How I Work Smarter: Rodney Fullmer, DO, MBS

One word that best describes how you work?

Passionately

Current mobile device

Samsung Galaxy 9 (sorry not an apple/mac guy)

Computer

PC- Dell XPS

What is something you are working on now?

I am working on two very cool education projects right now within our ED.

  1. I am creating a new curriculum for our senior ED residents at Swedish called MastER’s Class. The curriculum aims to prepare senior ED residents for life post-residency; looking at everything from contracts, litigation, finances, wellness, the business side of EM, job opportunities outside of the ED, and many more.
  2. Resident T-ED talks. Swedish ED residents give mini-talks/lectures to our ED nursing staff on varying topics. Some examples: talk on a metric that our ED could be doing better on, how to debrief as an ED better, or winter is coming so look out for frostbite and CO poisoning. Our staff loves these and I have needed to expand the scope and number of times the lecture is produced. So I recently bought my first microphone and downloaded editing software. We are now recording the lecture and mini wrap-up, starting a mini podcast-like series for our staff to be able to listen to our T-ED talks whenever they want.

How did you come up with this Idea/Project?

Project #1 came to me after listening to my residents and remembering my anxiety of becoming an attending. I realized there was so much I didn’t know about the other aspects of being an ED attending besides seeing patients. I wanted to make sure my residents were as best informed as possible prior to graduation or had the toolset to seek out their own answers. Enter, social media for the title idea of MastER’s Class.

Project #2 This is a project that has blossomed after talking to Dr. Tarlan Hedayati. I built it off an idea she was using at Cook County and expanded the scope. It has snowballed from there! Kudos to a colleague, Dr. Tarlan Hedayati for her inspiration.

What’s your office workspace setup like?

I am lucky enough to have a hospital office (not using much during Covid) and a home office that I split with my wife who works from home full time. But, honestly, my kitchen island gets the most action! I am a firm believer that a laptop, a good playlist, and headphones can help make any space a workspace.

 

 

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

Decrease distraction and set yourself up for success. I don’t work near a TV, I turn my cellphone to vibrate and avoid social media. Lastly, I set myself up with a good cup of coffee and workspace that isn’t cluttered with distractions and has just what I need for the project I am currently working on ( post-its, highlighter, book, microphone, etc.) Don’t forget to take breaks to keep you fresh- use this time to get out of the chair and check your social media if you can’t resist!

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

Google nudge is a great new tool I use for a follow-up! I use my Google calendar to set reminders as well for follow-up or reminders for email. I leave my emails marked as “unread” until I have responded or completed that task, using the bold font as my reminder that I need to do something with that specific email.

What apps do you use to keep yourself organized?

Google everything! Google Keep #1, Calendar #2, and Assistant #3. I use what I call “dead space time” to do other things. For example, I listen to a mini-podcast on local and world news events and “this day in history” (history buff) while getting ready. Makes brushing your teeth or showering informative! The same with driving. Medical podcasts fill my speakers while driving or when I go for a run. Often, I will have a great idea or something that needs follow-up while driving so I use Google voice assistant to set reminders for me. Google Keep is my online notepad and external brain. I can open my notes from any device. If you really want to know what’s going on in my mind, Google Keep will tell you everything. I use these apps to keep organized so I can cognitively off-load tasks. This clears my head and lets me focus and be more productive.

How do you stay up to date with resources?

  • I use Twitter to catch up on the FOAMed community and CME. Something I learned from Salim Rezaie about Twitter is to only follow a few specific accounts when it comes to FOAMed and education sources.
  • Mini podcasts (5 minutes or less) keep me up to date on current events. My day starts with “OK google read me the news”… This Day in History by the History Channel, NPR News Now, followed by a local Chicago news update.
  • Crowdsourcing: My Swedish ED residents keep me on my toes. It seems every week one of my residents asks me about a new journal article or FOAMed piece. I find myself adding it to my read list on Google keep. For years, my residency class has kept a running messenger feed that we started when we were in residency and continues to this day. It always has knowledge bombs and great GIFs.

