banishing busy

Medical professionals are busy people and exist in a constant state of “being busy.” How do we resolve chronic “busy-ness”? How do we manage our time effectively? In her recent talk at the CORD Academic Assembly 2020, Dr. Christina Shenvi, EM Physician and Associate Residency Director at UNC, provided 5 key actions to help us be productive, complete our work effectively, and strive for work-life balance. Dr. Shenvi recorded her lecture again to be shared with the ALiEM Faculty Incubator. This series of posts breaks down her talk into 3 sections in order to summarize her key points and to help us “Banish Busy” from our lives. This second post will discuss seven ways to avoid self-sabotage.



  • 00:23: Review Part 1
  • Key Point #2 continued Avoid Self-Sabotage
  • 1:30 Why do we self-sabotage?
  • 2:01 Why should we focus on effort rather than abilities?
  • 3:26 How do we decouple performance and self-worth? ->Achievement goal theory
  • 6:19 What adaptive behaviors can we use to remove self-worth from the performance equation?
  • 9:29 How does our work align with our big values/mission? (review Activity B)
  • 13:04 How do we cultivate curiosity in our actions and plan for it?
  • 16:03 How to make temptation inconvenient?
  • 18:06 What is the immediate next step?
  • 19:12 Why is it important to plan to fail?
  • 20:19: How can we develop expertise?
  • 26:03 Why do we experience Imposter Phenomenon and how do we overcome it?
  • 31:55 What do some great innovators think about failure?

Previously on:

In part 1 of this series, Dr. Shenvi introduced the framework for her lecture on “banishing busy” through her 5 key points on improving time management. She discussed the importance of value-based scheduling and the importance of recognizing our BHAGs (big hairy audacious goals) that help guide this process. Dr. Shenvi also emphasized the importance of avoiding self-sabotage by talking about different motivators for procrastination and the relationship between procrastination and emotion.

7 Ways To Avoid Self-Sabotage

How often do we get in our own way when we know we have something to accomplish?

1. Focus on effort, rather than abilities

In some cases, we get caught up in the feeling that our struggle to accomplish something is because we are not talented or skilled enough to get something done [1]. Instead of putting the blame on our inability to do something, we should focus on the effort that we will invest instead. Per Angela Duckworth, author of Grit:

Talent x effort = skill
Skill x effort = achievement

In this equation, effort counts twice! This can bring our natural talent and skill and move it towards achievement [2].

2. Decouple performance from self-worth by learning to love the process

Rather than making performance and outcome the goal of our task, we should focus our efforts on our own learning. Expect that there will be difficulty: our goal is to be an adaptive learner, rather than a master from the outset. Curiosity, motivation, mindset, and resilience drive this adaptive strategy [3, 4]. By seeing failure as part of the learning process and removing our self-worth from performance, we make our achievement about the process that it took to get us there, rather than the product [5-7].

3. Align work tasks with Big Values

Reflection on our Big Values is an important step to ensure our actions align with our goals. For instance, what makes us put on our scrubs and go to work? We know “helping people” is only part of the answer. We should explore how our work aligns with our Big Values:

  • Reframe negative emotions about a task so that it fits in with the Big Values.
  • Review tasks and determine what can and cannot be outsourced. If something can be outsourced, then delegate appropriately!
  • Decide which tasks need our best efforts, and for which tasks “adequate” work would be acceptable.

Yes, this means that we can’t do everything with all of our effort 100% of the time entirely by ourselves, but we don’t work in vacuums, so we need to prioritize tasks so that we get the most out of them, too. (If you wrote down your own BHAGs during Part 1 [4], take a moment to look at them)

4. Cultivate curiosity to explore our feelings about a task

Sometimes, lack of excitement about a task will keep us from getting things done. Take the time to be curious and explore the task, our feelings, and the outcomes [6]. We should make ourselves curious about the task so that we can be engaged in completing that task.

5. Make temptation inconvenient

Our greatest temptation is to procrastinate by doing little but “useful” things. It’s not really procrastinating if you have folded laundry and an empty inbox, right? (Answer: wrong). To avoid this, we should take drastic action to keep ourselves from getting distracted: turning off our phones, muting our notifications, or disconnecting from WiFi if it isn’t necessary.

6. Figure out the immediate next steps

If the idea of just starting keeps us back, break down a task into smaller more manageable pieces. For example, when revising a manuscript, we know the steps: open the file, re-read the draft. After that is done, make another immediate next step: review previous edits, and read the reviewer comments, and so on. We know how to do all of those things, and none of them are hard! By breaking it down into steps, it makes the task seem less insurmountable and lowers the activation barrier for getting started.

