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.

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.

One word that best describes how you work?

Fitfully and obsessively

Current mobile device

Two: an iPhone 8 supplied by my job for clinical work, and an iPhone 10 for home.

Computer

A very old MacBook Air that constantly pings me, requesting “more space.” I keep putting it in larger rooms, but…

What is something you are working on now?

I’ve been working on a series of 5-10 minute talks to be given prior to shifts that I call “Journal Watch Pictionary.” I read journal articles and then illustrate their key points using my own medium-poor quality cartoon illustrations. It’s fun and I like making people guess what I’m trying to draw, especially because I feel like that helps them pay attention and learn. It also keeps people up-to-date with current literature without having to get pedantic.

An example of the doodles used to illustrate Journal Watch Pictionary

How did you come up with this Idea/Project?

One of my life goals is to do only high-yield projects. The Journal Watch Pictionary project serves several purposes:

1. It forces me to read journals.
2. It allows me to be playful and do art.
3. It creates a theme for small disparate talks so I can slowly build a “body of work.”
4. Frankly, it’s easier than cobbling together a talk de novo.

What’s your office workspace setup like?

I use this terrible roll-top desk that was a gift from my father-in-law. It’s not a functional modern-day workspace by any means because there is no space for a large monitor. On the other hand, it has lots of cool cubbies into which I can put flash drives, pens, highlighters, random electronic equipment for podcast recording, and it has a good-sized work surface. The nicest thing about it is that it has a roll-top, which means I can spread my stuff all over the desk and then if I want to look respectable and put together (this is theoretical as this is the pandemic and no one has entered my home for the past 3 months) I can just roll it closed. Even better, it locks, so my 2-year-old has no access to my clinical stuff and he can’t do “projects” using my expensive fountain pens or steal my magic rub eraser.

The rolltop desk in action

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

At home: Outsource/delegate. I very carefully weigh the cost and time it takes to do work myself and then often hire someone to do it for me. To be honest I often think I’m doing really well with outsourcing/delegating and then I’ll get stressed out and realize that a good percentage of my stressors are things that I should/could be handing off. I then outsource/delegate more!

At “office” (imagine roll-top chaos): I’m quick to call someone if there’s any miscommunication although sometimes people are nervous to answer the phone. I find it easier and more efficient than a weird song and dance that you have to soft-peddle with emojis. Most of the time we are all good people doing our best but that doesn’t come through on the screen sometimes.

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

I try not to get too worried about being behind on emails. By this I mean I don’t get all verklempt about taking a while to respond to someone, but of course I apologize if an answer has been wallowing for weeks. If something is important and someone’s really burning up about a response, they’ll nudge me again!

What apps do you use to keep yourself organized?

Google Keep (which is like post-its for your computer and phone), Google calendar. I am a big fan of a handwritten checklist and a timeline for a day with hours and tasks designated for each hour. If a task takes less than an hour that means I’m winning! If a task takes more than an hour it means I’m still winning because I’m doing the task.

High-tech scheduling system

How do you stay up to date with resources?

I read Annals of Emergency Medicine and the Journal of Emergency Medicine. I also read ACEP Now and EM News. I get these all delivered to my house because I hate trees. In all honesty, I have found that trying to read and absorb on my computer screen is not as enjoyable as reading in print, and for something as arduous as reading primary literature, I need to make the experience as delicious as possible. This means that I am often reading these periodicals in a bubble bath, with a face mask on (one of the nourishing ones, not the disease preventers), and a glass of wine on the rim of the bathtub. Every shift I force myself to ask a clinical question and then that’s my homework assignment for my next shift. My last clinical question: Ward catheters and Bartholin cysts: Do we still have to do this? I also listen to podcasts on my commute but don’t consider that groundbreaking.

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

When asking someone to do something, say something nonclinical first. For example: first say, “Cool looking truck! I would get it in red.” Then say, “Could you recheck the vital signs in bed 5A?” This is super important in the long run–when people like you, they have your back, anticipate clinical problems for you, aren’t afraid to speak up if they think you’re wrong, and in general, prioritize you higher for future clinical interactions. Also, if you’re “rude” later (i.e., direct and forthright) they know it’s because you mean business.

ED charting: Macros or no macros?

Macros with care. More importantly, if you haven’t tried Dragon or other dictation software in the past 5 years it has gotten a lot better

Advice

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

Just remember, “If I were a dude, would I care?”

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

Be humble, be kind, remember that there are many ways to spread health and wellness in the clinical context. Listen and absorb when you have capacity and give yourself some grace when you have no capacity left. Try to do multi-purpose projects. If you find out that you hate what you’re working on at least it’s high yield.

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

• Erin Kane
• Jen Abele

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

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.