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

The 1440 Doctor: 3 Tips for Combating Distractions while Working From Home

We have all been there. You sit down to write your next masterpiece that you know any journal would be lucky to accept and “ding” your phone goes off. You check it, you type a few words on the google document, you hear some yelling in the other room (A kid? Your neighbor’s kid?). You try to focus and tell yourself not to worry about it. You need to get this section of the paper written today. The doorbell rings, you hop up to see what it is. Amazon has arrived.

Sound familiar? Our brains are hardwired for distraction. Back in the day, this was a good thing when the saber-tooth tiger was attacking us. Nowadays, it’s just taking your attention away from writing your next paper, finishing your charts, or concentrating on what is meaningful and productive. 

The case for banning distractions

You probably know distractions are bad for you. But as a data-driven cohort let’s talk about some numbers. A study out of Michigan State University found that an interruption 2.8 seconds long doubled the rate of errors in the task being performed. Not so great for ED physicians. The Harvard Business Review reported a study out of the University of California Irvine which showed that once interrupted it takes 23 minutes and 15 seconds to refocus back to the original task after an interruption (1). So that quick phone check is costing you more minutes than you think.

How do we stay focused while working from home?

Cal Newport defines “Deep Work” as “the ability to focus without distraction on a cognitively demanding task.” Doesn’t that sound nice? I’m going to give you 3 tips so that you can master deep work the next time you work from home (WFH).

distractions pause working from home WFH

We perform “time outs” in the Emergency Department to set ourselves up for success and improve the quality of our work, so why not have the same philosophy while WFH? Plan a “time out” that you will perform every time you WFH (or WFA, Work From Anywhere, for that matter). Ritualizing it, doing the same routine every day, can improve your performance (2). 

Step 1: Clear your physical environment from distractions

As we talked about in the WFH strategies post, our brains like order. My first step when I sit down to WFH is to clear my desk of anything that would lure my brain to start thinking about something other than the task at hand. Mail, paperwork, and old coffee cups all get the boot before I sit down to do deep work.

And yes, that definitely means clearing your environment of your smartphone too. Ward et al, published an article talking about the “brain drain” of a smartphone (3). The study found that working memory and fluid intelligence were both affected when a participant’s smartphone was in their visual field (it didn’t even have to be doing anything!). Out of sight (e.g., desk drawer) even had a negative effect, although not as much. If you want to retain your cognitive capacity for all that deep work you’re doing, the best place for your phone is in another room. If you think it’s heresy to have your phone that far from you, then at least put your phone out of your visual field and set it to Do Not Disturb (DND). If you are worried you are going to miss an emergency call, use the Emergency Bypass function to allow your emergency contacts to still be able to call or text.

Step 2: Declutter your digital space before starting your day

My computer lives in Do Not Disturb (DND) mode for 23 hours and 59 minutes a day. It gets one minute not in DND at 1:59 am. No banners, dings, pop-ups. As mentioned in the WFH strategies post, start your day with no icons on your desktop and only one window open for what you are currently working on. Your brain is easily nagged by things left undone or unexplored. Don’t give it options.

Step 3: Pause

Consider doing a 2-minute meditation before you start your WFH. Meditation has been shown in studies to improve your working memory, reduce mind wandering (3) and relieve stress-related memory impairments. My go-to apps are Insight timer (free!) and Headspace.

squirrel distractions

I have invested in a number of distraction busters that keep me focused while WFH. The first one I recommend is a white noise sound machine. I turn on my sound machine and I am naive to all screaming littles, construction, and traffic noises. Some studies show white noise can improve cognitive performance (5), being most favorable to those with lower attention spans (hello EMers!).

Also, consider investing in noise-canceling headphones. These have 2 purposes. First, they block out ambient noise (great if you are WFA and not home with your sound machine). Secondly, they have the bonus of creating a social cost for interrupting you. When people see headphones, they are less tempted to interrupt you since there is a subtle social barrier in their way (try it next time you have to work from the office if you are unable to shut your door).

One of my favorite distraction busters is the Be Focused Focus Timer. This iPhone app utilizes the Pomodoro technique, a nifty time management system that encourages people to work in 25 minutes blocks with 5 minute breaks. This timer sits on the top bar of my screen and counts down every second. Rather than feeling like I have endless time for a task, I know I only have 22 minutes and 24 seconds, for example, to write this section of my blog post. This sense of urgency helps me not to get sucked into distractions.

working from home distractions map plan

Probably one of my favorite time management quotes comes from Nir Eyal’s book Indistractable. He says “you can’t call something a distraction unless you know what it’s distracting you from.” I remember reading this quote and having one of those “a-ha” moments. We so often blame something, usually a technological device, for distracting us but if we haven’t planned our day, therefore our day having no traction, how can we call something a distraction?

