The Myth of Multitasking: Why It May Be Hurting Your Efficiency and Patient Care

Multitasking is often considered an essential skill for physicians and others in high-stakes professions. From my earliest days in medicine as an intern on the HIV wards in the late 1980s, those who could juggle the most tasks at any one time were considered the true heroes. And those who balked at the notion were considered dinosaurs or even slackers, out of touch with the reality of modern medicine.

Like many doctors, I embraced the challenge during the years and decades that followed. With ever-growing patient care demands, constant interruptions, and endless inbox messages, doing more things at the same time seemed like the only way to keep from stalling out. It was a point of pride, and it gave the illusion of intense focus and efficiency.

It’s now clear that the reality is starkly different: multitasking often leads to increased errors, inefficiency, and heightened stress.

A study of Australian emergency physicians found that ER doctors are interrupted nearly 10 times per hour. In this study, the more physicians were interrupted or attempted to multitask, the more medication errors they made. This effect was even more pronounced when the physicians were sleep-deprived. The researchers found that below-average sleep led to a disturbing 15-fold increase in clinical errors.

As you would expect, the ER is an ideal place to study the impact of multitasking, and other studies in theses settings have come to similar conclusions.

The same phenomenon plays out in the hospital. Picture this:

You’re on rounds in the CCU. A critically ill patient just had a rhythm change, your phone buzzes with a consult request, and you’re simultaneously reviewing morning labs, finalizing a discharge summary, and answering a staff question about another patient’s medication dose. You’re flipping between screens in the EHR—labs, imaging, notes, inbox, and back again—trying to keep up. Then suddenly, you realize… you almost signed off on the wrong discharge med for a different patient. Sound familiar?

In that moment, one thing—the critically ill patient—needs your full attention. The other tasks are important, but they are not urgent. Yet, the mental overload from constant task-switching makes errors more likely, slows you down, and increases stress.

Why We Think We’re Good at Multitasking

Physicians are highly skilled at managing multiple inputs simultaneously. It’s how we’re trained. But research shows that what we call “multitasking” is actually task-switching, and this constant shifting leads to cognitive overload and more mistakes.

Before EHRs, a common efficiency tip was: “Touch each piece of paper only once.” Although paper charts are long gone, it’s an adage that I learned to live by, and something that can improve both your efficiency and your accuracy. The same principle applies in today’s digital world. It means that whenever possible, close out one task before moving to the next. Review the labs, then answer the page. Finalize the note, then move on to the consult.

When you protect your attention in this way, you’re likely to create fewer errors, improve your efficiency, and, most importantly, deliver better patient care.

Practical Strategies to Reduce Multitasking and Increase Focus

While we can acknowledge the harm it may cause, the truth is that multitasking is not going to completely disappear. In healthcare, where dealing with the unexpected is part of the job, it’s not realistic to think that you can avoid multitasking completely. But you can limit it, and you can plan ahead so that the impact is minimized and your focus is protected. Here are some ideas to get you started.

✅ Prioritize Tasks by Urgency and Importance
Emergencies deserve immediate focus. Everything else? It can often wait. Develop the habit of quickly categorizing tasks so you can allocate your mental bandwidth accordingly.

✅ Break Large Tasks into Smaller Steps
A massive to-do list creates overwhelm, increasing the temptation to multitask. Instead:

• Focus on one completable step at a time.

• Track your progress to build momentum and reduce unfinished-task anxiety.

✅ Delegate When Appropriate
Trying to do everything yourself leads to burnout and inefficiency. For example, one of my coaching clients, a highly skilled proceduralist, was constantly behind on his work—not because he lacked skill, but because he spent too much time checking his staff’s work instead of delegating. His inefficiency put his job at risk, and it frustrated his staff. Learning to delegate strategically got him back on track. When done right, delegation builds trust and camaraderie while freeing up your cognitive resources for what matters most.

• Delegate lower-stakes tasks that don’t require your expertise.

• Trust but verify—educate your team, give them a reasonable degree of autonomy to carry out their assigned tasks, but maintain a structured review process.

✅ Use Time Blocking to Protect Deep Work
Scheduling dedicated time for specific tasks—such as charting, reviewing imaging, or preparing for boards—helps maintain focus and reduces cognitive switching costs.

• Communicate your schedule with your team or family to minimize unnecessary interruptions.

• Create a “protected time” window for deep work whenever possible. Turn off notifications, put hard limits on your social media use, set boundaries, and commit fully to the task at hand.

Final Thoughts

Multitasking isn’t a badge of honor—it’s a hidden drain on your performance. In a busy medical practice or an intense hospital environment, it can’t always be avoided. But by prioritizing effectively, reducing task-switching, and implementing strategies like delegation and time blocking, you can work smarter, reduce your stress, and improve both efficiency and patient care.

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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.

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When Physicians are Disrespected: My Guest Appearance on the Podcast by KevinMD

If you’re a physician, or anyone active in healthcare today, you have probably heard of Dr. Kevin Pho and his KevinMD podcast and website.

Not only does he offer a curated selection of articles tailored to physicians and others in healthcare, Dr. Pho also hosts a podcast for thought leaders in the medical field. I was honored to be invited back as a guest.

In this episode, which originally aired in October 2023, we talk about the epidemic of disrespect faced by physicians today, and clear steps you can take to advocate for yourself and reclaim your dignity.

This is a topic I wrote about in Preventing Physician Burnout: Reclaiming Your Dignity. An earlier version of the article also appeared on the KevinMD website.

When physicians and others in healthcare are treated respectfully, the practice of medicine becomes more sustainable and more inclusive.

My podcast appearance discussing disrespect on the Podcast by Kevin MD.

Thriving Amidst Chaos: Prioritizing Health, Self-Care, and Mindfulness

An earlier version of this article appeared on this website in October 2023

When your days are busy and your evenings are full, making time for your own well-being can sometimes feel like just another thing to check off your endless to-do list. If you’re like many physicians, self-care often falls by the wayside.

The truth is that you need to recharge and refresh in order to be the best version of yourself. And, as important as it is to care for your own health and happiness, it’s not just about you. When you care for yourself, you’ll be better equipped to care for those who depend on you.

In this article, we’ll explore why self-care matters, including the impact of self-care on stress management. Next, I’ll give you some simple steps that will help you to put these ideas into motion. By caring for yourself, you’ll be empowered to thrive amidst the daily storm of medical practice.

The Impact of Stress on Burnout

It’s common to think of stress as harmful and something to be avoided. But stress can affect your health positively as well as negatively.

Positive stress (or eustress) happens when you face a challenge or a deadline that you know you are capable of meeting. It might be a stretch, but you know it’s possible. And importantly, there is a reward waiting on the other side.

While positive stress can propel you towards your goals, negative stress (sometimes called distress) can lead to frustration and burnout. Negative stressors are those forms of stress over which you have no control. A boss (or spouse) who is never happy, a job for which you are never rewarded or thanked, and escalating demands at work without adequate time off to rest and reset are all forms of negative stress.

Constant and unrelenting stress can lead to burnout. The World Health Organization defines burnout as an “occupational phenomenon.” Burnout is characterized by

• Exhaustion and loss of motivation

• Cynicism and negativity

• Inefficiency

Given the current state of healthcare, it’s no surprise that nearly half of physicians reported at least one manifestation of burnout in 2024.

It’s important to remember that burnout is not your fault. By definition, it is a symptom of a dysfunctional system or workplace. Perfectionists, people-pleasers, and so-called workaholics seem to be more susceptible. Not surprisingly, these personality types are common for physicians. But developing some tools to help you get through tough times can lessen the impact and improve your overall happiness and wellbeing.

Self Care and its Benefits

Self-care is not just about pampering yourself. It's about taking care of your mental, emotional, and physical well-being.

Committing to self-care can enhance your focus, improve relationships, lower stress, and mitigate burnout. Acknowledging the mind-body connection is often the first step towards effective self- care.

Nutritional Psychiatry and Stress Management

The new field of Nutritional Psychiatry focuses on the growing body of research that strongly connects what you eat to how you feel. Without a doubt, mental health is complex and multifaceted. Diet is only one part of the big picture.

But when you’re famished and pressed for time, the quickest options can undermine you, sabotaging your best intentions and sapping your energy.

As it turns out, those ultra-processed foods that often pass for nutrition in the doctor’s lounge or office snack machine can raise your risk of anxiety, sleep disturbance, depression, food addiction, alcohol use disorder, and increased inflammation. Artificial sweeteners in particular have been linked to a greater risk for depression.

Instead, consider switching in simple elements of the Mediterranean diet like fruits, nuts, whole grains, olive oil and fish. You probably know that the Mediterranean diet supports heart health and may reduce the risk for certain cancers. But this diet is also linked to improved symptoms of depression and better mental health and well-being. There’s also emerging evidence that a Mediterranean diet can improve perceptual performance.