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

The ED needs to run like a restaurant: Always know where your patients are in their work-up. Anticipate! You have a really good idea who is going to get admitted and discharged after the initial H/P. Start your discharge instructions when you sit down to write your initial note on the patients you anticipate sending home. Know that the ED is a team sport so cognitively off-load where you can. Use your techs and nurses to help you with tasks. Have them double check on why a lab result hasn’t come back or if you’ll need vitals every 15 minutes for the next hour, can they complete these and let me know if BP or Heart rate is X? Closed-loop communication is key.

ED charting: Macros or no macros?

Macros! But carefully. As an educator, I see where Macros can and do go wrong. I built my own macros so I know everything that is them. I try to always do my focused PE the same way every time which matches the flow of my Macro. I can then quickly edit the pertinent positives/negatives or remove any part of the macro that wasn’t completed.

Advice

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

    • Residency is a sprint but being an Attending is a Marathon
    • Be kind to everyone
    • Most recently during the pandemic: Find balance, set boundaries, protect your wellness
  • What advice would you give other doctors who want to get started, or who are just starting out?

Say Yes. Be willing to volunteer for projects, lectures, or leadership roles, even if you feel under-qualified. Keep doors open by saying yes to these opportunities, as you may find your niche’. Be a sponge and soak up the knowledge you personally learn from each experience and tuck it away- you may not use that knowledge on your next project or leadership opportunity but it will come in handy sometime in the future. Get involved and be engaged in whatever you are involved in. Lastly, be kind and don’t burn bridges, always leave on good terms when an opportunity ends. It’s a small world out there.

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

Make sure to have mentors (more than one and for different parts of your life) aka your boardroom. Also, make sure you have someone that can give you honest, impartial feedback.

Who would you love for us to track down to answer these same questions?

  • Sean Dyer @SpyderEM
  • Tarlan Hedayati @HedayatiMD
  • Michael Gottlieb @MGottliebMD

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How I Work Smarter: Megan Stobart-Gallagher, DO

Megan Stobart-Gallagher, DO

One word that best describes how you work?

Innovative

Current mobile device

Galaxy S10

Computer

Lenovo Yoga (my 2nd one!)

What is something you are working on now?

I wish I could say something wonderfully innovative, but I am mostly just working on tying up numerous projects with our medical education fellows that resulted from the global shift to virtual learning. However, I have had a blast over the last few months building an asynchronous Toxicology curriculum with one of my fellows and a new EMS curriculum for our interns. My next project as chair of our clinical competency committee is to create a series of mini flipped-classroom sessions or asynchronous modules (or a combo!) for faculty development to help prepare junior faculty for their participation!

How did you come up with this Idea/Project?

It has been brewing since my first CCC meeting as a junior faculty meeting where I felt like a fish out of water and everyone else was speaking a language I had never heard before! I am hoping to make help to not only develop junior faculty’s knowledge of ACGME requirements but also to improve the quality of conversations had during our meetings!

What’s your office workspace setup like?

Currently tucked away in our 3rd-floor spare bedroom – a cozy space with natural light, and built-in bookshelves filled with EM texts and my children’s artwork. I am usually kept company by my live-in officemate, Hippo (a 7 year old rescue mutt!) with occasional visits from my girls.

 

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

If you have something you really want to dedicate time to completing – schedule it! Start your day by not opening your email and keeping your cell phone alerts off. It saves time in the long run – get in that Deep Work (and read that book by Cal Newport if you haven’t!)

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

While it is tempting to respond to every single email as soon as you see it – I try to triage them and respond to the emergent first and keep those that require more thought as “unread.” It helps me be able to focus longer amounts of time on projects/issues that really need it! Also, if it can be solved in a phone call or a text – just do that instead of filling up someone else’s email box!

What apps do you use to keep yourself organized?

