Work-Life Balance
Most physicians cite work-life balance as a top priority. Yet there is little clarity on what exactly work-life balance means.
You might be surprised to learn that art theory holds the answer.
In this article we’ll explore ideas of symmetric, asymmetric, radial, and crystallographic balance. And you’ll discover why asymmetric balance might hold clues for your own unique form of work-life balance.
An earlier version of this article was published on KevinMD.com in 2023
For most physicians, achieving work-life balance is a top priority. But what does balance mean? And is it even possible?
In this article, I propose that there is more than one way to conceptualize balance. Before we explore these new perspectives, it’s important to address a common alternative: the concept of work-life integration.
Because the concept of balance often feels unattainable, and perhaps even undesirable, some argue that “work-life integration” is the better term. This popular terminology implies that somehow work and personal life should seamlessly intertwine, one gently flowing into the other.
It’s a trendy buzzword in managerial circles, but for physicians, work-life integration is often not a choice—it’s a given. And between taking call, attending after hours committee meetings, slogging through the EHR, and making time for CME and recertification, what’s labeled as “personal time” often gets consumed by work-related demands.
That’s why the work-life integration construct for physicians often means no real boundaries at all.
In this model, work doesn’t just blend into your personal life—it takes over. And yet, the reverse is rarely possible. There may be no space in the work day for your own needs.
Let’s be honest: it’s rare that you can realistically bring family or personal responsibilities into the hospital or clinic. For most physicians, that’s neither practical nor desirable.
So where does that leave us? I believe that work-life balance—not integration—is still the better goal. But the way we think about balance is often flawed.
When we picture balance, most people imagine a seesaw or a perfectly balanced scale, where equal weight on both sides creates harmony. It’s a tidy image but one that’s unrealistic for most lives, especially for physicians.
Instead, there’s a deeper, more creative way to think about balance—one that borrows from the language of art. By embracing this alternative perspective, you will discover a dynamic and fulfilling concept of balance that can help you to create a more sustainable and happy life.
Before we go any further, it’s valuable to think about work-life balance as more than simply “work” and “life”. Work is an important part of life, and perhaps even a defining feature of the life you’ve chosen. But “life” isn’t just what’s left over after work. It can be useful to think about life as a array of different elements. Broadly speaking, these may include
Family
Friends
Leisure
Self-Care
Anything else that’s meaningful to you
Equalizing all of these factors our using traditional concepts of balance is virtually impossible.
But if we borrow the concept of balance from art theory, it all starts to make more sense.
Concepts of Balance
In art, balance can be
Symmetric
Asymmetric
Radial
Crystallographic (Mosaic)
Let’s take a little detour into art theory so I can show you what this means.
Symmetric
Think of the typical balanced scale, or a mirrored pair.
This is the traditional way that we think of balance.
Asymmetric
The perception of weight across the composition may be balanced, but each element has a different size or mass.
This form of balance tends to create more interesting and dynamic images.
Radial balance
This type of balance uses a central focal point
Rays, spirals, or ripples radiate outward
Fragment, Peru c. 1000-1476 AD, Kate S. Buckingham Endowment, Art Institute of Chicago
Crystallographic (Mosaic) balance
A large number of elements share equal weight
There is no single focal point
Choosing Asymmetry
Any of these constructs may work for you. For many physicians, an asymmetric concept of balance can be especially useful. Think about the way you might create a rock garden. With asymmetric balance, you have wide latitude to play with different scale and elements. There is no exact formula, but you feel it when it’s right.
Compared to the symmetric form of balance, where both sides hold equal weight, asymmetric balance falls apart when the elements are too similar.
In asymmetric balance there is usually a dominant element, with the other components playing a supportive or bridging role. Often two smaller elements work harmoniously to balance a larger one. In an asymmetric painting like Van Gogh’s Starry Night, there may be some tension, but the image still feels complete.
Asymmetric balance can be interesting to play with. Moving one element often means that the others must also be moved in order to maintain a sense of harmony. This new configuration might strike a different, even unexpected, chord and create different relationships between the pieces.
When thinking about creating your own work-life balance, asymmetric balance may be a good starting point to consider. As your priorities shift over time, your vision of balance may also change. At any time, you can rearrange the elements to make them work for you.
How do you begin to define your own work-life balance? Take another cue from the art world. Sit down with pen and paper and sketch it out in words or pictures. This form of reflection is a great way to get clarity on your own ideas so you can create your vision for the future.
If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.
And if you’d like to schedule a complimentary coaching discovery session, click the button below.