It might take a little planning, but going Mediterranean doesn’t have to be complicated. Simply packing a nourishing lunch or advocating for healthier options at work can make a difference.

Exercise and Health

You already know that regular exercise will lower your risk for heart disease, cancer, bone disease, and dementia, among other dreaded conditions.

But research has also shown that exercise can reduce anxiety, improve sleep, and improve immune function. It doesn’t take a lot of exercise to reap the benefits. A brisk 15 minute walk a few days a week is a great way to get started.

Mindfulness and Self-Care

"Mindfulness is the awareness that arises when we nonjudgmentally pay attention in the present moment.” These are the words of Jon Kabat-Zinn, PhD., Professor of Medicine Emeritus at the University of Massachusetts Medical School, and the godfather of mindfulness in healthcare.

Put even more simply, mindfulness is undistracted attention.

Practicing mindfulness has a wealth of benefits, some of which you might not anticipate, including

• Healthier lifestyle choices

• Less stress and anxiety

• Greater parasympathetic tone

• Better cardiovascular health

• Improved immunity.

If it all sounds a little woo, know that mindfulness doesn’t have to be about practicing yoga or meditating. You don’t need a special cushion or a meditation app, although those can be nice. Instead, it’s about being undistracted, nonreactive, and fully present in the moment.

Getting started with mindfulness isn’t complicated. Simply set aside 3-10 minutes of quiet time each day to observe the present moment. Notice your thoughts and let them go, returning to the present when your mind wanders.

It is this practice of continually returning to the present moment that develops the “mindfulness muscle.”

When you practice mindfulness, you may find that your presence, and hence communication, with patients and colleagues becomes easier and more engaged.

Create an Action Plan

Creating an action plan will help you to set realistic goals and track your progress. Write out the steps that you need to take to commit to your self-care. And develop a plan that is realistic and actionable.

Consider enlisting a partner or friend with whom you can share accountability to help you to stay committed. Something as simple as a daily reminder on your phone may also keep you on track.

The ripple effect of taking your own self-care to heart will show up in your energy level, creativity, and relationships. You may notice a greater sense of self-compassion and equanimity. And in time, your path forward toward the goals that matter will become more clear.

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.

References

Adan, R. A. H. et al. (2019). Nutritional psychiatry: Towards improving mental health by what you eat. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology, 29(12), 1321–1332.

American Medical Association & American Medical Association. (2024, July 2). Physician burnout rate drops below 50% for first time in 4 years. American Medical Association. https://www.ama-assn.org/practice-management/physician-health/physician-burnout-rate-drops-below-50-first-time-4-years

APA Dictionary of Psychology. (n.d.). https://dictionary.apa.org/eustress

Brulé, G., & Morgan, R. (2018). Editorial Working with stress: can we turn distress into eustress? ResearchGate. https://www.researchgate.net/publication/324531212_Editorial_Working_with_stress_can_we_turn_distress_into_eustress

Davidson, R. J. et al. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic medicine, 65(4), 564–570.

Ezzatvar Y, Ramírez-Vélez R, Izquierdo M, et al. (2022). Physical activity and risk of infection, severity and mortality of COVID-19: a systematic review and non-linear dose–response meta-analysis of data from 1 853 610 adults. British Journal of Sports Medicine 56:1188-1193.

Gilbert, D., & Waltz, J. (2010). Mindfulness and health behaviors. Mindfulness, 1(4), 227–234

Lane, M. M. et al. (2022). Ultra-Processed Food Consumption and Mental Health: A Systematic Review and Meta-Analysis of Observational Studies. Nutrients, 14(13), 2568.

Loucks, E. B.et al. (2015). Mindfulness and Cardiovascular Disease Risk: State of the Evidence, Plausible Mechanisms, and Theoretical Framework. Current cardiology reports, 17(12), 112.

Martinez-Gonzalez, M. et al. (2019). The Mediterranean Diet and Cardiovascular Health: A Critical Review. Circulation Research 124:779-787

Munoz, M.A. et al. (2009). Adherence to the Mediterranean diet is associated with better mental and physical health. British Journal of Nutrition. 101 (1821-1827),

Samuthpongtorn C et al. (2023). Consumption of Ultraprocessed Food and Risk of Depression. JAMA Netw Open. 2023;6(9):e2334770. doi:10.1001/jamanetworkopen.2023.34770

Shanafelt, Tait D. et al. (2022). Changes in Burnout and Satisfaction With Work-Life Integration in Physicians During the First 2 Years of the COVID-19 Pandemic. Mayo Clinic Proceedings, Volume 97, Issue 12, 2248 - 2258

Stubbs, B. et al. (2017). An examination of the anxiolytic effects of exercise for people with anxiety and stress-related disorders: A meta-analysis. Psychiatry research, 249, 102–108.

World Health Organization: WHO. “Burn-out an ‘Occupational Phenomenon’: International Classification of Diseases.” World Health Organization, 28 May 2019, www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases.

Yin, W. et al. (2021). Mediterranean Diet and Depression: A Population-based Cohort Study. International Journal of Behavioral Nutrition and Physical Activity, 18(1). https://doi.org/10.1186/s12966-021-01227-3

Young, H. A. et al. (2022). Mediterranean diet, interoception and mental health: Is it time to look beyond the ‘Gut-brain axis’? Physiology & Behavior, Volume 257.

My Podcast Appearance on Sustainable Clinical Medicine

I'm excited to share my recent podcast appearance on Sustainable Clinical Medicine with The Charting Coach, a podcast for physicians and others in healthcare hosted by Dr. Sarah Smith. Dr. Smith not only helps physicians who are struggling to keep up with charting, but she also hosts a podcast focused on the ideas and challenges that matter most to physicians and others in healthcare.

Here are three key takeaways from our conversation:

🔑Values Alignment: Discover the power of aligning your career and personal life with your core values.

🔑Saying No and Carving Time: Learn how to set boundaries and prioritize what brings you joy and fulfillment.

🔑Exploring New Avenues: Possibilities open up when you allow yourself to pursue interests outside of traditional medical roles, sustaining and supporting your life in medical practice.

You can take a listen at the link below, or find the podcast on Apple or Spotify.

Journaling for Physicians: Find Balance, Gain Clarity, and Envision Your Future

Journaling can help you to perceive the lines that connect the dots. Through this accessible and time-tested form of self-reflection, you can build stronger connections with what and who matters most, At the same time, a writing practice may help you to give name to the obstacles that may be keeping you from living a life aligned with your values and goals.

In previous articles, we’ve explored the way that journaling can help you think through challenges, reflect on the present, and see yourself through your own words and dreams. In this third and final set of journaling prompts for physicians, I offer prompts that you can use to explore your own definition of balance both now and for the future.

As you gain clarity on the ways the diverse branches of your life intertwine, unexpected or creative ways to bring harmony to your work, your personal life, and your passion projects may emerge. Through journaling, you'll gain a deeper understanding of how you want to shape the life you envision. You may even rediscover a path that you lost sight of years ago and find that it is ready to be explored once again.

Finding Balance

1. How do my work, personal projects, family, and relationships influence each other? Are they currently in harmony? If not, what might need to change?

2. What does a balanced and fulfilling life look like to me? How close am I to that vision? What small steps might I take to start the journey?

3. Are there areas of my life (work, personal projects, family, or relationships) that I feel are receiving too much or too little attention? How can I redistribute my time and energy?

4. How do I prioritize between competing demands from work, personal projects, and loved ones? Is this system serving me well?

5. What is one thing I could change this month to better integrate work, personal projects, family, and relationships?

Creating Alignment

1. How do my work and personal projects align with my values and the type of life I want to build for myself, my family and/or my relationships?

2. What shared values or goals do I want to cultivate in my family and/or relationships, and how can my work and personal projects support these?

3. Are there ways I can involve my loved ones in my personal projects or bring my personal passions into my professional life?

4. Are there personal projects that I enjoy or aspire to that could open the door to new and sustaining relationships or communities? If so, how might that look?

Evaluating Impact

1. How does my work affect my personal projects, family, and relationships? Are these effects positive or negative? What adjustments could I make so that the impact is positive and sustaining?

2. How do my personal projects enrich my work, family life, or relationships? Are there new projects I could pursue to strengthen these connections?

3. When was the last time I felt deeply connected to both my professional and personal life simultaneously? What factors contributed to that feeling?

Fostering Connection

1. How do I make space for meaningful connections with my family and/or relationships despite work and personal project commitments? Is there one thing I could do this week to foster a deeper connection?

2. What specific actions can I take to ensure my loved ones feel valued and supported while I also pursue my work and personal goals?

3. How can I communicate my professional and/or personal aspirations and priorities with my family and relationships in a way that strengthens our connection?