Cal Newport, author of “Deep Work,” actually has a section in his book called “Schedule Every Minute of Your Day.” He suggests at the beginning of each workday, write down your schedule for the day with every minute accounted for. He time blocks his day, with each block being 30 minutes. He goes on to add that it’s okay if your schedule is disrupted and a task takes longer than expected. He recommends during the next transition to revise your day plan. Consider giving that task more time in the future or making “overflow conditional” blocks that are “catch up” time. This exercise encourages you to continually ask yourself “What makes sense for me to do with the time that remains?” What is my next most important task?

Action items

  1. Each time you sit down to work, be it WFH, WFA, or even your office, perform a “time out” ritual. Make it your own. Set yourself up for focused and productive work. Clear your physical environment of distractions, disconnect from all technology, and pause.
  2. Think about what distraction busters will set you up for success while WFH. Invest in a white noise sound machine or noise-canceling headphones. Close your door, let your family/housemates know you are doing deep work. Create a social barrier to interrupting your focus.
  3. Schedule every minute of your day. Write it down somewhere. I like using OmniFocus Task Management App. Make sure to have traction in your day-to-day life.

References

  1. Mark G, Gudith D, Klocke U. The cost of interrupted work: More speed and stress. Conference on Human Factors in Computing Systems – Proceedings. 2008; 107-110. https://doi.org/10.1145/1357054.1357072
  2. Wood Brooks A, Schroeder J. et al. Don’t stop believing: Rituals improve performance by decreasing anxiety, Organizational Behavior and Human Decision Processes, Volume 137, 2016, Pages 71-85, ISSN 0749-5978, https://doi.org/10.1016/j.obhdp.2016.07.004.
  3. Ward AF, Duke K, Gneezy A, Bos MW. Brain Drain: The mere presence of one’s smartphone reduces cognitive capacity. Journal of the Association of Consumer Research, 2017; 2(2), 140-154. https://doi.org/10.1086/691462
  4. Mrazek MD, Franklin MS, Phillips DT, et al. Mindfulness Training Improves Working Memory Capacity and GRE Performance While Reducing Mind Wandering. Psychological Science. 2013; 24(5), 776–781. http://www.jstor.org/stable/23409426
  5. Angwin AJ, Wilson WJ, Arnott WL, et al. White noise enhances new-word learning in healthy adults. Sci Rep 7, 2017; 13045. https://doi.org/10.1038/s41598-017-13383-3

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 |2021-10-06T09:44:20-07:00Oct 22, 2021|1440 Doctor, Academic, Life|

20 Tips for Career Success and Longevity in Emergency Medicine

career success and longevity in emergency medicine EM
Photo by Snapwire on Pexels.com

The practice of emergency medicine (EM) is consistently challenging. At any given moment during a shift, emergency physicians are responsible for making numerous decisions about multiple patients. Many of these decisions are time-sensitive, some a matter of life or death. Physical, intellectual, and spiritual fatigue can set in during or after a shift. Our consultants, clinic physicians, or hospital administrators rarely understand the roller coaster we ride. Out of necessity, those of us practicing EM look for ways to navigate the peaks and valleys that make up the natural rhythm of the emergency department.

I was recently celebrated for more than 30 years practicing EM in the same ED. Following this virtual luncheon, one of my talented new colleagues (David Cisewski, MD) asked me to share my secrets for longevity and career success. I figured others might be interested as well, so I crystalized 20 tips for emergency physicians (and perhaps all physicians) looking to achieve more joy, professional satisfaction, and wellness throughout their careers. I’ve separated them into 3 categories: Attention to Self, Mastery of Skills, and Finding Joy and Purpose.

