Educational resources discussing lifestyle, public policy, and wellness relevant for all healthcare providers

The Fall of FOAM

Fork in Road Disappearance of FOAM blog podcast

The landscape of emergency medicine and critical care (EM/CC) blogs and podcasts has changed dramatically over the past 20 years. The number of free, open-access EM/CC blogs and podcasts has plummeted. As reported by Lin and colleagues in JMIR Education (2022), these sites decreased in number from 183 in 2014 to just 109 this year– a drop of 40.1% [1].


This comes after a period of rapid growth of these educational resources in the late 2000’s [2], with expectations that new sites would continue to come online. It is unclear when the combined number of EM/CC blogs and podcasts peaked, or how recently it declined.

Why do we care in these declining numbers?

The FOAM (free open-access medical education) movement has become an important component of EM curricula at many training programs. Online learning resources such as medical blogs and podcasts have all but replaced traditional textbooks, and research suggests that some trainees use these products as their primary study materials [3]. Therefore, the observed decrease in FOAM sites is alarming, as training programs and trainees have come to rely on their availability.

Featured paper

In our JMIR Medical Education paper, Lin et al. sought to identify active EM/CC blogs and podcasts during a 2-week period in May 2022. The authors found a total of 50 blogs, 25 podcasts, and 34 blogs + podcasts (n=109). The age of these FOAM sites ranged from 1-18 years and most were physician-led. Just over half had leadership teams of 5 or more individuals. Support was identified for approximately 75% of the sites and included advertisements, institutional sponsorship, or the sale of goods and services (though site access remained free).

The Christensen Theory of Disruptive Innovation may explain the recent decline in EM/CC blogs and podcasts. Using this lens, FOAM sites are considered ‘disruptors’ in medical education that quickly gained market share previously dominated by ‘incumbents’ such as medical textbooks, journals, and in-person conferences. Rather than cede their influence, incumbent organizations co-opted the disruptive innovation itself, in this case leveraging their assets to create their own online learning resources, blogs, and podcasts. As these incumbent offerings grew, there was less need for new, independent FOAM sites. Concurrently, FOAM sites continue to generate little-to-no revenue and academic value for the creators, making it difficult for the disruptors to challenge the market dominance of incumbents or to create its own unique, sustainable market space. We theorize that older sites likely succumbed to these financial and academic opportunity costs as well as high user expectations for design and functionality.

What is the future of FOAM?

Though EM/CC blogs and podcasts changed the landscape of medical education in fundamental ways, they will likely not endure as independent entities without new business models for sustainability. A recent study suggests that the costs of FOAM might be offset by advertising or other revenues [4]. Based on our observations of current practices on existing FOAM sites, this might include at least incorporating any/all of the following:

  1. Inserting advertisements
  2. Creating products for sale such as books, courses, swag, or consulting services
  3. Developing partnerships
  4. Soliciting for donations

In the meantime, we posit one of 3 potential futures of new and existing blogs and podcasts: hybridization, disappearance, and new-market independence.

future of foam christensen

  1. Hybridization strategy: Incumbents partner with or create their own blogs/podcasts. This loss of independence, which was part of the initial appeal of FOAM grassroots efforts, is traded for more stability and infrastructure. Already 44% of EM blogs are officially affiliated with a sponsoring institution.
  2. Continued disappearance of sites: Progressively fewer independent, free blogs/podcasts because of site demise, merging of sites, or conversion to paid subscription model
  3. Independent sustainability: Growth of independent, free blogs/podcasts as its own new-market endeavor, separate from the incumbent market space, only achievable with better return on investments (academically and financially) for bloggers/podcasters. Once FOAM efforts are no longer a major opportunity cost, educators may even be able to pivot their careers towards this primarily, rather than as a side project.

It remains to be seen whether FOAM can withstand market and academic pressures or whether it is destined to be assimilated by better-resourced incumbent organizations.

What is the future of ALiEM?

We hope to stick around and hope the rest of the FOAM community will evolve with us.


Join the interesting discussion on Twitter. We are thrilled to bring this conversation to the forefront.