Reframing Challenges

1. What challenges arise from balancing work, personal projects, family, and/or relationships? How can I view these challenges as opportunities for growth?

2. How do I handle moments when one area of life feels overwhelming and starts to impact others? What strategies or boundaries might help?

3. Are there sacrifices I’m making in one area of life for another? Are those sacrifices necessary or avoidable?

4. Is there something that I should let go of in order to give space for other opportunities, or for my relationships?

Visioning the Future

1. What would an ideal day look like if I seamlessly integrated work, personal projects, family, and/or relationships? What steps can I take toward that vision?

2. How do I want my work, personal projects, family, and relationships to evolve in the next 5-10 years? What specific actions can I take to guide this evolution?

3. Imagine celebrating a major milestone in my personal or professional life with my loved ones. What does that moment look and feel like, and how can I create more of those moments?

Reflecting on Fulfillment

1. What brings me the deepest sense of fulfillment? How can I prioritize those elements so that it encompasses the people and things that matter the most to me?

2. How do I ensure that my successes in work and personal projects don’t come at the expense of meaningful relationships and family life?

3. What legacy do I want to leave behind in my career, personal life, and relationships? Are my current efforts moving me toward that legacy?

I hope that you’ve enjoyed this journaling series. If you have any prompts that you’d like to share, I’d love to hear from you!

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.

Bike Shedding for Physicians: Avoiding Trivial Time Wasters

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.

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.

Journaling Prompts for Physicians: Rediscovering Your Personal Life

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

1. How do I currently nurture my relationships with my family? What more could I do?

2. What values do I want to model for my family? How can I live those values more fully?

3. What are some of the most meaningful moments I’ve shared with my family recently? How can I create more moments like those?

4. If I could describe the ideal dynamic I want with my family in one sentence, what would it be?

5. Are there any unresolved tensions or conflicts in my family relationships? How might I approach them with compassion?

6. How does my professional life affect my family life, and are there changes I could make that might bring greater harmony?

7. What are some small ways I can show appreciation to my family this week?

Journaling to Strengthen Relationships

1. Which relationships in my life feel most nourishing? What makes them important to me? How can I deepen those connections?

2. Are there relationships that feel draining or misaligned with my values? What boundaries might I need to set?

3. 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?

4. When was the last time I expressed gratitude or love to someone important in my life? How did it feel?

5. Who do I turn to for support, and how can I show them appreciation for being there for me?

6. 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?

7. What qualities do I bring to my relationships that make them stronger? How can I lean into those strengths?

8. How can I better communicate my needs, desires, and feelings in my closest relationships?

Empowering Personal Projects

1. What personal project excites me the most right now? What about it feels important or meaningful to me?

2. Are there projects I’ve set aside that I would like to revisit? What’s holding me back?

3. How do my personal projects reflect who I am and who I want to become? Where might they lead me?

4. 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?

5. If I had unlimited time and resources, what would I pursue? Why? How might that change my life?

6. How do my personal projects bring a sense of balance to my life, and how can I prioritize them more effectively?

7. What have I learned about myself through my personal projects? What strengths or interests have I uncovered?

Integrating Self, Family, and Community

1. How do my personal projects, family, and relationships influence each other? Are they in harmony or competition?

2. How might the personal projects that inspire me connect me more deeply with people who share my passions and values?

3. What would it look like to balance meaningful work, personal growth, and rich relationships all at once?

4. What’s one thing I can do this week to bring these aspects of myself into greater alignment?

5. 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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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 meeting, click the button below.

Using the Language of Art to Create 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.

Thomas Nordwest, CC BY-SA 4.0 <https://creativecommons.org/licenses/by-sa/4.0>, via Wikimedia Commons

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.

Starry Night, Vincent van Gogh, 1889. Public domain, via Wikimedia Commons

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.

References

Fallon-O’Leary, D. Work-Life Integration Is the New Work-Life Balance. Is Your Team Ready? CO. July 2021.

McManus, I. Symmetry and asymmetry in aesthetics and the arts. European Review, October 2005.

Meyer, I. Balance in Art – Exploring Different Types of Balance Artworks. Art in Context. August 2023.

Saley, C. Survey Report: Millennial doctors still finding jobs the old-fashioned way. CompHealth Blog. April 2018.

Vincent van Gogh, The Starry Night. MOMA.org , 2019.

Connecting With Your Inner Wisdom: A Journaling Guide for Physicians

With countless demands on your time and attention, it’s easy to lose touch with yourself as you slingshot from one task to the next. This can get you through the day, but after a few months, years, or maybe even decades of living this way, it can be difficult to find your way back to your true self.

I know this, because I experienced this sense of disconnection firsthand. From starting medical school in 1984, through decades of practice, I felt as if I was on a treadmill. I was constantly striving for the next level, whatever that was, and rarely taking a chance to pause or to celebrate. I stayed active, had hobbies and friends, but it all felt pretty frantic. As I began to contemplate my life after cardiology, I wasn’t exactly sure who the “real” me was, or what she wanted next. That’s when I began journaling as a regular practice.

As a full time cardiologist with a busy practice, my days and evenings were highly regimented, with little room to add on yet another task. I was getting nowhere with perseverating over what was making me discontent, and I knew that I needed a way to sort things out.

Journaling was something that I played with over the years, but the habit had never stuck. To be honest, the empty pages always felt a little daunting. So this time, I made a commitment to myself to spend just 10 minutes a day sitting with my thoughts.

The Power of Journaling: A Path Back to Your True Self

Every evening I would pose questions to myself, trying to unravel the knots that I had tied over the years, until I rediscovered the threads that could lead me to my next steps. And remarkably, the process worked! Through introspection and time, I developed a set of goals and a sequence of tiny little steps that got me farther than I ever could have imagined.

This article is the first in a three-part series. In each one, I’ll share a different collection of journaling prompts designed to help you to connect your own dots and rediscover what truly matters to you. Whether you’re exploring a new professional path, planning for retirement, or seeking greater happiness and satisfaction in your life, these prompts will guide you towards clarity and self-awareness.

Getting Started with Journaling

Journaling is a wonderful way to access your own thoughts and values, getting in touch with what matters most to you. It’s a form of mindfulness that doesn’t require any skills or knowledge. All you need is a pen and paper and as few as five minutes.

Why do I say pen and paper, and not a keyboard? Because research has convincingly shown that writing by hand is far more activating for the brain than typing. Newer devices that save and transcribe handwriting, like the reMarkable, may help to bridge the gap between analogue and tech. If writing doesn’t come easily, you could also experiment with dictation. Most important is that you find something that works for you and feels comfortable and natural.  

Journaling to Uncover Your Next Steps

This series of prompts will help you to reflect on your values and your sense of purpose, realigning the trajectory your life into something that feels resonant and clear.

For a kick start, if you haven’t already completed the Values Workbook, this is a great time to begin that exercise. You can get your free copy through my website.

Don’t feel as if you need to take on every prompt. There’s a lot to ponder here! Perhaps choose one or two for the week and see where it takes you.

Exploring Your Values

1. What do I value most about my role as a physician? Are these values reflected in my daily work and life? If not, what changes would need to happen in order for my values to be aligned with my work?

2. If I could describe the legacy I want to leave in one sentence, what would it be? How do I want people to remember me?

3. When have I felt most fulfilled in my career? What about those moments made them meaningful?

Clarifying Your Purpose

1. Why did I choose to become a physician? Does that "why" still resonate with me today? If it has changed, does it still feel true? And if not, what is missing?

2. What parts of my work energize me the most? How can I focus more on these aspects?

3. How does my work align with my personal definition of success? Where am I now in relation to that definition?

Evaluating Your Current Path

1. If my current career trajectory continued for the next 10 years, would I feel proud and content with my life?

2. What sacrifices am I making to sustain my current career path, and are they worth it?

3. Are there aspects of my personal life or passions that I’ve neglected? How can I reintegrate them?

Imagining the Future

1. If I could design my ideal work-life balance, what would it look like? What small steps could I take to get closer to that vision? What could I do today that would start to change things?

2. Imagine a day in your dream life. What are you doing, who are you with, and how do you feel?

3. What skills or interests do I have that I’m not currently using in my career? How might I incorporate them? And what skills do I wish I had? Are they important enough that I want to explore how to acquire them?

Confronting Barriers

1. What fears or doubts are holding me back from making a change I know I need? Are these fears grounded in reality? If so, is there something within my power to change?

2. Who or what am I afraid of disappointing if I follow my heart? How might I address that fear?

3. What is the worst that could happen if I pursued a career change or took on a new role? What strategies could I take to mitigate that? Are there other opportunities that outcome might open up for me?

