Focus on Physicians:
Insights, Ideas, and Strategies
Mindfulness: A Surprisingly Practical Tool for Time Management
When you’re busy and feeling time-pressured, mindfulness may seem to be an uneasy, even unwelcome, construct. Who has time for it? Yet it turns out that simple mindfulness practices can help you to reframe and de-escalate the struggles of the day. In this article I will show you how using mindfulness can create the mental space you need to confidently and calmly manage patient care while protecting your precious time.
As a doctor you’ve studied, trained, and practiced for years, probably decades, to provide the best care for your patients. But as our world has become increasingly tech-driven and connected, the pressures from both within and outside of the healthcare workspace for your time and attention have multiplied.
Whether it’s pings from the EHR, text messages from the hospital, urgent calls from colleagues or families, or the never-ending torrent of emails, your attention has become more fragmented than ever before.
When you’re busy and feeling time-pressured, mindfulness may seem to be an uneasy, even unwelcome, construct. Who has time for it? Yet it turns out that simple mindfulness practices can help you to reframe and de-escalate the struggles of the day.
Mindfulness won’t cure the ills that physicians face in the current healthcare environment, but it can mitigate their impact. In this article I will show you how using mindfulness can create the mental space you need to confidently and calmly manage patient care while protecting your precious time.
Start with Mindful Mornings
Mornings can often feel a little frantic, but finding room for a simple 5-minute mindfulness practice can help to set the tone for your day. Here are some ideas to get you started:
Sit quietly with your morning coffee, allowing time for it to cool while you check in with your breath. Take a slow deep breath in through the nose, pause for a moment, and then breathe out through the mouth. You can use the box breathing technique, or simply find a rhythm that feels comfortable.
Use a mindfulness app like Insight Timer or Headspace. You can enter the time you have available and you’ll find a wide range of guided meditations.
Set a 5-minute timer and journal about anything that comes to mind.
Practice Mindful Transitions
Mindful task transitions can help you maintain your focus and prevent mental fatigue. Before moving on to a new task, appointment, or procedure, take a moment to pause, breathe deeply, and clear your mind.
You’ll be more present for your patient, which can build trust and connection. And this mindful pause can enhance your efficiency by helping to prevent the accumulation of mental clutter, or what is known as attention residue.
Embrace Single-Tasking
Multitasking used to be considered a prerequisite superpower for productivity. Doing two or more things at once--what could possibly go wrong? A lot, it turns out.
Emergency Department physicians may be the most pressed to multitask, with a recent Scandinavian study finding that almost 20 percent of their time is engaged this way. Not surprisingly, this study found that the more a physician multitasked, the more stressed they became. And other studies have found that multitasking can increase the risk for errors.
While you may not always have control over who or what interrupts you, it can help to remain mindful of the things that are pulling on your attention. When you are able to tune out distractions and put non-pressing matters on hold, you’re likely to be more productive and efficient with your time.
To tune up your ability to focus, regular meditation can help. That’s because mindfulness meditation is, at its foundation, a practice of returning your attention to the present moment.
Cultivate Presence
What exactly is presence? Actress Anna Deavere Smith, in her book Letters to a Young Artist, counsels that “Presence means you hold your own space, control the space around you, and sometimes welcome others into it.” Here she is describing the persona of an artist, but as a physician, you too are tasked with holding space, while simultaneously creating a place of safety for your patients to enter.
In being present, you are listening mindfully, without jumping to conclusions or judgments. You’re paying attention not only to the words but to the body language and, sometimes, to the unspoken fears beneath the words.
This might sound like it could add time to the encounter, but the truth is that when you lead with mindfulness, your patient is more likely to feel heard and safe. You are more apt to integrate information that might otherwise slip beneath your radar, so your differential may be more accurate.
And as you build trust, your treatment plan may be more readily accepted, and you’re likely to get fewer in-box messages or worried phone calls after the encounter.
End with Mindful Reflection
As you close out the day, take five to ten minutes to reflect on your “wins”, your “dones”, and your “to-dos”. Acknowledge both your successes and areas for improvement, without falling into self-criticism.
By creating a to-do list for the next day, you can set aside your lingering worries and unchecked boxes, knowing that you’ve made a plan to tackle them tomorrow.
Your closing-down practice could even include stopping at a coffee shop on your way home to enjoy a cup of decaf and take a few minutes to journal and debrief before entering into your home life.