  1. Lin M, Phipps M, Yilmaz Y, Nash CJ, Gisondi MA, Chan TM. A Fork in the Road: Mapping the Paths of Emergency Medicine and Critical Care Blogs and Podcasts. JMIR Medical Education. 2022 (preprint available:
  2. Cadogan M, Thoma B, Chan TM, Lin M. Free Open Access Meducation (FOAM): The rise of emergency medicine and critical care blogs and podcasts (2002-2013). Emerg Med J. 2014;31(e1):e76-e77. doi:10.1136/emermed-2013-203502
  3. Branzetti J, Commissaris C, Croteau C, et al. The Best Laid Plans? A Qualitative Investigation of How Resident Physicians Plan Their Learning [published online ahead of print, 2022 May 24]. Acad Med. 2022; doi:10.1097/ACM.0000000000004751
  4. Lee M, Hamilton D, Chan TM. Cost of free open-access medical education (FOAM): An economic analysis of the top 20 FOAM sites. AEM Educ Train. 2022;6(5):e10795. Published 2022 Sep 9. doi:10.1002/aet2.10795

Need your help: A master list of free EM and Critical Care blog and podcast sites

Calling all who read or listen to emergency medicine/critical care (EM/CC) blogs or podcasts. In 2014, we helped to publish the master inventory of free open-access medical education (FOAMed) resources spanning the period of 2002-2013 [1]. In that publication, we demonstrated an exponential rise of both blogs and podcasts with 141 blogs and 42 podcasts (total 183 sites). In 2019, the Life in the Fast Lane (LITFL) team identified 251 active sites. But where are we at now?

Why create an EM/CC master list of sites?

Most of the time, we encounter new resources by word-of-mouth or through Google search engines. There are, however, so many more quality sites that are available for teaching and learning. We aim to find them all. Are the numbers like 50 or more like 500? So far, we have reviewed the 2019 LITFL list and identified 119 and 9 still-active blog and podcast sites, respectively. But we likely have missed some, especially those sites launched after 2019.

Why the rush on updating the master list now?

Since 2014, we have prided ourselves in running the Approved Instructional Resources (AIR) Series, which identifies quality blog posts and podcast episodes, specifically to help residency programs award asynchronous learning credit to their residents [2]. Posts and episodes are identified from the top 50 sites, based on our validated Social Media Index (SMI) score [3] and are selected from a modified version of the 2019 LITFL list. The SMI formula incorporates the Alexa rank, which unfortunately just retired on May 1, 2022. So we are working towards an updated SMI score, using Ahref’s Domain Rating as well as new platform followerships that includes not only Twitter and Facebook but also Pinterest, Reddit, YouTube, Instagram, and LinkedIn.

Call to action: What sites did we miss?

We want to get as comprehensive a list as possible. If you don’t see a blog or podcast on these lists, fill out the Google form below! Thank you for your help.



Submission Form


  1. Cadogan M, Thoma B, Chan TM, Lin M. Free Open Access Meducation (FOAM): the rise of emergency medicine and critical care blogs and podcasts (2002-2013). Emerg Med J. 2014;31(e1):e76-e77. doi:10.1136/emermed-2013-203502. PMID 24554447
  2. Lin M, Joshi N, Grock A, et al. Approved Instructional Resources Series: A National Initiative to Identify Quality Emergency Medicine Blog and Podcast Content for Resident Education. J Grad Med Educ. 2016;8(2):219-225. doi:10.4300/JGME-D-15-00388.1. PMID 27168891
  3. Thoma B, Sanders JL, Lin M, Paterson QS, Steeg J, Chan TM. The social media index: measuring the impact of emergency medicine and critical care websites. West J Emerg Med. 2015;16(2):242-249. doi:10.5811/westjem.2015.1.24860. PMID 25834664
By |2022-05-03T17:04:12-07:00May 4, 2022|Academic, Social Media & Tech|

The 1440 Doctor: Achieving Precision Focus – 3 Ways to Strengthen Your Attention Muscle

1440 doctor attention magnifying glass

If you’re like most people, your mind wanders. You may be sitting down to finish your charts, make that presentation (or write that blog) and your mind is off thinking about what you’re making for dinner or the fact that you need to call the plumber. Our minds wander and lose focus more often than we think. A study by Harvard psychologists Matthew Killingsworth and Daniel Gilbert showed that our brains spend 46.9% of our waking hours in wandering mode, focusing on something other than the task at hand. That leaves only 53.1% of your attention going to what it’s actually supposed to [1]. We all know though the less attention you devote to a task, the more time it takes to complete it. So that hour it would take to finish your charts, just turned into two with your favorite Netflix show on.