Building Resilience and Courage

1. When have I faced significant challenges and grown from them? What strengths did I discover?

2. What does courage look like for me right now? How can I embody it in my decisions?

3. Who in my life inspires me to live authentically? What lessons can I learn from them?

Finding Alignment

1. Are there moments in my work when I feel disconnected from my authentic self? How can I realign?

2. How do I want to feel at the end of each day? What changes would help me experience that feeling more often?

3. What small, actionable steps can I take this week to bring more meaning into my work and life?

Cultivating Gratitude and Joy

1. What aspects of my career am I most grateful for? How can I focus more on these positives?

2. When was the last time I felt joy in my personal or professional life? What contributed to that moment?

3. What can I do today to make space for more joy and connection in my life?

In the next article in this series, I’ll share prompts to guide your exploration of personal projects, family connections, and meaningful relationships. The final article of the series explores journaling to envision your future.

If these prompts have been useful, or if you have some of your own that you’d like to share, drop me a line! I’d love to hear from you.

This post contains Amazon affiliate links. I may earn a small commission when you click on the links, at no additional cost to you. These commissions help to support the website.

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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.

Taking Action Creates Clarity

An earlier version of this article appeared on this website in August, 2023

Do you ever feel like you’re standing on the edge of a cliff, unsure of how to move forward but knowing you can’t stay where you are? Maybe it feels like you’re staring down a steep ski slope, wondering how you’ll ever get to the bottom in one piece.

I’ve been there—literally. As I hesitated at the top of a daunting ski run, my adventurous friend Erica hollered, “Just point your skis down the mountain and go!” It wasn’t the most comforting advice, but it was the nudge I needed.

Spoiler alert: my descent was not graceful. But by simply starting, I learned to navigate the pitch of the slope, feel the texture of the snow, and chart a strategic path to my goal— the hot toddy waiting for me at the bottom of the mountain.

The same principle applies when tackling a big life decision or career shift: you don’t need to have all the answers or even all the skills upfront—just the courage to take the first step.

Why Taking Action Matters

When you’re physically stuck on a freezing ski slope with hot-shot skiers zooming past, you have no choice but to move. But when you’re stuck in the figurative sense—facing an unfulfilling job, a stalled project, or a major life change—it’s easy to freeze in place.

The key to breaking loose? Take action in small, low-risk increments. These manageable steps not only build momentum but also chip away at the stress and anxiety that come with feeling stuck.

How to get unstuck? Here are five steps that can help you jump start the process.

Step One: Get Out of Your Head and Onto the Page

Although there are a lot of great apps for note taking, mind-mapping, and the like, research shows that putting something on paper is often more meaningful and memorable.  Simply pick up a notebook and write out what it is you hope to accomplish: that is, your goal.

Step Two: Make it SMART

Run your goal through the SMART test. Writing your responses to these questions in your notebook can help bring your ideas to life.

• Is it Specific?

• Is it Meaningful to you?

• Is it Achievable given your current circumstances?

• Is it Realistic?

• Is it Time-bound, with a clearly defined deadline?

Step Three: Break It Down

List every action step you can think of, starting with the smallest one. Tiny steps add up. Whether there are five or fifty, writing them down gives you a roadmap. Each step leads you closer to your goal.

Step Four:  Schedule It

Commit to your steps by scheduling them. Apps like Todoist can help you stay on track by sending reminders and giving you that satisfying “pop” when you check something off. Prefer analog? Keep a running list in your notebook. The method doesn’t matter—what counts is consistency.

Step Five: Celebrate Your Wins

Progress deserves recognition! After completing a major step—or a cluster of smaller ones—reward yourself. Whether it’s indulging in your favorite treat, going for a walk, diving into a good book, or sharing the moment with an accountability partner, celebrate what you’ve achieved.

Just Starting Changes Everything

Here’s the beauty of taking action: it often brings unexpected clarity. Goals can evolve as you learn and grow, and that’s perfectly normal. As you continue to move forward, the process itself becomes a source of insight and empowerment.

It’s also important to understand that while you have control over your actions, the outcome may not always be under your direct control. Those unexpected turns are often a source of clarity, moving you closer to a life that is personally authentic, sustainable, and meaningful. 

Whether you’re staring down a treacherous ski slope, contemplating a career change, or trying to find your way through a knotty problem at work, progress happens when you take that first intentional step.

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.

References:

Masicampo, E. J., & Baumeister, R. F. (2011). Consider it done! Plan making can eliminate the cognitive effects of unfulfilled goals. Journal of Personality and Social Psychology, 101(4), 667–683.

Umejima, K. et al. (2021). Paper notebooks vs mobile devices: Brain activation differences during memory retrieval. Front. Behav. Neurosci., 15. 1-11.

Making Peace with Your Inner Critic: A Guide for Physicians

Your inner critic is that harsh internal voice muttering in the shadows of your thoughts, constantly critiquing, second-guessing, and comparing. It may take form as the voice of a family member, a tough or challenging attending from your years in training, or a demanding patient. It might even arrive in the guise of your own voice. It’s not surprising that most physicians have their own version of the inner critic.   

No one likes the inner critic, but here’s what you might not realize: Despite its harsh and heckling tone, constantly telling you that you’re not good enough, the inner critic may actually believe that it’s on your side. It may be trying to protect you from what it senses as impending harm or shame.

Of course, sometimes the inner critic is intentionally cruel. That’s a voice that needs to be locked in a box and put out with the trash. It does not deserve your attention or respect. If it is especially powerful, therapy can be life changing.

But your inner critic often emerges from an authentic drive for self-improvement and accountability. Although its intentions may be well-meaning, if left unchecked, this inner critic inevitably creates an unhealthy cycle of self-doubt, perfectionism, and burnout.

In this article, you’ll learn how to recognize the inner critic as a voice rather than a truth. And you’ll see how you can harness its intentions, putting it to work to develop a more compassionate self-dialogue that allows you to thrive and grow.

Noticing the Inner Critic

Your inner critic might say things designed to make you question yourself, such as:

• "You should have caught that diagnosis sooner."

• "What if you made a mistake during that procedure?"

• "You’re not smart enough to keep up with your colleagues."

The inner critic thrives on echoing your deepest fears, drawing strength from your attention. The more you engage with it, the more amplified and persistent it becomes. That’s why it’s crucial to recognize its influence and take steps to quiet its power.

You might visualize your inner critic as an annoying and unwelcome distant relation, tagging along for the ride. But instead of sitting quietly like a polite passenger, or offering constructive advice, this protective character goes into overdrive, grabbing the steering wheel and becoming harsh and punitive when it senses danger ahead. It might believe that it is trying to protect you. But instead of helping you discover your own route, the inner critic may actually run you off the road and into a ditch.

To create some distance, it can help to give your inner critic a name. Take away its sting by making it something ridiculous or silly.

No matter how you conceptualize it, keep an eye out for this dangerous character. By tuning in to the patterns and triggers of the inner critic, you can begin the process of disarming it.

Facing Down the Inner Critic

Identify Patterns

When does the inner critic tend to appear? Does it strike at a specific time of day, day of the week, or month? Do you notice it when you are doing certain types of tasks?  Or does it show up when you’re exhausted and unable to block out its annoying chatter?

Understanding the recurring patterns can provide insights into the core issues your inner critic is amplifying.

Voices in Your Head

Delve into the narratives your inner critic spins. Recognize its dramatic and querulous nature. When your inner critic surfaces, pay attention to the specific phrases and statements it uses. These may include self-defeating remarks, doubts about your abilities, or a barrage of negative predictions.

Tap into the self-talk your inner critic stirs up and ask yourself if there might be a different way to see things. For instance, if your inner critic says, “You’ll never get this right,” counter it by recalling times you’ve successfully navigated similar challenges. Reframe its negativity into constructive, empowering thoughts. By turning its drama into dialogue, you’ll regain control.

Emotional Impact

Explore how your inner critic drives your emotions. Does it trigger self-doubt, frustration, or a sense of being overwhelmed? What are the underlying fears it amplifies? Can you seek out the root causes? Perhaps there’s a different way to tackle these issues.

For instance, if fear is present, can you dissect it into its parts? What are you afraid of, and what's the worst-case scenario? What skills and knowledge do you already possess? How might you target areas for improvement in knowledge or skillset that might disarm the fear?

Physical Sensation

Consider the physical manifestations caused by the inner critic. Do you notice increased stress, tension, or even physical discomfort? Recognizing your physiological responses can serve as an early warning sign when the inner critic is near.

This is a perfect time to integrate mindfulness techniques like focused breathing or even a brief walking meditation. Just a minute or two can break the spell. When you feel the inner critic approaching, remind yourself to be present in the here and now, avoiding the temptation to ruminate over the past or over-analyze what’s to come.

Excessive Restraint

Pinpoint the actions your inner critic prevents you from taking.  Evaluate how the inner critic seeps into your decision-making process. Does it hinder your ability to take calculated risks or make decisions with confidence? Is it fear or is there something you need in order to gain confidence? Acknowledge the limitations, if they are real, but then make a plan.