This time between work and home can also give you a safe space to decompress from your work day so that you’re able to be present for your loved ones, making the most of the time remaining in the day.
Conclusion
Mindfulness is not going to solve all that is troubling healthcare. It doesn’t mean pretending that the troublesome systemic problems facing physicians don’t exist. But by cultivating a mindful approach to the day, it’s likely that your time will be spent more meaningfully. And as a result, your focus and productivity will improve, and you’ll have more bandwidth to be present for your patients and your loved ones.
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.
Maximize Efficiency and Achieve Work-Life Balance: The Time Priority Matrix for Physicians
Do you ever finish the day feeling as if the time raced by, but instead of making progress on your goals, you’ve just been putting out fires? With a constant surge of urgent issues, combined with daily responsibilities and opportunities, it can be challenging to prioritize effectively.
Using the Time Priority Matrix (or Eisenhower Matrix) can help you to visualize not only where but how you are spending your time. By categorizing your daily activities, you will discover how your attention is being directed, and where you might be able to streamline and optimize the way you use this most valuable and limited resource.
Do you ever finish the day feeling as if the time raced by, but instead of making progress on your goals, you’ve just been putting out fires?
With a constant surge of urgent issues, combined with your daily responsibilities and opportunities, it can be challenging to prioritize effectively.
Using the Time Priority Matrix can help you to visualize not only where but how you are spending your time. By categorizing your daily activities, you will discover how your attention is being directed, and where you might be able to streamline and optimize the way you use this most valuable and limited resource.
This tool is also known as the Eisenhower Matrix. Former US President Dwight D. Eisenhower didn’t create the idea, but he famously referenced Dr. Roscoe Miller, a former president of Northwestern University, when he said: "I have two kinds of problems: the urgent and the important. The urgent are not important, and the important are never urgent.”
The matrix was subsequently popularized by Stephen Covey in his landmark book The 7 Habits of Highly Effective People. It’s something that’s often taught to business leaders, but the concepts can easily be applied to physicians and anyone else seeking to take back some control of time and attention.
How to Use the Time Priority Matrix
Quadrant I tasks are both urgent and important. Ideally these are limited, but as a physician, these tasks are part of daily life.
The critically ill patient, the urgent report, the call from a worried family member. Often these issues are out of your control. But sometimes there is a way to mitigate the urgency, and that's where Quadrant II comes into play.
Quadrant II: Preparation, planning, and prevention fall into Quadrant II. By working in this quadrant, you anticipate and trouble shoot before trouble arises. That's what preventive care is all about.
You can also apply this idea to your own life. For example, if you're studying for your boards, taking a set amount of time every day for a few months will get you much farther ahead than waiting until the last couple of weeks to study. And learning a new skill or technique and making the time to practice it will ensure that when you need it, you'll be more confident and prepared.
Building trusting relationships with patients and colleagues also falls into Quadrant II. By taking the time and putting in the work at the outset, you’ll build trust and confidence. Ultimately that will enhance your ability to provide care more efficiently and collaboratively.
Work in this quadrant might not always be exciting or immediately fulfilling, but it will keep you on track to accomplish the goals that are meaningful to you.
You can apply Quadrant II ideas to your personal life as well. Think about your relationships, family, and other interests. What can you do to ensure that the things that matter to you outside of work are cared for and able to flourish?
Quadrant III is more problematic. In this quadrant, you're dealing with things that are not particularly important, but which require some urgency to complete.
As a physician, you're probably all too familiar with this quadrant. Interruptions, EHR redundancies and pre-authorization inefficiencies that have to be addressed are daily if not hourly occurrences. Some meetings and much email fall into this category.
Sometimes it can help to work on these things in "chunks" so that your attention is focused and you can be more efficient. This is known as task batching, and it can be a highly effective way to clear out some of the clutter that routinely piles up. Making it clear that these non-urgent issues will only be addressed on a certain day at a given time is one way to not only set boundaries but to limit interruptions.
Delegating whenever possible is an important aspect of Quadrant III management. For example, can someone else be assigned to fill out routine paperwork, leaving only the physician-specific sections for you to complete? Perhaps staff can be empowered to respond to simple patient requests for notes or documentation, or to schedule a visit when it’s clear that a non-urgent call or message requires more than a simple response.