Given the fact we are living in a distraction economy, with new technological advances vying for our attention on a daily basis, it is important as ever to talk about how we can maintain our focus. This is part 1 of a 3-part series on achieving precision focus. I use the word precision, since I want you to think about focus refined and adapted to you and your life, rather than the generalized concept. There are 3 ingredients that go into achieving precision focus: attention, deliberateness, and energy. In this post we are going to tackle attention and discuss 3 tips for strengthening your attention muscle so you can achieve precision focus. Stay tuned for future posts on making sure you are deliberate with the items you choose to focus on and how to boost your energy levels to help you achieve precision focus.

Productivity isn’t about doing more, it’s about doing the right things, deliberately and with intention.

One Thing

Many of us bask in the glory of “multitasking.” Checked off 10 emails while on that zoom call or responded to some Slack messages while at our kid’s baseball practice. Many of you likely already know this: multitasking is a myth. Dr. Eyal Ophir, a Stanford University neuroscientist, showed that our brains are simply not capable of focusing on 2 things at once. Rather our brain rapidly “task switches” its attention between the 2 items. This process of task switching causes performance to suffer, leaving you ultimately working less efficiently on both tasks. A Harvard Business Review article entitled “How (and Why) to Stop Multitasking” quoted a 40% loss in productivity when we attempt to multitask. Scientist Harold Pashler showed that when people do two cognitive tasks at once, their cognitive capacity can drop from that of an MBA to that of an 8-year-old [2, 3].

You can’t execute more than one conscious task at a time without impacting accuracy.

Are you looking to remember the tasks you’re working on?

If so, don’t divide your attention. A study by Madore et al showed that giving partial attention to your tasks limits the ability of the information to go from short-term to long-term memory. Subjects that attempted to multi-task had attention lapses and poor memory [4]. So if you want to remember the information from your department faculty meeting, don’t surf the web during the research updates.

My advice, stop doing it all and do ONE thing. How refreshing will it be to sit down and just concentrate on the task at hand? Here are some ways to try to single-task this week:

  • For this week’s Zoom meeting/lecture, don’t have your web browser open, don’t text, and don’t check email. Say “no” to any Zoom call you’re not willing to single-task for. The partial attention you are giving to both tasks is not worth your time.
  • Single-task your deep work this week. This week when sitting down to do deep work, have only ONE tab/app open on your computer for the one task you are working on.
  • For your next conversation with a friend or family member, be intentional about single-tasking conversations with a family/friend. Listen to them, and soak in the conversation. No phone, no doing the dishes, just be deliberate in listening to what they have to say.

You sit down to do deep work, and your phone lights up with a text message from a friend. Picking up your phone, you see you also have a new email notification. 20 minutes later you are surfing Twitter and wondering how you got here. While technology has had considerable benefits in our lives, it’s also made it so much easier to procrastinate. Attention is a currency, and we don’t have unlimited amounts. 

Combat distractions and improve your attention by incorporating a “startup” ritual into your workday.

Do the 3 D’s:

  • Declutter. Our brains don’t like disorganization. This is important not only for your physical environment, but your digital environment too. Clean off your desk and delete icons cluttering your desktop. 
  • Do not disturb. Make sure your phone and computer are on “do not disturb.” Put your phone out of your visual space. Put it at least 20 seconds away to really stop temptation. Go to your email and take all accounts offline so you’re not tempted to check your email.
  • Design. Look over your planned design for the day. By reviewing what you intend to focus on, you will be less likely to get distracted.

I have a meditation confession. It took me some time to be convinced to try meditating. After reading countless attestations of the benefits of meditation, I gave it a try. The benefits of meditation go beyond reducing stress, generating kindness, and improving sleep. Mindfulness meditation affects various psychological outcomes. It can not only improve your cognitive performance but also enhance your attention. A meta-analysis done by Ofir et al., looked at 27 studies on mindfulness based interventions and found that meditation can reliably enhance attention and executive control [5].