I am old school and still use a written planner and post-it notes! But as for technology, my life lives on Google calendar.

How do you stay up to date with resources?

I usually binge EMRAP instead of Netflix! Also, anything that I assign my residents for asynchronous learning including EMedHome lectures or ALIEMu modules – I do first!

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

Real-time verbal communication with nursing and ancillary staff.

ED charting: Macros or no macros?

I have templated notes for sign-outs and resident addendums so I do not miss any important information but try to limit macro utilization to keep my charting personable and conversational. It does slow me down but helps tell the story should a patient bounce back or if someone logs into Epic and needs to read my note!

Advice

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

“You are enough.”

“When you see a hill, thank it for making you stronger.”

“Don’t hit send when you are angry.”

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

Be kind to everyone you meet. Stay humble. Never stop asking questions.

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

You can learn from EVERYONE inside and outside of medicine and just keep your mind open. Listening the first time will save you a tremendous amount of time in the long run – do it right, the first time. :)

Who would you love for us to track down to answer these same questions?

  • @k_goodsell (Kelly Goodsell)
  • @BossyLadyDoctor (Katrina Kissman)

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

How I Work Smarter: Jaime Hope, MD

Jaime Hope

One word that best describes how you work?

Systematically

Current mobile device

iPhone 11

Computer

Dual-monitor PC

What is something you are working on now?

An educational product to help elderly adults discover their risk factors for falls and use prevention strategies for fall prevention.

How did you come up with this Idea/Project?

Falls are the main cause of morbidity and mortality in older adults, we see this daily on shifts. Helping them reduce trip hazards and improve balance, proprioception, and strength can make substantial reductions in falls.

What’s your office workspace setup like?

Dual monitors (lots of open tabs!!) with all of the supplies I need within reach. My walls have calendars and lists of upcoming events as well as inspiring quotes and pictures that make me smile.

Jaime Hope setup part 1

Jaime Hope setup part 2

 

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

Taking the time and effort up front to get organized and systematized up front will save you a lot of time down the road! I have baskets for upcoming stuff, to-do lists (prioritized in order) at hand, and I color code things for ease of use. I also have a sheet of paper with each project I am working on (heading at the top) and when an idea comes to me, I add it on the paper. When I am ready to tackle the project, I captured all of the ideas and I’m ready to roll!

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

I am not glued to my inbox. Answering every ding is a distraction and can pull me away from other high-yield activities and take time with task switching. Setting aside time in the morning and afternoon to check emails protects my other productivity time from being interrupted.

What apps do you use to keep yourself organized?

Reminders and Anylist are the 2 I use most frequently. I also use the Notes app a lot to capture ideas for articles, talks, projects that come up when I’m on the go

How do you stay up to date with resources?

‘Reading’ is an important part of my schedule – whether that is a physical journal, a podcast, an audiobook, or strategic social media postings. Having time scheduled for this on a regular basis makes a difference in staying current! Also, utilizing ‘mindless’ task time, such as laundry, cleaning, driving, etc for audio content has been very helpful in remaining up to date.

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

Be present with your patients and listen actively. Stay curious and ask questions. It seems more time-consuming at the moment but will save you lots of time down the road in missed diagnoses, patient complaints, lawsuits, and bad outcomes. That extra time with patients, in the grand scheme, not only make you a better clinician, it saves you a lot of downstream stress.

ED charting: Macros or no macros?

Yes macros! BUT don’t ever pre-enter a macro or have it tick off stuff you didn’t ask or examine. It is a slippery slope, don’t set a toe on it! My EMR also allows time-saving dot phrases, which I utilize frequently and again follow the firm rule don’t chart it until it happened.

Advice

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

Remove unnecessary stuff from your cognitive load so you can concentrate your mental energy on what is most important. I use a paper with patient stickers to keep track of who I’ve staffed. I use a 4-color pen to take notes as I ’round’ on my staffed patients so you don’t forget something when the next distraction arises. Memorize the important stuff for crashing patients and know what tools you can use to look up anything you need.