7. Plan to fail

Never failing means under trying (see tip #1, effort is required). At times, we let our imposter syndrome get in the way of achievement. By attributing our success to an external cause, we continue to contribute to our own imposter syndrome [8-11]. To combat this, when we embark on a task, we should use deliberate practice, meaning:

  • Seeking input from outside resources,
  • Having an organized, intentional, and focused practice
  • Staying in the zone of proximal development. In other words, doing something we can do with some supervision and help. This is where we can develop the most growth.
  • Seeking honest/specific feedback
  • Self-regulating [12]

By planning to fail, when things don’t turn out the way that we wanted, we can check that off as something on our to-do list, and get back to working out a more successful strategy. The zone of proximal development [12], that region between our terror and comfort zones, is important here: the discomfort we have with being outside of our comfort zone helps us assess our negative emotions and adapt appropriately. However, this doesn’t mean that it’s not an unsettling place to be in!

Coming soon in Part 3

In part 3, Dr. Shenvi discusses how to take control of our time. How can we manage our minds so that we can be more efficient? Where is our time really going, and how can we re-allocate it to the areas we value? How can we focus our efforts on work that will progress our joy and fulfillment, while addressing the mundane tasks that are much more numerous?

References/Recommended readings

  1. Voge N. Nic Voge: Self Worth Theory: The Key to Understanding & Overcoming Procrastination. Presented at TEDxPrincetonU. Nov 2017
  2. Duckworth A. Grit: The Power of Passion and Perseverance. New York: Scribner; 2016.
  3. Seifert T. Understanding student motivation. Educational Research. 2004;46(2):137-149. doi:10.1080/0013188042000222421
  4. Covington M. Goal Theory, Motivation, and School Achievement: An Integrative Review. Annu Rev Psychol. 2000;51(1):171-200. doi:10.1146/annurev.psych.51.1.171
  5. Brown, P. Make It Stick : the Science of Successful Learning. Cambridge, Mass:The Belknap Press of Harvard University Press, 2014.
  6. Cutrer W, Pusic M, Gruppen L, Hammoud M, Santen S. The Master Adaptive Learner. 2019
  7. Dweck, C. Mindset: The New Psychology of Success. New York: Random House, 2006
  8. Langford J, Clance P. The imposter phenomenon: Recent research findings regarding dynamics, personality and family patterns and their implications for treatment. Psychotherapy. 1993;30(3):495-501. doi:10.1037/0033-3204.30.3.495
  9. Sakulku, J. The Impostor Phenomenon. The Journal of Behavioral Science, 6(1), 75-97. 2011
  10. Clance P, Imes S. The imposter phenomenon in high achieving women: Dynamics and therapeutic intervention. Psychotherapy.1978;15(3):241-247. doi:10.1037/h0086006
  11. Matthews G, Clance, P. Treatment of the impostor phenomenon in psychotherapy clients. Psychotherapy in Private Practice. 1985; 3(1), 71–81.
  12. Ericsson K, Pool R. Summary Of Peak: Secrets From The New Science Of Expertise. Houghton Mifflin Harcourt; 2016
  13. Coyle, D. Culture Code: The Secrets of Highly Successful Groups. Bantam, 2017.
Brian Barbas, MD

Brian Barbas, MD

Assistant Professor & Clerkship Director
Department of Emergency Medicine
Loyola University Chicago – Stritch School of Medicine
Brian Barbas, MD

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Laryssa Patti, MD

Laryssa Patti, MD

Assistant Professor
Emergency Medicine Clerkship Director
Department of Emergency Medicine
Rutgers - Robert Wood Johnson Medical School
Meenal Sharkey, MD

Meenal Sharkey, MD

Medical Student Clerkship Director and Core Faculty
Assistant Program Director
Department of Emergency Medicine
Doctors Hospital, Columbus, OH
Meenal Sharkey, MD

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Eric Blazar, MD

Eric Blazar, MD

Clinical Assistant Professor
Department of Emergency Medicine
Rowan University
Inspira Medical Center
Eric Blazar, MD

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Christina Shenvi, MD PhD
Associate Professor
University of North Carolina
Christina Shenvi, MD PhD


Emergency Medicine and Geriatrics trained, Educator, Professional nerd, mother of 4, excited about #educationaltheory, #MedEd, #EM, #Geriatrics, #FOAMed.
Christina Shenvi, MD PhD

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