You may think you don’t have the time to meditate. Your schedule is already so busy! Studies show that even a small “dose” of meditation has benefits. Moore et al. asked meditation-naive participants to meditate daily for 10 minutes. The results suggested that mindfulness meditation can lead to improved self-regulation of attention [6]. Basso et al. studied non-experienced meditators and found that at 8 weeks, 13-minute daily meditation decreased negative mood state, enhanced attention, increased working memory, and decreased anxiety [7].

Don’t know where to start? Check out the free app Insight Timer. I also enjoy Headspace (also check out their amazing “Sleepcasts” that not only help your drift off to dreamland but also feature a “Nighttime SOS” section that provides guided meditations if you wake up in the middle of the night).

Summary Action items

  1. Try out single-tasking this week, be it a conversation with a friend or your next Zoom meeting. Do ONE thing and stop living a life of partial attention.
  2. Read my 3 Tips for Combating Distractions while Working From Home blog on preventing distractions. Start your day with the 3 D “startup” ritual every day.
  3. Try 10 minutes of meditation one day this week. Download the Insight timer (free) and pick one to do.



  1. Killingsworth M, Gilbert D, A Wandering Mind Is an Unhappy Mind. Science. 2010; 330, 932. DOI: 10.1126/science.1192439
  2. Rock D. Your Brain at Work. 2nd Edition. Harper Business. 2020.
  3. Pashler H. Dual-task interference in simple tasks: Data and theory. Psychological Bulletin. 1994; 116(2), 220–244.
  4. Madore K, Khazenzon A, Backes C, et al. Memory failure predicted by attention lapsing and media multitasking. Nature. 2020; 587, 87–91.
  5. Yakobi O, Smilek D, Danckert J. The Effects of Mindfulness Meditation on Attention, Executive Control and Working Memory in Healthy Adults: A Meta-analysis of Randomized Controlled Trials. Cogn Ther Res. 2021;45, 543–560.
  6. Moore A, Gruber T, Derose J, Malinowski P. Regular, brief mindfulness meditation practice improves electrophysiological markers of attentional control. Front Hum Neurosci. 2012; 6(18).
  7. Basso J, McHale A, Ende V, Oberlin D, Suzuki W. Brief, daily meditation enhances attention, memory, mood, and emotional regulation in non-experienced meditators. Behav Brain Res. 2019; 356:208-220. PMID 30153464.



As physicians we are managing many different roles in our lives: academician, researcher, clinical provider, spouse, parent, just to name a few. Despite our many roles, the amount of time we have in a day to complete the tasks of each role remains the same: 1,440 minutes. Is how you’re spending your 1,440 minutes in a day the way you want to spend them? By assessing your priorities, practicing time saving tips and being proactive and not reactive you can live the balanced life you’ve dreamt of. There are only 1440 minutes in a day. Are you utilizing them well?

The 1440 Doctor series, originally launched on the Medutopia site, is authored by efficiency guru, Dr. Jennifer Kanapicki.


By |2022-05-08T21:28:49-07:00Apr 27, 2022|1440 Doctor, Life|

Dear emergency physicians: We see you

The COVID-19 pandemic has placed incredible stress and strain on the personal work lives of emergency physicians. We have endured these almost 2 years of misinformation, PPE shortages, fear, frustration, grief, and death. So much going on in the world politically and socioeconomically, we at ALiEM wanted to share a message that WE SEE YOU. We’re with you, and we’re in this together.


Thank you for the tireless work on this video by animator Spencer Evans, who is a soon-to-be-emergency physician attending medical school currently at the University of Colorado. Also thanks to the entire ALiEM team for contributing to the message and storyboard, especially Drs. Al’ai Alvarez, Andy Little, Carl Preiksaitis, Chris Belcher, Christian Rose, Felix Ankel, Jason Woods, and Teresa Chan.

How I Work Smarter: Simiao Li-Sauerwine, MD

One word that best describes how you work?


Current mobile device

iPhone 12


MacBook Air

What is something you are working on now?

I’m working on a research study examining the impact of EM faculty demographics on learner evaluations.

How did you come up with this Idea/Project?

I’ve always been interested in the impact of implicit bias on physician professional development and advancement. We use learner evaluations of attendings for promotion, for compensation, for recognition with departmental awards. So, I was interested to know how the demographics of a faculty member might impact a resident’s expectations of how they teach at the bedside and on shift. Do they impact those metrics that affect advancement?

What’s your office workspace setup like?