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

Self-care isn’t selfish!! Make sure you get nourishing food, energizing exercise, restorative sleep, stress release, and meaningful connection in your life. A healthier you makes a better (and more patient!) doctor!

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

Concentrate on what is most important first, and that is patient care. The patient’s ‘wait’ clock starts when you leave the room. They are scared and unsure and waiting. Updating them makes a huge impact on their care and ensures you have all of the info you need for the best diagnostics and therapeutics. You should be going in the room multiple time, other than for the simplest cases.

Who would you love for us to track down to answer these same questions?

  • Dr. Ryan McKennon DO, JD @RyanMcKennon

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By |2021-01-06T09:42:28-08:00Jan 8, 2021|How I Work Smarter, Medical Education|

How I Work Smarter: Drew Kalnow, DO

Drew Kalnow image

One word that best describes how you work?

Conscientiousness

Current mobile device

iPhone X

Computer

MacBook Air

What is something you are working on now?

InSitu EM Simulation

How did you come up with this Idea/Project?

Identified the need to improve critical patient care in the ED. This project uses senior residents as resus leaders with the ED critical patient team in one of our ED resus bays. Through this, we improved team communication and understanding of work-flows while also identifying and addressing latent safety threats.

What’s your office workspace setup like?

Most of my work is done in my home “office” currently. I work in our 3rd-floor loft away from most of the other house distractions. There is good natural and artificial lighting, room to spread out and with my AirPods Pro headphones, I can get down to business. Also, have a microphone and sound barriers that can be easily set up when podcasting or giving virtual lectures. When I am at the hospital, I use a shared workspace with other faculty, mainly my laptop at a desk, only using the hospital computer system if needed since it is much less portable and has built-in firewalls.

 

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

Having a to-do list with some general time allotments is a must. Knowing what tasks need to be accomplished when I start my day and giving myself a time limit to try and complete the task is critical. Part of this is also being realistic and honest with myself about what I am going to work on and how much is going to get completed. I can’t just say “work on X manuscript” and hope to be productive, I am much more specific with my todo list, breaking things up into accomplishable sub-tasks. Nothing begets productivity more than feeling like you are being productive checking things off your list, some go so far as to include making your bed, just to be able to check something off at the start of the day. Oh, and a really good cup of coffee and music helps too (pre-COVID, the local coffee shop often served as my office space).

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

Don’t rely on email to be your task manager. Find a way to move to-do items into another format that actually works. There are lots of apps that do this, or it can be done manually using notes or a calendar. Part of this is also staying on top of emails, if not addressing the email right away, placing it (or the todo item) somewhere that it will actually get done. For example, when I got the email asking me to write this article, I sent it to Todoist and scheduled it for a day I knew I could get it done. This is especially important when working out of multiple emails (I have 3).

What apps do you use to keep yourself organized?

Todoist has become my main project manager. It’s an intuitive app that syncs well with the google platform so I can link google drive files to it and also have it link to my master calendar (I use Google for this). I still use the sticky note function on my computer so that my “big ticket” items stay in the front of my mind, even if there is not an immediate deadline. Finally, I use good old fashion 3×5 index cards to take notes about projects when I am at my home or office desk. If I need to make an electronic version to work off of, I will either in notes or google doc and link those into Todoist, but often they stay at my desk as a reminder of ideas or subtasks for the projects I am working on.

How do you stay up to date with resources?

Being an active consumer of social media keeps me up to date on what is going in EM and medicine in general. I am an avid podcast listener,, staying up to date on the hot topics but also reviewing core content and more of the social conversations ongoing in medicine. It also helps that I also produce content through the EM Over Easy Podcast and some other sources, kind of hard to be active in that realm without knowing what’s out there too.