Attention to Self

  1. Change your attitude from “woe is me” to “WOW is me” (Pearls from the Practice of Life). Dr. Peter Rosen used to say “Nobody woke up this morning and decided to ruin your day. Don’t get angry at your patients… Happiness is your choice.”
  2. Be positive whenever possible. Bring a positive attitude to the ED every shift. Start each day (or at least each shift) by asking yourself “Will I make war or peace with this day?”
  3. Nurture your health. Focus on and improve your diet, exercise, sleep, and spiritual wellness. Avoid drugs, tobacco, alcohol, energy supplements, and soporifics. Protect your time off, and schedule time for activities such as reading or exercise. Make time to connect with family and friends, as social isolation and loneliness put your health at risk. Some people now refer to these as the “new smoking” (Together: The Healing Power of Human Connection in a Sometimes Lonely World, also Relationships #8).
  4. Practice mindfulness. Some form of daily meditation, yoga, relaxation, or self-reflection such as journaling (which does not mean posting on social media) is beneficial. The proper use of and participation in the right social media groups and networks can provide support for some physicians. The positive effects from these activities can be present throughout your shifts, and often contribute to wellness and better sleep.
  5. Know when you need help. When you need help, get it without feeling shame or guilt. Seeking help is a sign of strength, not weakness. This must be a cultural shift in EM (and the medical profession in general). The more normalized that seeking help becomes, the better for us, our patients, our colleagues, our friends, and our families. Despite being trained to act heroically, we are nevertheless human and need (and deserve) support.

Mastery of Skills

  1. Work to improve your technical, communication, leadership, efficiency, delegation, charting, and relationship skills. Embrace beginner’s mind – there is always something new to learn. Commit to developing emotional intelligence (EQ), which is as critical to your success, longevity, and mental well-being as are the technical skills you learned in residency.
  2. Learn continuously. Every patient, consultant, EM colleague, advanced practice provider, nurse, and staff member has something to offer. Learn from reading textbooks and the medical literature. Discover what leaders in our field or at your medical center think or believe. Attend lectures and conferences related to EM or other areas of interest (including non-medical topics) to develop your intellect. Grow your knowledge base. As a bonus, you will have more interesting things to discuss with others.
  3. Relationships matter. Nurturing and cherishing them will help you feel satisfied during your career and throughout life. Foster and maintain healthy professional relationships. Get to know your co-workers in the ED. In addition, network with people outside of the ED (physicians and non-physicians). Always make sure to strengthen and prioritize relationships with your family and friends. Disengage from and avoid toxic relationships.
  4. Show interest in others. Be curious about what’s important to them, their lives, their families, and their interests. This gives your mind and heart a needed break from all things EM. Plus, it is the right thing to do and the best way to live.
  5. Develop good listening skills and show empathy. Understanding empathy (and being good at using it) will not only help you in your practice, but also with your relationships.
  6. Connect with patients and their stories. See your patients as people with lives outside of the ED. Patients are not just the “abdominal or chest pain in room 10.” (A Piece of My Mind. Gomer, JAMA 2004 and The Name of the Dog, NEJM, 2018).

Finding Joy and Purpose

  1. Celebrate your successes (even small ones) and your good fortune. Consider changing how you “define” success if your current definition doesn’t make you happy.
  2. Take one day at a time and, when possible, one moment at a time. Look forward to the future but immerse yourself in the present.
  3. Take pride in your work, your training, and your skills. Don’t lose confidence when you make an error. Instead, assume responsibility for your errors and don’t blame others. There are no failures, only growth opportunities. Commit to learning from your mistakes and from the mistakes of others.
  4. Work hard with intentionality and purpose.
  5. Remind yourself of the privilege and honor to care for patients who neither choose you nor have a prior relationship with you. Patients and their families are often afraid or have problems that they simply can’t handle without help. Be humbled by their courage to seek help, and that they’ve placed their trust in and hopes with you.
  6. Mentorship. Seek mentoring early from experienced, trusted faculty who will commit to your success with passion, integrity, and confidentiality. Mentors do not all need to be from your discipline, of the same gender, or of similar training, cultural, or socioeconomic backgrounds. It is reasonable to have more than one mentor supporting your growth. Throughout your career, keep in touch with mentors, and add new ones as necessary. When you are ready, take on the responsibility of serving as a mentor to “give back” to a colleague. (Mentoring in Emergency Medicine, Ch. 4, in Practical Teaching in Emergency Medicine, 2nd ed).
  7. Look forward to each patient and each shift as an opportunity to “cure sometimes, treat often, and comfort always” (Hippocrates).
  8. Express gratitude and offer sincere thanks. Think about thanking at least one person each hour. This doesn’t have to only be for major things; it can be for simple things and can be directed to anyone – patients, families, nurses, consultants, staff, colleagues, EMS personnel, and environmental services who clean up after us. Be sincere and specific with your gratitude. Even better, use people’s names as a show of respect.
  9. Keep a happy folder on your computer and establish a happy “area” in your office or home that has patient cards, gifts, perhaps your diploma, any recognition or important mementos, family items, and inspiring photos, quotes, or books. These items will likely make you smile, so refer to them regularly or as often as needed. Honor the impact you’ve had on others.