Are these limitations that you want to overcome? Envision them as roadblocks and strategize how you might get over, around, or through. You don’t need to go it alone. Perhaps a coach or a therapist would be valuable, depending on the type of obstacle that you’re facing.

Transforming the Inner Critic

Imagine your world without the inner critic. If nothing was holding you back, what are three small actions you'd take immediately in your medical practice or your life? How might that improve your well-being, or your capacity to practice your profession at a level you aspire to?

While it may not be possible to squelch the inner critic completely, there are several important ways that you can disarm it, turning it into an ally instead of a fiend.

Acknowledge Its Intentions

When your inner critic pipes up, pause and ask, “What is this voice trying to protect me from?” Naming the underlying fear—like avoiding a mistake or preserving your reputation—can reduce its intensity while offering a tool for reflection and positive action.

Reframe the Dialogue

Instead of letting the critic dominate, respond with curiosity and self-compassion. For example, “I hear you’re worried I missed something, but I reviewed everything thoroughly.” This turns self-judgment into a productive conversation.

Redirect Its Energy

Channel the inner critic’s vigilance into positive actions. This might include creating a checklist for complex tasks, learning new skills, or seeking feedback from a trusted mentor to grow your expertise.

Balance with Self-Compassion

Remind yourself that mistakes can happen even under the best circumstances. Failure doesn’t always mean that you did something wrong. Learn from less-than-ideal outcomes and move forward. Your patients, family, and community need you.

Why Taming the Inner Critic Matters

What’s your inner critic trying to protect you from? Next time it speaks up, take a moment to listen with curiosity, not judgment. You don’t need to hand over control, but you might be surprised at how much it’s been trying to help.

By recognizing the inner critic as a well-meaning—if sometimes misguided— ally, you can reclaim your confidence, stay motivated to grow, and expertly care for your patients. At the same time, you’ll cultivate the self-compassion you so readily give to others. When needed, a coach or a therapist can be a valuable ally. In the end, taming the inner critic is about becoming the best version of yourself.

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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.

Why Are We Afraid to Talk About Work-Life Balance?

An earlier version of this article appeared on Doximity, where I was a 2022-2023 Op-Med Fellow.

For many physicians, work-life balance (WLB) is the elephant in the room. According to CHG Healthcare, in 2018, 63% of physicians finishing residency programs cited WLB as their number one consideration when choosing a job. In 2022, it was 85%.

Dissatisfaction with WLB is strongly correlated with burnout, and is a common reason that many physicians choose to leave their current practice.

Although women physicians tend to rate WLB as somewhat more important than men, among millennials it is a top priority for both genders.

Yet physicians often avoid raising this crucial issue with potential employers and even colleagues for fear of being judged and found lacking.

The Fear is Real

This fear of judgment is based in reality: providing the best and most timely care to patients often requires self-sacrifice. The profession is demanding and the stakes are high; it’s a given that occasionally, or maybe even often, you will have to put personal needs aside to care for patients whose needs can’t wait.

But it’s not uncommon for physicians to fall prey to the notion that consistently putting aside their own, or their family’s, well-being is necessary to answer the “calling” of medicine. Healthcare institutions sometimes perpetuate this with an “always on” culture, idealizing self-sacrifice without adequately compensating for it.

For physicians whose work requires collaboration and partnership with others in the profession, openly wanting more from life may also stir up fears of being perceived as weak, lazy, or not a team player.

These concerns are real, and the demands of the profession are heavy. But when you get past the angst of admitting that you want more out of life and make an effort to seek balance, you will find that your relationships, your sense of fulfillment, and ultimately the care you give your patients can flourish.

Tangible Benefits of Seeking Balance

Research shows that not only do people who make time for family, hobbies, and health feel a greater sense of balance, but they may also become better physicians for it.

• A British study found that employees who engaged in creative activities were more likely to discover creative solutions to problems at work.

• A study of nearly 300 ICU staff members, including physicians, found that those who engaged in hobbies experienced less post-traumatic stress.

• And a Duke study found that higher WLB measures among hospital staff, including physicians, correlated with greater patient safety and improved teamwork.

On the opposite end of the spectrum, not attending to life outside of work can have serious consequences. A study of members of the American College of Surgeons published in 2012 found that those with conflicts between work and home life were more than twice as likely to experience burnout and depression. Experiencing this conflict also meant that the surgeons surveyed were more likely to leave their current practice.

And yet, balancing your life is easier said than done.

A Personal Story

Each doctor has a different story. Here’s mine:

As a cardiologist I was able to find WLB, although it required a substantial degree of focus and dedication. While in practice, I wrote four books (admittedly health related), became a yoga teacher, and competed successfully with my horses. I also made time to travel and hike around the world.

However, these efforts were not without sacrifice: I had to give up significant income in order to take a half day off a week to train with my horses. And I usually chose to take most of my allotted (uncompensated) vacation time.

Although I was fortunate enough to have an organized system of cross-coverage with my partners, the time off nevertheless meant that I was often catching up on EHR responsibilities late into the evening, sometimes even from the other side of the world.

Still, for me the loss of income and long nights catching up on charts was worth it. Not only was my life richer, but my diverse experiences and friendships made me a more compassionate and open-minded physician. My patients were always curious about my adventures, and often felt more connected to me when they realized that I shared some of their own interests. And having the opportunity to “fill my cup” gave me more energy and enthusiasm for my work.

What Does Work-Life Balance Look Like for You?

Work-life balance is deeply personal. It shifts with life’s seasons—whether you’re a new parent, an early-career physician, or a seasoned leader.

• Parents of young children might prioritize family time and set hobbies aside for a while.

• New physicians may need to focus on building their patient base and refining their skills.

• Ambitious professionals seeking leadership roles might accept that these positions come with time demands that require trade-offs.

Whatever your circumstances, achieving balance starts with acknowledging your needs and crafting a plan to meet them.

Discovering Balance

Here are some things to consider as you embark on your new path:

• Acknowledge Your Desires: Wanting more from life doesn’t make you less dedicated. You’re allowed to be a doctor and a spouse, parent, or adventurer.

• Create a Plan: Start small. Identify what balance looks like for you right now, and map out achievable steps to get there.

• Reassess Your Practice: Are there opportunities to cut back hours or take a regular day off? Could changing roles or employers help you reclaim time?

• Delegate Wisely: Hire help where needed—whether it’s a scribe, a babysitter, or a housecleaner. Small investments in assistance can free you for the things that matter most.

• Reevaluate Your Commute: Use your travel time for audiobooks, meditation, or CME. Or consider moving closer to work to reclaim precious hours.

• Say No Strategically: Not every committee or project is worth the sacrifice. Be intentional about the responsibilities you take on.

• Embrace Imperfection: You don’t need to dive headfirst into a new hobby. Start small—10 minutes of yoga, a quick walk, or a short meditation can work wonders.

• Limit Distractions: Replace mindless scrolling with meaningful activities, whether it’s reading, journaling, spending time with loved ones, or pursuing a creative interest.

• Try Something New: Join a workshop or pick up a hobby you’ve always been curious about. The joy of learning can be invigorating.

• Book a Getaway: Set a date, buy a ticket, and commit to taking time off. The anticipation alone can be rejuvenating.

Taking the First Step

No matter what work-life balance means to you, realize that an ideal balance looks different for each person. It can change over the course of a lifetime.

The most important way to achieve the balance you’re seeking is to put your ideas into action. Your life will be so much richer if you consciously put in the effort, often in ways that you might not anticipate today. And you may find that in the process, you generate more joy, creativity, and resilience in your medical practice.

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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.

References

Colville, G et al. Coping with staff burnout and work-related post-traumatic stress in intensive care. Pediatric Critical Care Medicine. July 2017.

Dyrbye LN et al. Work-home conflicts have a substantial impact on career decisions that affect the adequacy of the surgical workforce. Arch Surg. 2012 Oct.

Eschleman, K.J. et al. Benefiting from creative activity: The positive relationships between creative activity, recovery experiences, and performance-related outcomes. J. Occup. Organ. Psychol. April 2014.

Saley, C. Survey Report: Millennial doctors still finding jobs the old-fashioned way. CompHealth Blog. April 2018.

Saley, C. Survey: Work/life balance is #1 priority in physicians’ job search. CHG Healthcare. March 2022.

Sexton JB et al. The associations between work-life balance behaviours, teamwork climate and safety climate: cross-sectional survey introducing the work-life climate scale, psychometric properties, benchmarking data and future directions. BMJ Qual Saf. 2017 Aug.

Shanafelt TD et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. October 2012.

Visual Thinking Strategies for Healthcare Teams: Elevating Collaboration, Care, and Creativity

Visual Thinking Strategies (VTS) is a dynamic, evidence-based process that uses art as a springboard for exploration and collaboration within medical teams. By engaging with visual art, physicians and other healthcare professionals can unlock critical thinking and communication skills—cornerstones of effective medical teamwork. These skills not only enhance team cohesion but may also translate into improved patient care and outcomes.