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

In Box Zero – totally stolen from the email management concept, but it is crucial to success in the ED. I complete my charts at the time of dispo, often the only time I chart. This minimizes times spent in the chart but also ensures that I am not occupying bandwidth for patients I am no longer actively caring for and can leave my shift essentially on time. I also make sure everything else in my EMR inbox is done before I leave my shift, sign APP attestation notes, verbal orders, etc. That way, I leave the hospital and start my next shift with an empty clinic to-do list.

ED charting: Macros or no macros?

Yes to physical exam macros and basic care charts but ABSOLUTELY NOT medical decision making. I firmly believe that MDM macros cloud the chart and make it harder for another provider to actually discern what is going on with the patient. I can’t tell you how many charts from other providers I have looked at, that I have no idea what they were thinking with patient care because the chart is all macros. That may work for billing and legal purposes, but ultimately, the chart needs to drive patient care forward and tell your story of how and why you cared for the patient.

Advice

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

Balance – the person that introduced me to Todoist recommended that the first item needs to be about your personal/family life. This is so important to being productive and not burning out. Keep perspective on what is important, and that does not always need to be work.

It’s okay to say no – I am finally at a place professionally that I am beginning to say no to projects that I am not currently interested in or don’t have time for. It is such a hard thing to do, but it is crucial to maintaining balance and sanity. The key is to say no in a way that keeps doors open or even moves the project forward by referring it on to someone else.

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

Decide who you want to be in terms of your medical career. This might seem a bit strange at first, but I think it helps to provide focus and context as you are starting out. What are your interests that you will focus on and what type of career do you think you want? Part of the question is checking in on the person you are as a whole and making sure your medical persona and trajectory are true to you.

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

Do the Next Right Thing – This is beyond cheesy but so true. If you can say to yourself, I am doing the next right thing for me, my family, my patients, my career, then you are doing really well. BTW, this is totally stolen from a song in Frozen 2, which I have watched countless times with my 3yo, “I’ve seen dark before, but not like this. This is cold, this is empty, this is numb…But you must go on and do the next right thing”.

Who would you love for us to track down to answer these same questions?

  • Tanner Gronowski, @MOX13
  • Rodney Fullmer, @Dr_Fullmer
  • Katie Fisher, @KatieFisherEM
  • Katie Holmes, @KatieHolmesEM

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

By |2020-12-20T10:20:12-08:00Dec 30, 2020|How I Work Smarter, Medical Education|

How I Work Smarter: Alexandra Mannix, MD

Alexandra Mannix

One word that best describes how you work?

My work style is very Task-Oriented. I have a To-Do list that I regularly update and is always prioritized.

Current mobile device

iPhone

Computer

MacBook Pro (at home). We have PCs at work.

What is something you are working on now?

I’m currently working on a project looking at both gender and racial bias in the SLOE. This has been something I was interested in for a while, and it’s been really exciting to see the project take off.

How did you come up with this Idea/Project?

I have a gender research group, which includes female and male faculty from all across the country and Canada. Over the past 2 years, we have published 4 articles (with 3 more in the process). We are in multiple time zones AND are all Emergency Medicine Docs. This group functions primarily on Slack and we use google docs for our writing. Both of these platforms have really helped improve our efficiency and communication.

What’s your office workspace setup like?

I have an office in my home, which includes my laptop and an extra monitor. Prior to COVID, I did a lot of my work from my work office, but due to COVID, I have been working much more often from home. Having dual monitors has drastically improved my ability and efficiency when working from home.

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

Make a to-do list, prioritize it, and start at the TOP! It’s so easy to start with the “easiest” task, but starting from the TOP helps me stay ahead of deadlines.

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

Know it is OK to have unread emails. I have 4 email accounts and it was physically impossible to stay on top of all of them. Prior to starting my faculty job, I always wanted my inbox to say 0. I had heard from so many people to just RESPOND and move on- but when I did this I felt like I was ALWAYS at work. I just can’t live like that. (I also turned off that little red number on the email app on my iPhone. This was mostly done for my wellness).

What apps do you use to keep yourself organized?