My office in the Department of EM at OSU is right across from our Program Managers – very convenient for quick questions and discussions! I have a PC but often also bring my laptop for a centralized work machine. I have a French press with coffee and tea and mugs so that folks can get a caffeine fix when they stop by. I also make sure to have snacks available for quick nutrition between meetings.

My home setup is my MacBook Air on a laptop stand. About a year into the pandemic as I was continuing to work from home, I purchased the stand and it’s been a game-changer! Less neck strain and better angles for Zoom :). I usually work on the couch in our home office or wherever I can find a quiet space for deep work.

What’s your best time-saving tip in the office or home?

I have no magical time-saving tips but I keep an aggressively up-to-date to-do list which I re-prioritize every day. If it’s not on paper (or on my Notes app), it tends to fall off my radar. So everything gets written down.

What’s your best time-saving tip regarding email management?

Triage your email. I either glance at it, respond if necessary, and move on, or flag the email if it requires more thought or an in-depth response. Then, when I have blocks of time to sit down, the flagged emails become their own TO DO list. I try to keep this down to less than one page.

What apps do you use to keep yourself organized?

The Reminders app is nice because I can sync it across all my Apple devices. I use this primarily for groceries and personal TO-DOs. I use Notes for work-related tasks; each line is a deadline for a task (either real or self-imposed) with a title and descriptor.

How do you stay up to date with resources?

I go to our resident conference every single week – it’s a privilege to continue to learn. Free knowledge! Who doesn’t love that?

What’s your best time-saving tip in the ED?

Save your teaching until after you’ve seen a patient, so you can focus on discussing the most relevant and high yield educational pearls.

ED charting: Macros or no macros?

No macros! It takes time to click through. I use dot phrases and change the text – it goes much quicker.


  • What’s the best advice you’ve ever received about work, life, or being efficient?

    Choose your projects based on 1. Are you passionate about the topic? 2. Are you really excited to work with the people involved? and 3. Will it build your dossier for promotion? Hitting one is great, two is better, and ideally all three! Wise words from Jorge Fernandez that have guided my junior faculty years.

  • What advice would you give other doctors who want to get started, or who are just starting out?

    • Find your passion, and academic products will follow.
    • You are entitled to mentorship from anyone and everyone – don’t be afraid to ask for it.
    • Your personal brand is important – are you solutions-oriented, do you get things done, are you timely.
    • Work time is work time, and make it count – but protect your non-shift weekends and evenings for family and the stuff that matters.
  • Is there anything else you’d like to add that might be interesting to readers?

    I am an avid foodie who loves to read up on local and regional specialties – so if you find me at a conference, ask me where to eat!

Read other How I Work Smarter posts, sharing efficiency tips and life advice.

How I Work Smarter: Al’ai Alvarez MD

One word that best describes how you work?


Current mobile device

iPhone 12


MacBook Pro

What is something you are working on now?

Where do I begin? The pandemic has opened doors for virtual talks and conferences, so I’m just taking it week by week sometimes. I’m also doing a fellowship, the Stanford Byers Center for Biodesign Faculty Fellowship. I’m learning how to apply design thinking to well-being interventions in the ED, and hopefully collaborating with other high-performance teams. I am also co-directing a conference in May 2022 on High-Performance Resuscitation Teams.

How did you come up with this Idea/Project?

re: High-Performance Resuscitation Teams Conference, I have been attending the Mission Critical Teams Institute summits over the past several years. We wanted to create a conference focused on healthcare and high-performance teams. I’ve had the opportunity to center my areas of interests in Medical Education, Process Improvement (Quality and Clinical Operations), Recruitment (Diversity), and Well-being (Inclusion) through human-centered design. A natural area was focusing on team performance and professionalism under stress.

What’s your office workspace setup like?

I’m in the middle of 5 people-office space. I have a plant, some snacks, and a big monitor. I haven’t been there in months. My home office is somewhat similar.

What’s your best time-saving tip in the office or home?

Paper and pen writing of big deadlines in a week. I’ve tried calendaring after learning from Dr. Jennifer Kanapicki, though I have yet to develop the discipline to do this weekly. My coach offered an alternative, which is focusing on 3 big projects a week to focus my energy. This helps me put things in perspective, as opposed to having so many loose ends, and writing it down cognitively frees up memory space for me.