What sets VTS apart from simply art appreciation is its ability to

• nurture active listening,

• enhance observational skills,

• build cultural awareness, and

• foster a tolerance for ambiguity

These are qualities essential for leaders in our increasingly complex healthcare landscape. Over the past three decades, VTS has been widely adopted and studied across universities, medical schools, and healthcare settings, attesting to its versatility and impact.

Unlike traditional arts-based programs, VTS requires no prior knowledge, experience, or even a passion for art. Instead, a work of art serves as a neutral and engaging medium to spark conversations that might otherwise feel forced or uncomfortable.

By focusing on observation and open-ended discussion, participants uncover new insights, foster deeper connections, and gently challenge their own preconceived ideas and biases. This process creates a safe and creative space for professional growth and team development.

How to Access Visual Thinking Strategies

Visual thinking doesn’t require artistic skill or an aesthetic eye; it simply asks you to think differently. Here are a few ways you can begin:

Team Workshops

VTS follows a very specific evidence-based process, so it’s important that your facilitator has been trained in the method.

In a VTS session, a facilitator presents an artwork, allowing participants time for close looking. The process then transitions to asking each individual to describe what they think is going on in the picture. After they have shared their perspective, the facilitator follows up with a question asking them to relate what they see in the work that makes them say that.

Each person takes turns, so no one's interpretation bears more weight than another's. Many times the interpretations differ a great deal between participants. Often, the observations surface ideas or assumptions that the participant may later decide are not exactly what they expected. At times, this might even feel uncomfortable, but since VTS is designed to be supportive, not confrontative, this is part of the unfolding experience.

After everyone has a chance to speak, there is a debriefing that includes a discussion of what might have been challenging or unexpected. We also talk about how this experience might connect to something that would be encountered in the clinic or hospital.

For those in healthcare, Harvard offers an extensive VTS training course that includes an option to apply for certification after completion. As a student of this program, I can vouch for its high quality and engaging, thorough training.

Daily Observational Practice

Spend a few minutes observing an image, whether it’s art, a medical scan, or even nature. Ask yourself: What do I notice? What stands out? How does this relate to my work today? You might use this as a journaling prompt, perhaps setting a timer for 10-15 minutes to give yourself time to go deeper.

Patient Communication

Visual tools can help simplify complex medical concepts for patients, improving understanding and trust. By understanding how VTS works, and putting the method to use in your encounters, you may create deeper and more trusting relationships with your patients.

Why Physicians Can Benefit from Visual Thinking Strategies

More than most professionals, physicians operate in a world of complexity, ambiguity, and precision. Visual thinking strategies can:

• Enhance Diagnostic Skills: By practicing detailed observation through VTS exercises, you can sharpen your ability to notice subtle clinical signs and patterns.

• Improve Team Collaboration: Through VTS, each person has an opportunity to share their own experience of the work being presented. This can open up diverse perspectives, especially in interdisciplinary teams.

• Boost Creative Problem-Solving: Medicine often requires innovative thinking, whether solving a patient care dilemma or optimizing workflow. Visual brainstorming can unlock new approaches.

• Foster Emotional Intelligence: Engaging with imagery—whether art, diagrams, or patient stories—can help cultivate empathy and awareness.

• Improve Comfort with Ambiguity: Patient presentations are often nuanced, diagnoses may be unclear, and treatment outcomes can be uncertain. Developing comfort with ambiguity allows physicians and other healthcare professionals to remain calm, curious, and open to new ways of seeing, enabling them to make sound decisions even in the face of incomplete information.

Why I’m Passionate About VTS

As a physician and coach, I’ve experienced firsthand the ways that VTS can spark new insights and foster confidence and team cohesion. In a profession where burnout is all too common, VTS provides a refreshing, engaging way to reconnect with your sense of purpose and curiosity.

Final Thoughts

Visual thinking strategies offer physicians a unique and valuable way to navigate the complexities of modern medicine. By integrating these techniques into your daily practice, you can enhance your observational skills, improve communication, and reignite your passion for the art of healing.

I’m considering offering a free workshop on VTS tailored specifically for physicians. If this is something that piques your interest, I’d love to hear from you!

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Learning the Art of Delegation: A SMART Tool for Physicians

An earlier version of this article appeared on this website in July 2023.

Delegating can be a challenging skill for many physicians to master, but it’s often an integral part of safe and efficient patient care. The need to maintain control over every detail—especially when you bear ultimate responsibility—can make letting go feel risky. That’s why the most effective delegation is not just about offloading tasks; it’s about empowering your team to work at their best.

In this article, we’ll explore which tasks are most suitable for delegation, how this practice can strengthen teamwork, and strategies to make the process efficient and effective. Plus, I’ll share a practical template to help you overcome common barriers, enabling you to maximize your team’s potential.

Of course, you can’t (and won’t) simply assign a task and hope it all works out. Instead, when you delegate, the goal is to get the same or better result than if you did the task yourself.

As a physician, there can be a blurry line between what you need to do to assure the optimal care for your patients and what others must do in order for you to accomplish your best work. Creating a cohesive team mentality will help you to reach these goals with greater confidence.

Begin with creating clarity around responsibilities and purpose. You are the team leader. The goal is to provide the best and most timely care for your patients, and to administer that care with compassion and professionalism. By establishing clear and well documented instructions and expectations, you’ll set your team members up for success.

You may already know about SMART goal setting, but the SMART Delegation mnemonic is a distinct tool designed to help you manage your workload more effectively and make the most of your time. By following its steps, you can delegate tasks successfully while empowering and motivating your team to perform at their best.

 SMART Delegation

(Based on the work of Kate Christie of Time Stylers)

SELECT: Choose the best person for the task. This may be someone with little experience but a willingness to learn, or it could be someone with years of practice in the same or related field. Be choosy, but consider thinking outside the box.

MOTIVATE: Motivate your team by explaining why the task is important. This will create buy-in and a sense of importance and pride. This step is important to revisit periodically, especially at first.

ACTIVATE: Explain the details of the task in detail. Be sure to include a checklist if appropriate, and a written guideline that can easily be referred to and updated as needed. Once you put in the work to create the guideline, this bit of heavy lifting is done. This is a crucial part of time management.

RESULTS: Describe and explain clearly what a good result looks like. Be sure your delegated team member understands the purpose of their work, and how to recognize common complications.

TIME FRAME: Set realistic but firm deadlines when implementing new protocols. Consider setting up a mid-point check in if appropriate.

What to Keep in Mind When Delegating

Trust but Verify

Delegation requires trust in your team, but it’s also essential to check in periodically to ensure the task is on track. Verifying progress not only helps catch potential issues early but also reinforces accountability and builds confidence in your team’s ability to meet expectations.

Acknowledge the Learning Curve

Remember, your team or individual members may be learning a new skill. Take time at the outset to be available, approachable, and patient—especially in the early stages. The time you spend now will be paid back in multiples once the process is clear. Ensure the person taking on the task fully understands their role and the expectation that they will eventually handle it independently in most cases.

Keep Communication Open

Maintain open lines of communication so your team feels comfortable seeking help with complications or unexpected situations. Whenever possible, turn their questions into teaching opportunities instead of simply providing answers. Foster a spirit of teamwork by encouraging them to brainstorm solutions and come to their own conclusions, while also offering a safety net of support.

Utilize Supervisors as Needed

If appropriate, involve a supervisor to provide additional support. This allows your team members to seek guidance on minor issues or questions without always relying on you. It also brings the supervisor into the process, building camaraderie by acknowledging their role and creating stronger team cohesion.

Provide Constructive Feedback

Be generous with your praise and constructive criticism. Patience is essential, but if someone consistently struggles to meet expectations, consider delegating the task to someone better suited for it. Avoid slipping back into the time-consuming habit of doing everything yourself.

Embrace Discomfort

Delegating can feel like relinquishing control, so it’s normal to experience some discomfort at first. Be patient with yourself and your team while setting clear and achievable expectations.

The Ripple Effect of Effective Delegation

When you commit to the principles of SMART delegation, you’re not just easing your workload—you’re fostering a culture of trust, accountability, and growth. With the right people and processes in place, delegation can make you more productive, improve safety, strengthen teamwork, and enhance patient satisfaction.

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Overcoming Disrespect in Medicine: Protecting Physician Dignity

An earlier version of this article appeared on the KevinMD website in August, 2023.

Treating patients with dignity is one of the cornerstones of our profession. While we’ve all had moments when we—or our colleagues—didn’t quite measure up, most of us genuinely aim to make our patients feel safe and respected. But what about the flip side of this dynamic? It’s not talked about nearly enough: physicians are often not treated with the same dignity by their systems or even their patients.