Google docs- so I can access my work everywhere (home computer, office computer, cellphone, etc). I also LIVE my life on my google calendar. I have multiple calendars (Personal, Med Ed, Clerkship, Residency, Sim Center, SheMD, Shifts, Etc). Each has its own color, which visually helps me stay organized. I block out days off and post/pre-night shifts, so I don’t accidentally schedule a meeting at noon on those days.

How do you stay up to date with resources?

Twitter… Which I admit is not the best option. I haven’t found a platform I love.

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

Try not to get distracted. Complete a task before moving on. Multi-tasking is basically impossible, but efficiently task completing and task switching IS possible.

ED charting: Macros or no macros?

100% all about the macros and “dot phrases” that include *** (so I have to update them). And DON’T duplicate your work when using Macros. EG. if you already clicked it, don’t type it too.

Advice

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

Make a to-do list, prioritize it, and start at the TOP. It’s ok to outsource (groceries, cleaning, whatever). Make your partner a real PARTNER.

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

Block out time (just like you block out a shift) on your calendar for you, your wellness, and your family.

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

Develop good sleep hygiene. It is vital in Emergency Medicine.

Who would you love for us to track down to answer these same questions?

  • Melissa Parsons. @MEParsonsMD
  • Kat Ogle @DrKittyKat
  • Al’ai Alvarex @alvarezzzy

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

By |2020-12-23T13:38:11-08:00Dec 11, 2020|How I Work Smarter, Medical Education|

How I Work Smarter: Geoff Comp, DO

Geoff Comp

One word that best describes how you work?

Deliberate

Current mobile device

iPhone 7

Computer

MacBook Pro

What is something you are working on now?

I am working on a series of EM department recommendations for the treatment of various environmental conditions, including heat associated injury and hypothermia, with multiple residents interested in wilderness medicine.

How did you come up with this Idea/Project?

Like all great projects, these were developed while chatting about interests over beers! We reviewed current recommendations from various sources during a wilderness medicine interest group meeting and discovered the department does not have official guidelines for these topics.

What’s your office workspace setup like?

Unfortunately, most work is done on the couch. When I need a truly dedicated space, I use my wife’s home office for multiple monitors and a desk.

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

Rely on a schedule! Be mindful and deliberate with your time so you can focus on a specific project for a shorter period of time in a day and know the boundaries of a new task. My calendar has brief “work periods” of 1.5 hours, where I turn off external alerts/distractions and plug away at a predetermined list of goals for one project. Also, use applications that will communicate with all of your devices seamlessly. If your email, calendar, to-do list, personal finance, etc. don’t play well with all of your devices, you won’t use them.

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

Don’t use it as a to-do list. I work hard to go through emails in the morning and at night and clear out or address them. If it is a request for a task or a new project/opportunity, I will respond right away with acknowledgment and let the person know I will give a full response before a deadline. Then that task gets added to my own to-do list, rather than the constant reminder and irritation of a positive email balance that continues to spiral out of control.

What apps do you use to keep yourself organized?

Apple Calendar app. My work, personal, and family calendars all get pushed to this. I have sub-calendars for to-do lists, exercise, work meetings, etc. I always open this up and make sure I am available before agreeing to a commitment.

I also recently switched to Microsoft To-Do after the app “Wonderlist” was acquired by the company. It allows me to create a specific “next step” action items for big projects and allows for some success momentum as I see progress. I can make personal deadlines and reminders as well as assign tasks to a daily to-do list.

How do you stay up to date with resources? (FOAMed, CME, Current Events, etc.)

With targeted subscriptions and personal organization. I subscribe to only a handful of resources that are automatically emailed to me or populate my podcasting app. It is very easy to get overwhelmed by all of the incredible resources out there. I use Feedly as my aggregator and will scroll through frequently. After I exhaust my “go-to” resources, I search for Google FOAM.

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

Identify roadblocks to your flow and address them early on to decrease your aggregate cognitive load over the duration of your shift. Procedures and in-depth exams take priority so I can free up that mental space and be ready for more patients. #StopPuttingOffTheLumbarPuncture

ED charting: Macros or no macros?