What’s your best time-saving tip regarding email management?

Quick run-through in the morning, and start deleting.

What apps do you use to keep yourself organized?

On Chrome: OneTab for all my tabs. Omnifocus for my to-do stuff. My calendar is a part of my life so my calendar is an extension of my brain. When2meet to find mutual availability for meetings plus My calendar with zoom links.

How do you stay up to date with resources?

Twitter. I know.

What’s your best time-saving tip in the ED?

Eyeball patients immediately so I have a sense of who’s sick and who’s not. Talk to the nurses. They know more about the patient most of the time. For the rest, I follow the mantra, “Quality care takes time,” and I am on the faster end of the dispositions in my group, as I’ve learned to be more comfortable with managing uncertainties.

ED charting: Macros or no macros?

No macros. I also don’t chart as much as I should. I write for the sake of documenting and not for billing. I’m OK with that. We can’t do it all.


  • What’s the best advice you’ve ever received about work, life, or being efficient?

    #selfcompassion. Can’t do everything perfectly. Show up. Learn to say no. The power of perspectives. In 1 week, 1 month, 1 year, 10 years will this really matter? This grounds me on how I tackle tasks and often the emotions surrounding deadlines.

  • What advice would you give other doctors who want to get started, or who are just starting out?

    Easier said than done, practicing self-compassion has allowed me to really develop a growth mindset. To start, simply doing a daily mindfulness practice of even 5-10 minutes. This trains my mind to slow things down when things become chaotic. This also trains me to be attuned to how my body reacts to stress, and therefore, tending to it whenever I notice these sensations (neck stiffening up, etc).

  • Is there anything else you’d like to add that might be interesting to readers?

    I may be doing a ton of stuff, and in the background, I’m doing a ton more and failing. For me, the more things I’m working on that I’m truly passionate about, the more I get done. I’m OK with failure, and whenever I do (and not if I do), these offer me a great opportunity to learn how to be better (or choose better opportunities). Last and also very important, I find the collaborations bring more meaning to my work.

Read other How I Work Smarter posts, sharing efficiency tips and life advice.

By |2022-01-18T09:55:16-08:00Jan 21, 2022|How I Work Smarter, Medical Education|

The 1440 Doctor: How to Unplug While Working From Home

unplug from work working from home WFH

When we are scheduled for a clinical shift, we are well aware of our work hours for the day (and any added charting time afterwards). However on our academic days working from home (WFH) the separation between work and leisure time becomes more blurry. 

Harvard Business Review studies found that being on the road can help people switch gears between home and work (1). Blake Ashforth et al. in “All in a Day’s Work: Boundaries and Mirco Role Transitions” writes about the importance of the transition between work to non-work, including “boundary-crossing activities,” such as putting on work clothes and driving in your car (2). The paper emphasizes the importance of physical and social indicators that tell us something has changed. 

Given WFH is not going away anytime soon, let’s talk about strategies to set boundaries and aid in the transition between these 2 environments when the physical commute is gone.

hourglass stop working from home

Parkinson’s law describes how the amount of work expands to fill the time available for its completion. The principle should be etched at the top of every physician’s calendar. Most of us have experienced Parkinson’s law while writing a paper, preparing for a lecture, or just about anything else with a due date. Suddenly it’s the day before the deadline and instantly your effort increases as the time for completion decreases. 

There are 2 applications of Parkinson’s law that can aid us while WFH.

  1. Apply Parkinson’s law throughout your workday. Do our 1-hour standing meetings ever end early? Not likely. When we plan for more time than a task actually takes, we often take advantage of that time, even if it’s not productive. Challenge yourself to complete that 2-hour task in 1 hour. Use an aid to help you, like the BeFocused timer app, to set a hard stop to your task. It also instills a sense of urgency to watch the timer ticking down.

When you are planning your WFH day, don’t think about the time you HAVE to complete a task; think about how much time you will NEED

  1. Set a hard stop to your work day. These hard stops are not only important for each task at hand but also the end of the work day. At what time do you want to end your WFH day? Calendar the time. Use your BeFocused timer and with that final “beep” you are done with your workday. By having a hard stop to your day, you will increase your effort to work more efficiently because your work day will be ending at a certain time (regardless of how many emails are in your inbox). 