In this article, I’ll dive into the major shifts that have led to this reality and share five practical strategies to help you push back against the disrespect and reclaim your sense of dignity.

The Roots of the Problem: Disrespect and Breakdown in Advocacy

We’ve been conditioned to expect, and even accept, that patients in distress might lash out, but the toll this has taken on physicians in recent years has been enormous. As recently as five years ago there was still a general expectation of respect for the expertise and sacrifices that a physician’s work entails.

But disrespect from patients is currently at an all-time high, sometimes even escalating to physical violence from patients. A recent study found that more than one third of public health workers in the US experience some form of workplace violence. Examples included stigma or discrimination, job-related threats, and bullying or harassment.

Adding fuel to the fire is the rise of administrative oversight of physicians and their practices by people who may have little experience in direct patient care. Their reach extends not only to metrics and billing, but into personal and professional decisions that once would have been completely off limits.

What’s more, employed physicians may have little say into whether threatening patients can be dismissed from their practices. 

And at the intersection of patient and administrative stress are the widely published patient satisfaction scores. While these scores often have no relevance to patient outcomes, they’ve become yet another pressure point, pushing physicians to prioritize arbitrary expectations over doing their best work.

 Although physicians are tasked with regular training in sensitivity and respect for patients and employees, they get little instruction in how to protect their own dignity. Often physicians are advised to just let it go.

It’s not unusual for doctors, especially women, to attempt to deal with these situations with passivity and even self-deprecation, in a misguided attempt to get along. Younger physicians who lack strong mentorship may be especially vulnerable to these situations.

Unfortunately, these well-meaning attempts to smooth things over often have the opposite effect. They can actually embolden the bully and do nothing to improve the situation.

The status quo is not sustainable, and it is incumbent on healthcare systems to work to create safe and respectful environments. As a physician, you have more power than you may realize. Here are five ideas that you can implement right now:

How to Reclaim Your Dignity

 1. Establish Boundaries

Boundaries are essential for maintaining professional relationships and protecting your sense of self. Being a compassionate and caring physician doesn’t mean being a friend to your patients or colleagues.

Keep a clear line between work and personal life—avoid interacting with patients or administrators on social media, and be intentional about separating the two spheres. Setting clear expectations for respectful behavior can help prevent issues before they arise.

2. Advocate for a Respectful Work Environment

If you don’t stand up for yourself, who will? Open discussions about mutual respect—at meetings or through anonymous feedback systems—can pave the way for change.

Remember, you’re not asking for anything unreasonable. Advocating for policies that address disrespect and burnout can help create a healthier, more supportive workplace for everyone.

3. Strengthen Doctor-Patient Communication

Good communication is at the heart of the physician-patient relationship. By being empathetic and respectful in your interactions, you can set the tone for civility with both patients and staff.

Stay calm during difficult conversations—pause, take a deep breath, and step away if needed. Active listening, showing genuine interest in patients' concerns, and involving them in decision-making can help build trust and respect.

And although the EHR is great tool for communication, keeping EHR messages brief and focused can help to maintain your professional boundaries while addressing patient concerns.

4. Don’t Accept Disrespect

Firmly but politely calling out an incident of disrespect can be a first step towards creating a solution. When an issue persists or escalates, document what’s happening—it’s often more effective than just voicing complaints.

But if you feel that your safety or that of your staff is at risk, don’t allow yourself to be talked into accepting a dangerous situation. If you’re employed, your healthcare system bears responsibility. If your concerns are not addressed, sometimes engaging with and reporting to security or even law enforcement personnel is the best course of action to protect everyone.

5. Take Care of Yourself

Prioritize your own well-being. Make time for self-care, whether it’s through exercise, meditation, or hobbies to help you recharge emotionally and mentally. Mindfulness practices can give you tools that help you to stay present, focused, and composed during difficult encounters, preventing potential escalation.

Don’t overlook the importance of making time for your family, friends and loved ones. By nurturing these ties, you will stay connected to the world outside of your practice.

Reclaiming your dignity as a physician will require commitment and fortitude. While it’s crucial to acknowledge the culpability of our healthcare systems, real change will depend on strong advocacy from physicians like you. By starting with the steps above, you can begin to build a workplace that’s not only more respectful but also more sustainable. And ultimately everyone, including the patients you care for, will benefit.

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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.

References

Fenton JJ et al. The Cost of Satisfaction: A National Study of Patient Satisfaction, Health Care Utilization, Expenditures, and Mortality. Archives of Internal Medicine. 2012

Ofri, D. The Business of Health Care Depends on Exploiting Doctors and Nurses . The New York Times. June 8, 2019

Schneider, B.J. et al. The Effect of Patient Satisfaction Scores on Physician Job Satisfaction and Burnout. Future Science. November 12, 2020.

Tiesman, H. M. et al. Workplace Violence and the Mental Health of Public Health Workers During COVID-19. American Journal of Preventive Medicine. March 2023

Yeluru H et al. Physician Burnout Through the Female Lens: A Silent Crisis. Frontiers in Public Health. May 2022

Retirement Planning for Physicians: Introducing the Future Self Exercise

For many physicians, the concept of retirement may seem distant, daunting, or even unattainable. That shouldn’t be surprising. It’s likely you’ve spent the greater part of your adult life as a doctor, and most of your youth studying and striving to become one.

The idea of leaving the profession may seem frankly overwhelming. After so many years of dedicating your life to others’ health and well-being, what does a fulfilling retirement look like for you?

Retirement is different for each one of us. Some people happily move out of the profession and take a new path, never looking back. Others will repurpose some of the skills they’ve acquired and dedicate that to an endeavor such as volunteering or teaching. And, sadly, some physicians mourn the life they’ve given up, never quite finding their footing in the outside world.

No matter where you are in your professional arc, the “future self” exercise is a powerful tool for envisioning and then creating a meaningful retirement. In this article, we’ll explore how you can use this exercise to develop and align your retirement plans with your personal values, dreams, and aspirations.

Introducing the Future Self Exercise

It can be difficult to imagine yourself many years into the future. Instead, a one-to-five-year time line might feel more tangible. That’s partly because it’s normal for our needs, wants, and dreams to change over time. If you think back to the person you were ten years ago, it’s possible that version of you feels very different from your current self. Research on the “future self” confirms that we often perceive this unknown version as an “other.”

Nevertheless, it is important to set yourself up for success and happiness for both the short term and the more distant future. Especially if it’s early on in your professional life, thinking of the future you as a person you care for can foster a sense of compassion and responsibility.

If you’re contemplating retirement, then the future you becomes much more knowable. And in this context, the future self exercise can be especially actionable.

This exercise can help you design your goals both by creating self-awareness and clarity, but also through aligning your current actions with your long-term hopes and dreams. You can’t control the future, but you can take ownership of your direction during this major life transition.

Your Step-by-Step Guide to the Future Self Exercise

Step 1: Set the Stage

• Choose a quiet, comfortable space to reflect on your life from the perspective of your future self.

• Have a journal or notepad ready for capturing thoughts.

Step 2: Imagine your ideal retirement.

• Close your eyes and picture yourself 1-5 years into retirement.

• Questions to consider:

  • What does your day look like?

  • Where are you living?

  • Who are you spending time with?

  • What activities bring you joy and fulfillment?

Step 3: Making an impact

• Staying with the future you, ask yourself:

  • What am I proud of accomplishing since retiring?

  • How am I continuing to make a difference or live meaningfully?

Step 4: Identify values and priorities.

• Still holding the future in your mind’s eye, reflect on:

  • What matters most to me in this phase of life?

  • How do I want to feel every day?

Step 5: Nurturing relationships and connections

• Sitting with your future self, consider:

  • Who are the friends, family, and community that I care about or hope to develop?

  • How am I creating a life that keeps me connected and supported?

Step 6: Carrying strengths forward

• Ask yourself:

  • What strengths and skills from my life as a physician do I use in this next phase of life?

  • How do I ensure that I continue to learn and grow?

Step 7: Write a letter to your future self

• It can be helpful to write a letter to your future self, describing your hopes, goals, and dreams. Seal it and set a date to read it in the future. Create a reminder on your phone or calendar to ensure that you don’t forget.

Translating Your Vision into Action

Once you’ve completed the process, take a look at what you’ve written. Highlight the recurring themes or patterns that stand out for you. Next, set actionable goals that will help you to create the life in retirement that you want to live.

• Financial goals: You may want to enlist a trusted advisor to help you plan out and refine your financial goals so that you are on track to enjoy your retirement without excessive worry about money or savings.

• Lifestyle goals: Begin to define your ideal balance between relaxation, hobbies, and productivity. Physicians often overlook their own health when life gets busy, but pre-retirement is a crucial time to make it a priority so that you are able to enjoy your retirement when the time arrives.