Absolutely. I use “dot-phrases” when documenting and have a pre-populated chart. If you use macros, make sure you either created them yourself or are very aware of everything included in it and ultimately in your note. You always want to make sure every portion is reviewed to ensure all of the abnormal findings are changed from your prepopulated “normal exam.”

Advice

  • What’s the best advice you’ve ever received about work, life, or being efficient? (Give multiple if you have them.)

Have and rely on a family and personal time calendar. I tend to have a self-inflicted busy schedule due to projects and work events, and it is easy for me to see free time and fill it up with work. However, I know it is essential for me to prioritize my family and ensure my wellness. My wife has access to edit my electronic calendar, and we frequently block off and reserve time for date night or time with friends. This helps me turn off “work brain,” as I am forced to complete my daily goals before spending time together, and I am not always thinking of my other projects or work.

Prioritize your work, not someone else’s. It is easy to start the day looking at your email and complete tasks like getting documents signed, responding to requests, and completing EMR training modules (yuck). These are all based on someone else’s timelines rather than your own. It is easy to go through a large chunk of time in your day completing tasks without making progress towards your personal goals and ultimately feel like you were “busy” but not “productive.” I set aside time blocks where I don’t respond to emails/slack/text messages and focus on one of my own projects.

Identify all of the small steps needed to accomplish a big goal and give yourself some wins by completing the tasks. It is sometimes very daunting to think of how to start or end a new project or job. I spend some time being mindful of all of the smaller steps that will need to be completed before finishing a final product. If you set and complete specific, measurable, and time-sensitive goals, you will gain that momentum to finish that fantastic project!

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

Never stop learning. When you finish residency, continue to take the same advice we give to new residents: read as much as you can, learn something new each day from a patient. We are fortunate to have the best job in the world, and we must continue to grow and learn, allowing us to provide the best care possible throughout our careers.

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

Work with a mentor! Find someone you think has a sound system for organization or efficiency and reach out to them to ask what they do.

Who would you love for us to track down to answer these same questions?

  • Mike Gottlieb
  • Drew Kalnow
  • Luz Silverio

Read other How I Work Smarter posts.

By |2020-10-08T16:10:34-07:00Oct 9, 2020|How I Work Smarter, Medical Education|

How I Work Smarter: Meenal Sharkey, MD

How I Work Smarter Sharkey

One word that best describes how you work?

Thoroughly

Current mobile device

iPhone 11 — my whole life runs because of this phone!

Computer

MacBook Pro — thank goodness for the iCloud that syncs my calendars, notes, and texts

What is something you are working on now?

Just finished the Grounded in EM curriculum and am now creating a Grand Rounds for Evidence-Based Medicine for Sepsis.

One of my weaknesses is public speaking and also evidence-based medicine presentations. I like the concept of sepsis in general, so I picked this topic on purpose. It combined a topic I enjoy and an area of weakness, in the hopes that I’ll become a better clinician and educator because of it — I present it in September so we will see!

What’s your office workspace setup like?

HAHA. I live in a state of chaos with three kids and my husband, a newly-minted EMS fellow after finishing an EM residency. I typically work at the dining room table or on the kitchen counter, either once the kids are napping or asleep, or during quiet time. My husband has a study, which I often use as it has a door that closes (and locks!), but with the quarantine and 3 little kids not in school or daycare, there is always a lot of banging on the door for entry! Pre-COVID, I would often drop my kids off to daycare, so they have lunch and a nap on days I needed to get work done and go to a coffee shop around the corner, and then pick them up once nap time was done. I would get 2-3 hours of uninterrupted work time, and wouldn’t miss much of their day as they had lunch and then a nap. I honestly get more done when I’m working outside of the house, as I am not seeing other tasks that may need done or around distractions (laundry, dishes, dog walks, couch and TV time, etc).