This is an area we must all practice self-compassion. When a day of hard work is done, it’s okay to stop. What this means is no emails when the kids go to bed, no late night work texts or Slack checks. You want some supporting data? Check out the article, Psychological Detachment From Work During Leisure Time: The Benefits of Mentally Disengaging From Work, by Sonnentag. Her research talks about psychological detachment, a state of being when you are mentally disengaged from work and you are not thinking about any job-related activities (like that patient from last night) or doing any job-related activities (yes, that means no email, Slack, charts). Sonnentag found that workers that practiced psychological detachment after work were more satisfied with their lives, experienced fewer symptoms of psychological strain, and had a better job performance (3).

laptop couch working from home

We know that commuting helps the transition between work and personal life. But this transition doesn’t need to be a physical one. An article, The Positive Utility of the Commute: Modeling Ideal Commute Time and Relative Desired Commute Amount, from the journal Transportation reported that the most optimal commute length is 16 minutes (4). The happiest commuters use this time to plan their workdays on their way to work (5). 

So on your next WFH day, block off 15 minutes at the start of your day and 15 minutes at the end of your day and plan your own WFH commute. Use this time for what has been shown to lead to happiness. For instance, my morning WFH commute consists of 15 minutes reviewing my day. I look through my Omnifocus (protip: check out this amazing time management software app) and calendar to get a sense of what the day entails. I usually also try to fit in a short meditation, which is known to reduce stress, increase your attention span, and improve sleep (evidence behind the benefits of meditation).

For the last 15 minutes of my WFH day, I plan my evening. I go to my favorite website for pursuing local events, print out some activities I can do with my kids, and reconfirm how I want my evening to look. I plan every minute because I’ve learned if I don’t plan, I am more likely to just sit around the house. Think also about scheduling that 6 pm work out or 9:30 pm appointment with a good book. 

Want to do something more active with your WFH commute? Consider using this time to call a friend while on a short 15 minute walk. Both connecting with others and walking have been shown to have a positive effect on your mood (6).

Creating a WFH ritual will help distance you from your workday.

feierabend work from home

Feierabend (Feier=celebration + abend = evening) is an evening celebration that German’s partake in that marks the moment when your work day has ended. Many Germans celebrate with a German beer, but I want you to think about what you’d like to reward yourself with at the end of a hard-worked day. Is it calling family/friends, a run, a dance party with your kids, your own favorite beverage? Make your own ritual, it will help you celebrate what you have accomplished during the day (instead of focusing on what needs to be done).

Summary Action items

  1. Set limits on the amount of time you spend on a task, and consider using the BeFocused timer. The last “beep” of the timer signals the end of the workday. Hard stop.
  2. Plan out your ideal 15-minute virtual commute to start and end of your work day. Doing so will help you transition mentally between roles.
  3. Celebrate the work you do every day. Get in the habit of being intentional about celebrating something every evening at the end of your work day, even if it’s something small (like a boba tea). Schönen Feierabend!



  1. Jachimowicz J, Lee J, Staats BR, Menges J, Gino F. Between Home and Work: Commuting as an Opportunity for Role Transitions. Harvard Business School NOM Unit Working Paper No. 16-077, Columbia Business School Research Paper No. 16-7. 2019.
  2. Ashforth BE, Kreiner GE, Fugate M. All in a Day’s Work: Boundaries and Micro Role Transitions. The Academy of Management Review. 2000; 25(3), 472–491.
  3. Sonnentag S. Psychological Detachment From Work During Leisure Time: The Benefits of Mentally Disengaging From Work. Current Directions in Psychological Science. 2012; 21(2), 114–118.
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As physicians we are managing many different roles in our lives: academician, researcher, clinical provider, spouse, parent, just to name a few. Despite our many roles, the amount of time we have in a day to complete the tasks of each role remains the same: 1,440 minutes. Is how you’re spending your 1,440 minutes in a day the way you want to spend them? By assessing your priorities, practicing time saving tips and being proactive and not reactive you can live the balanced life you’ve dreamt of. There are only 1440 minutes in a day. Are you utilizing them well?

The 1440 Doctor series, originally launched on the Medutopia site, is authored by efficiency guru, Dr. Jennifer Kanapicki.


By |2022-01-25T11:50:35-08:00Jan 19, 2022|1440 Doctor, Life|
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