Quadrant IV is where you have the greatest likelihood of clearing out some time and space. Mindless scrolling, low-value emails, watching random TV shows, and stressing over social media are good examples of this quadrant's activities.
Sometimes you need a little downtime, but being cognizant of how you are spending it may help you to gain some well-earned margin for the things that matter most to you.
It can be a great thought exercise to think through the way you are using your time. The Time Priority Matrix is a valuable tool that can help you to manage your workload and your personal life more effectively. By identifying and prioritizing tasks based on urgency and importance, you’ll have a tool that can enhance your productivity, improve patient care, and help you achieve a healthier and more fulfilling work-life balance.
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.
Five Simple Ways Busy Physicians Can Save Time
Despite your many years of school, training, and continuing education, you were probably never taught time management. Somehow it was just expected of you. Yet as the demands of medical practice have continued to rise, administrative burdens have increased and managing time is now critical to simply getting through the day.
Time is a precious commodity, but there’s only so much of it to go around. Your patients, your administrators, your family, your community—everyone wants some of it. With just 24 hours in a day, it may seem that there simply isn’t time to give everyone what they need, let alone take care of your own needs.
The reality is that, especially if you work in primary care, you might actually need 27 full working hours each day to get everything done that’s expected of you. And that’s before taking care of yourself, your personal relationships, and those who depend on you.
Ironically, despite your many years of school, training, and continuing education, you were probably never taught time management. Somehow it was just expected of you. Yet as the demands of medical practice have continued to rise, administrative burdens have increased and managing time is now critical to simply getting through the day.
Unfortunately, there is no way to magically manifest more time. You might be tempted, or even encouraged, to multitask. But it’s important to realize that you can truly only do one thing well at a time. In fact, an Australian study found a nearly two-fold risk of errors with multi-tasking.
As a Physician Coach with additional certification in Time Management Coaching, it’s been my experience that when you improve your time management skills, you’ll experience greater control and clarity over the direction of your life. You’ll strengthen your own well-being. And you’ll create the margin that you need to pursue your passions and reach the goals that matter to you.
Time management doesn’t have to be complicated or convoluted. Simply starting small can lead to big improvements.
In this article, I’ll tell you about five simple ways to reclaim wasted time. These are battle-tested strategies that served me well over many years as a busy cardiologist, and have helped many of my clients as well.
1. Organize your physical and virtual workspaces.
Make it easy to find all the tools you need for your daily routine. Don’t forget to put them back in place at the end of the day to avoid having to hunt for what you need the next morning. As simple as it sounds, an organized workspace helps to set the stage for a well-ordered day.
Keep your computer files tidy as well, and organize your “smart phrases” in your EHR. Take advantage of any available technical support at work to make things run more efficiently. Developing a system that makes sense to you means less friction in your daily routine.
2. Commit to only touching each piece of paper or emailonce.
Block time to tackle your virtual and real-life inbox, and complete whatever task is required before moving on to the next. Even a 5- 10 minute block can make a difference. Delete (or recycle) whatever is unnecessary, and organize your virtual and real-life inboxes.
Chances are you get dozens if not hundreds of emails daily along with piles of paper. Most of it is likely unnecessary and distracting, but other documents are time-sensitive and important. Organize your inbox so that your attention is focused on those more critical communications, and let the others drop into a secondary file or forward them on to someone who can take care of them.
3. Get your charting done before moving on to the next patient.
When you do your charts as you go, you’ll remember the details that you need to make the note accurate, and you’ll be less likely to forget to include things like orders, refills, and instructions. Patients will appreciate it, and you may have fewer requests for clarification after the appointment. I learned this early on, and it made all the difference.
Consider using AI to help with your notes if a good system is available. A scribe (or virtual scribe) can also be a valuable asset. It can be a little tricky to get up to speed with your charting, but I promise it will save you time and aggravation if you can manage to do it efficiently. The next tip will help with this.
4. Automate and delegate your common phrases and tasks.
Use smart phrases in your EMR for common scenarios. And do your best to stay out of the weeds by delegating administrative tasks to your office staff whenever possible. Make it easy for them to know what you need. Smart phrases can be helpful here as well. And when you empower your staff this way, they may feel more connected and engaged.
5. Streamline Team Communications
Efficient communication with nurses, assistants, and other team members can significantly reduce time spent on back-and-forth clarifications and miscommunications. Establish clear, direct, and respectful communication. Take the time to create protocols to handle common situations that don’t need your direct input. This proactive approach can foster teamwork, reduce errors, and keep your patients happy.