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

I have several “notes” in the notepad function on my phone and laptop that I regularly update: To-Do lists, notes on resident progress, email drafts, grocery lists, kids needs, web-searches that I want to do. Since the program updates across my phone and laptop, I can jot down notes during the day when I’m on the move, dictate emails while I’m at my kid’s tutoring, etc. I can pick up the work right where I left off when I have more focused time on my laptop once my kids go to bed or I have some quiet time during the day.

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

I have three email addresses (one for personal, work, and clerkship/faculty). Within each, I have created filters for specific email addresses that auto-tags the emails. That way, I can quickly browse through and not be overwhelmed. I try to do my best to keep a zero-inbox, which for me is hard since I have a lot of FODSI (fear of deleting something important). Instead, I opt to have everything tagged so I can quickly archive when I feel like I have addressed the email.

What apps do you use to keep yourself organized?

I use the Notes function on my computer quite a bit! I have a shareable calendar with my husband and my parents to keep track of the logistical aspect of shifts, kids, after-school activities, etc. Basic, I know, but it works for me!

How do you stay up to date with resources?

I like to really make the most of my commute, so I’m a big fan of listening to Rebel EM and EMRAP on my drives into work. I get on Twitter a few times a week to see what is new there. I also really like JournalFeed and Pediatric EM Morsels for tidbits that go to my email, and will catch up on these every few days. I usually get my current events from my husband as this is an area that he likes to stay on top of, and I….don’t.

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

  • While working, I make a list of the room number, the patient/CC, and then two boxes. One box signifies I’ve completed the HPI, PE in their ED chart, and the second box means I’ve completed the EKG/MDM. I cross out the entire line once I’ve signed the note. This keeps me on top of my notes, as that tends to be the area where I can quickly become behind. It also entices the type-A in me to check off the unchecked boxes!
  • The nurses are essential for patient throughput. I update my nurses on my plans for patients, and so they are moving the patient through their course actively, rather than reacting to orders in the computer. If you see a nurse starting an IV at the bedside, alert him or her that you need blood cultures, lactate, VBG, ammonia, etc, so that they don’t have to go back in afterward. Alert them of the meds/fluids you will be ordering if you’re all in the room together so that they can go to the med room rather than go to the computer to discover they have ordered. Do your best to batch your orders rather than trickling them in as this is extremely frustrating for them and slows your turn-around time! The nurses are an excellent resource for the vague/nebulous patient complaints, to get a different perspective for what the patient really wants or is concerned about.
  • I also have perfected my clean catch urine sample spiel, which I recite while walking patients to the bathroom!
  • I am especially more vigilant of specific tasks in the last 3 hours of the shift! Prioritize pelvic exams early in the patient course!

ED charting: Macros or no macros?

I do use macros, but I am deliberate about confirming that all the auto-populated areas are true! My biggest time savers are a pre-populated neuro exam, back exam, and extremity exam, as I do the same thing every time.

Advice

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

One of my senior residents told me once: “The goal is to get out on time, with your notes done, and make decisions your mom would be proud of” — I loved that! I love practicing medicine, but I also love leaving work behind to spend time with my family. Rather than finding a balance that suggests equal weight, I consider all my various roles as a massive juggling act, re-focusing on the task that is my hand, and then on to the next. And I wouldn’t have it any other way!

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

In the beginning, it is typical to have self-doubt, but that WILL go away! You trained for this, and you ARE good at this. It takes a little while to get your bearings in a new role, so give yourself a little time and a lot of grace.

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

As cliche as it is, find something outside of work that you LIKE. You don’t even have to be good at it, just enjoy doing it! It will replete you on days on which you feel like you don’t have anything left.

Who would you love for us to track down to answer these same questions?

  • Laryssa Patti
  • Brian Barbas
  • Eric Blazer

Read other How I Work Smarter posts.

By |2020-09-17T16:51:51-07:00Sep 18, 2020|How I Work Smarter, Medical Education|
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