• Relationship goals: Define who you want to share your time with, and in what way. It’s never too soon to work on your relationships and cultivate friendships, even if it means a just brief text or email to keep the lines of communication open.

• Legacy goals: Explore ways to contribute to your community. That could take the form of teaching, mentoring, or volunteering, or anything else that appeals to you. This is a great time to explore areas of interest that you might never have had time for during your working life. You don’t need to make a commitment until you’re ready, but get to know where the needs are, and think about how you might contribute to something personally meaningful.

Although your goals and plans may change over time, the Future Self exercise can be a powerful way to strengthen your vision and jump start your plans. It’s never too early to begin taking small steps now to integrate elements of your future self into your current life.

When your life and identity have been shaped by your profession, it’s easy to feel overwhelmed and unmoored when you make the decision to retire. It can help to think of retirement as an opportunity to redesign a life that aligns with your values, passions, and aspirations. The Future Self exercise offers a powerful way to gain clarity and intentionally shape this next chapter into something rich, meaningful, and purposeful.

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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.

Burnout is an Expression of Grief, Not a Lack of Compassion

An earlier version of this article appeared on the KevinMD website in June, 2023

Over the last 5 years, the word “burnout” has become nearly synonymous with the state of healthcare. With nearly 50 percent of physicians surveyed reporting burnout in 2023, it’s an epidemic in our profession.

Physicians are often made to feel responsible for their symptoms of burnout, but by definition, burnout is not a personal failing or a psychological illness. Rather, burnout is defined as an occupational phenomenon that happens in response to chronic workplace-related stress.

Symptoms of burnout include:

• Exhaustion

• Cynicism

• Inefficiency

Burnout is not a failure of compassion.

If you’re feeling burned out, it doesn’t mean that you don’t care. In fact, burnout may be a natural reaction to the recognition that you are unable to provide the compassionate care that your patients need.

The experience of burnout may mirror in some ways the experience of grief. Both are a response to loss. And like burnout, grief is often experienced as exhaustion and difficulty thinking clearly.

Compassion fatigue on the other hand is defined as a sense of indifference to the suffering of others. It’s an emotional withdrawal often caused by exposure to traumatic events. For physicians, it may be a response to relentless illness and death.  The COVID-19 pandemic is a classic example of a driver of compassion fatigue, especially for those who worked in the ER and ICU in the early days of this disaster.

It’s not uncommon for physicians to experience compassion fatigue from time to time. It doesn’t mean that they are not compassionate people, but rather that they are suffering and in need of relief.  

We might consider burnout as a type of disenfranchised grief. But it is not compassion fatigue. In fact, equating burnout with a lack of compassion may be a heavy-handed way of placing the blame on physicians while deflecting it from the systems that created the problem.

As a coach, I have found that many physicians with burnout are in fact grieving the lack of connection to their patients. Often this is due to system-wide emphasis on RVUs combined with excessive clerical work that undermines their ability to spend meaningful time with patients.

National organizations and many health care systems are beginning to take note, and as supportive processes are put in place, rates of burnout do seem to be slowly improving. But there is much work to be done.

If you’re experiencing burnout, it’s important to recognize it for the wound that it is, have compassion for yourself, and create a plan to move forward.

In the words of the poet Rumi, “the wound is the place where the light enters you.” What does this light illuminate for you?

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Mindfulness: A Surprisingly Practical Tool for Time Management

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.

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Twelve Tips for Creating Realistic To-Do Lists for Busy Physicians

An earlier version of this article was published on this website in July, 2023.

Creating a realistic and actionable To-Do list can feel like a daunting task for a busy physician. But the truth is that your To-Do list can free up hours of your valuable time, create structure out of chaos, and help you to reach goals that will bring you closer to your ideal life.

In this article, I’m going to share twelve actionable and realistic tips that will help you to develop your own sustainable To-Do List practice.

Tip Number One: Write it Out

I encourage you to write out your daily to-do list and carry it with you, rather than using your computer or phone.  Research shows that handwriting notes, including important schedule reminders, activates the brain’s memory functions more strongly than entering the information into an electronic device. My favorite tool is my Bullet Journal. But a simple piece of paper that you can slip into your pocket will do.

Tip Number Two: Don’t Include Everything

Your To-Do list should not include patient appointments, consults, rounds, or other foundational tasks of your practice. Instead, use it to create and keep track of tasks such as

✅meetings

✅strategic tasks

✅planning

✅study time

✅personal appointments

✅exercise

✅meditation

✅creative endeavors

✅any other personal projects that are meaningful to you

Tip Number Three: Make a Weekly Appointment with Your List

Choose a recurrent time to devote ten to fifteen minutes creating a list of your weekly tasks, keeping the above list in mind. For me, Sunday evenings work best.

Be sure to include tasks that may not be due the following week, but that might require planning over the next several weeks to months. For those tasks, make note of the deadline so that you can prompt yourself to plan accordingly. These might include

⭕lectures

⭕papers

⭕vacation planning

⭕studying for boards

⭕tax preparation

⭕business planning

⭕writing an article

⭕learning a new skill

Tip Number Four: Take Ten Minutes Every Evening

Each evening, take ten minutes to review your tasks from the day, revisit your weekly task list, and create a list for the following day. It’s easy to add more things to the list than you can reasonably accomplish. To avoid this trap, include a general range of time required to complete each task. That way, you’ll keep your plans realistic and set yourself up for success.

Don’t forget to take into account steps that you need to take to reach your upcoming deadlines. Keep these events in mind as you plan your list and break down the necessary steps into actionable tasks.

Tip Number Five: Prioritize, Delegate, and Delete

Prioritize your tasks so that the most important things take priority.

Before committing to your To-Do list, take a look to see if there are tasks that you can delegate or automate. If so, decide how you are going to do that, and put those steps on your list. Although this can take some time to work out at the beginning, it will save you multiples of time once you’ve put the process in place.

Tip Number Six: Batch Your Tasks

Now that you have your To-Do list, think about how you might organize or cluster several related tasks together. This is known as “batching”. Mentally, this keeps you from constantly switching context, a hazard of multitasking. It can also help you to avoid procrastination.

By batching your tasks, you’ll optimize your time and keep your focus. And that will give you more breathing room, or margin, for the things that matter the most to you.

Tip Number Seven: Take Advantage of Unexpected Open Time

Refer to your list when you find yourself with unexpected open time, especially when the tasks only require limited blocks of concentrated effort. Even 10 minutes of focused work can reduce your in-box burden.

Tip Number Eight: Use a Timer

When possible, use a timer to encourage yourself to maintain focus. Twenty- to thirty-minute segments are usually a good idea. But when you’re struggling to get started, even a five-to-ten-minute commitment can get the task launched.

The important thing is to overcome the inertia that might be holding you back. If possible, turn off notifications on your phone or computer to limit interruptions during high-focus times.

Tip Number Nine: Budget Your Energy

Think about optimizing the way you use your time. Use your low-energy times, like the end of a busy day, for things that demand the least amount of focus. And use the times where you have the most mental energy for those commitments that require creativity and mental flow.

Tip Number Ten: Beware of the Energy Drain from Your Devices

Although device use is a necessity of life, it can also be an attention drain. Consider setting a timer for checking email or surfing the web. And whenever possible, batch your email time so that you’re not constantly checking your inbox. Delete, unsubscribe, or delegate whenever possible.

Tip Number Eleven: Allow Time for a Pause

Whenever feasible, give yourself time for a mental pause. Most people need at least 5-10 minutes per hour in order to maintain optimal focus. Although that may not always be possible during the busiest times of your workday, try to build brief pauses into the structure of your after-hours time.

Consider adding a daily meditation to your To-Do list. You can use this as one of your mental pauses. A brief meditation using one of many available apps (including HeadSpace and Waking Up) may help you to re-focus the mind and let go of the stress of the day. By practicing mindfulness meditation regularly for even a few minutes, you’ll train yourself to become more present and less irritable.

Tip Number Twelve: Don’t Give Up

No matter how you structure your To-Do list, remember that it can take several weeks for a habit to stick. Choose a method that will be easy to access and easy to remember. If you skip a few days, simply start over. And make sure to take a little time at the end of each day to review the day’s tasks and set up your list for tomorrow.

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My Podcast Interview with Livia Robic of Withings for BeamO

I recently spoke with Livia Robic of Withings about the BeamO device for the TechLink Health podcast. This handheld consumer device includes a pulse oximeter, a thermometer, a mini-ECG and an electronic stethoscope.

BeamO is designed to help physicians take better care of their patients remotely, and was named one of Time magazine's "Best Inventions of 2024". This was such an interesting and engaging episode, and I can imagine a number of scenarios where this device could make a difference for patients with chronic disease or those recovering from surgery. I’m excited to see what the future holds for BeamO!

You can find our conversation anywhere you listen to podcasts, or through the Spotify link below.