If you’re like most physicians, you are probably pulled in many different directions at once. It should go without saying that healthcare systems need to step up and reduce the burden on physicians. In fact, there is growing recognition that the current demands on physicians are unsustainable. But meanwhile, if you can create a little more margin in your day, you may find that you reduce your stress and have a little more time to devote to your patients.
An earlier version of this article appeared on this site in October 2022.
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.
References
Hodkinson A, Zhou A, Johnson J et al. (2022) Associations of physician burnout with career engagement and quality of patient care: systematic review and meta-analysis BMJ
Porter, J., Boyd, C., Skandari, M.R. et al. (2022). Revisiting the Time Needed to Provide Adult Primary Care. J Gen Intern Med (2022)
Westbrook JI, Raban MZ, Walter SR, et al. (2018) Task errors by emergency physicians are associated with interruptions, multitasking, fatigue and working memory capacity: a prospective, direct observation study. BMJ Quality & Safety
Maximize Your Time: Essential Toolkit for Physician Time Management
Being a physician often means that you are expected to be a wizard with time, creating minutes and hours out of thin air. When every second of your day seems to belong to someone else, managing your personal time isn’t just an option, it’s a necessity. But despite the ever-growing demands of the profession, the skills of time management are rarely taught in our training years. As a physician coach, I enjoy sharing my favorite 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.
Being a physician often means that you are expected to be a wizard with time, creating minutes and hours 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, some healthcare systems and many medical associations are beginning to take note. The problem is multifactorial, but administrative burdens are an important issue for many physicians. 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.
Meanwhile, when every second of your day seems to belong to someone else, managing your personal time isn’t just an option, it’s a necessity. But despite the ever-growing demands of the profession, the skills of time management are rarely taught in our training years.
As a cardiologist in a busy practice for many years, I developed a keen interest in productivity, educating myself by studying some of the masters in the field. The skills I learned allowed me to practice more efficiently. And equally important, I found meaningful ways to nurture my interests outside of medicine, and to create more time and energy for my friends and family.
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.
You can pick and choose what works best for you, but 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.
Bullet Journal
A bullet journal is more than just an old-school planner. It's a customizable, hand-written system that combines planning, organizing, goal setting, and reflection. Here’s why it’s beneficial:
Customizable Layout: Tailor it to your specific needs, whether it’s daily to-dos, long-term goals, or reflective journaling. Don’t worry about making it look pretty. I use a very simple to-do checklist, and scribble notes as they pop into my head during the day.
Mindfulness Practice: The act of writing by hand encourages memory retention and mindfulness and will 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 meet all of my goals for the day, simply writing them down creates an intention and makes it more likely that they will be completed in the future.
If you want a deeper dive into bullet journaling, check out The Bullet Journal Method, written by Ryder Carroll. There’s no rush to get through it. Commit to reading just 10 minutes each evening (or morning), and over time you’re likely to create serious momentum.
Colored Pens
Never underestimate the power of colors for organization. When you use your colored pens for your Bullet Journal or to take notes while studying for boards, talks, or other commitments, you will:
Enhance Organization: Assigning different colors to various tasks or appointments helps create quick visual categorization.
Boost Memory Retention: Color coding will help you to remember important ideas, tasks and deadlines.
Audiobooks
In general, multitasking is 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:
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.
Online Yoga (or other activities)
Physical and mental well-being is integral to managing time effectively. As a registered yoga teacher, I love the option of online yoga classes. That’s because they offer:
Flexibility: Yoga apps allow you to practice at your convenience, fitting sessions into a busy schedule. Most yoga apps give you a range of types, levels, and duration. 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 is a great way to unwind and maintain physical and mental health. So are many other forms of physical activity. If you want to start, but exercise isn’t part of your routine, simply commit to 10 minutes twice weekly, and see where that takes you.
One caveat: if you’re new to yoga, Pilates, weight training, or any other chosen activity, consider taking a few classes or working with a private teacher first. That way you’ll have the basics, get your questions answered, and develop a practice that is safer, more effective, and more enjoyable.
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: When you track your time online, you may pinpoint activities that take up unnecessary time. That doesn’t mean you shouldn’t stay up to date on email or social media, but when you know where your time is going, you may find that you naturally begin to make choices that are more aligned 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.
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.