I hope these pearls help readers enjoy long and productive careers. I recommend reviewing the modern version of the Hippocratic Oath from time to time to remind yourself of medicine’s greater purpose. I also suggest Viktor Frankl’s book Man’s Search for Meaning. Although somber at times, Frankl beautifully relays the significance of finding meaning during life’s most challenging experiences. Our work in EM and healthcare in general is demanding, difficult beyond description, yet remarkable. As such, it has the potential to transform us in meaningful and lasting ways. I wouldn’t trade my last 30+ years in EM for any other profession despite the exceptional focus and effort it requires. Only by challenging ourselves do we learn the depth and breadth of what’s in our hearts. I hope that everyone reading this is fortunate to feel similarly about their career choices and clinical practices.

Good luck with your careers!

(special thanks to Laura)

By |2021-10-05T13:08:15-07:00Oct 13, 2021|Academic, Life, Wellness|

The 1440 Doctor: Working From Home (WFH) | 3 Strategies for Being Productive

Physicians have practiced medicine in a variety of practice settings in the past. Some in rural environments, others in austere conditions on a mountain top in Nepal. The recent pandemic has created even a new practice environment in the field of medicine: our own homes. The idea of working from home (WFH) is not a new concept. It’s been gaining momentum for several decades in other fields but healthcare has been slow to embrace this trend. COVID19 changed that.

There are many benefits of this new practice environment (basically a 0-minute commute, being able to see family/furry friends during the day), but it also has its struggles. This 3-part series is going to tackle the top obstacles of WFH and give you the tools to combat them.

A company called Buffer surveyed 2,300 remote workers and charted their top struggles when working from home. Coming in at #1 was not being able to unplug. Difficulties with collaboration, loneliness, and distractions basically tied for the #2 spot. A study from YouGov mentioned similar challenges and included the struggle to find a proper workspace. So let’s talk about some solutions. This post will focus on setting up your new practice environment to optimize your productivity and increase your focus.

working from home WFH efficiency

Tip 1: Declutter your physical space

What does your WFH workspace look like? Is it pristine or is it filled with old papers, coffee mugs, and clutter? A 2011 study by Princeton University showed us that our brains like order. The study found that a cluttered, disorganized environment impairs your ability to focus and restricts your capacity to process information [1]. The Harvard Business Review discusses the negative effect clutter can have on your stress and anxiety levels. Don’t let your focus be thwarted by old coffee mugs, make sure to set yourself up for success, and at the end of each day clear your desk of any items that aren’t helping you to focus on the task at hand.

WFH clean desk

Tip 2: Declutter your digital space

Many productivity books like Digital Minimalism and Indistractable emphasize that it’s not only your physical space that needs to be free of clutter but your digital one. Think about your last Zoom meeting, was Zoom the only window you had open? Likely not. Each window we have open, each tab on your internet browser, is nagging your brain of things left undone or unexplored. Our brains like to solve problems so these are tasty distractions for it. 

Now let’s take a look at your desktop. How many icons are tempting your brain? Get rid of them. This digital clutter is distracting your brain and causing it to continuously task-switch, which slows your thinking and decreases your productivity. Free your mind to concentrate on what’s important. If you decide to attend a meeting, conference, or any digital event, make sure to be present in both virtual body and mind. Otherwise don’t go.

WFH plant on desk

Tip 3: Put items in your workspace that have been shown to be beneficial

Once we have cleared our physical and digital space of clutter now it’s time to make sure it has the items that we know help us focus. Let’s look at the data. There are obvious aspects of our work environment that increase productivity like natural light or a nice view. If you can find a workspace with any view of nature, this has the ability to reduce your blood pressure and circulation of stress hormones as well as increase your capacity to focus. Get a green plant. Not only can a green plant increase your productivity by 15% [2], but they have also been shown to reduce stress [3] and boost cognition by 26%.

These environmental modifiers sound wonderful, but you might not always have the option of remote working with a gorgeous view. Or do you? Who says it needs to be an “H” in WFH? Make the “H” an “A” for anywhere. Nowadays, you can work from anywhere (WFA) with a hotspot. Is there a place you can go to be closer with family and work from there for a couple of weeks? Maybe rent a VRBO or Airbnb and spend the week working from Tahoe or Cape Cod. You don’t need to travel either. Go to your local park, get out your hotspot, and get to work.

Make some lemonade out of the COVID lemons.

Action items:

  • At the end of each workday, clear your workspace of any clutter. This will allow you to start your next WFH day fresh and increase your ability to focus.
  • Make it a point to have only 1 window on your computer open at a time. Set a goal for no icons on your desktop. Allow your brain to work on one thing at a time (that’s what it’s good at), which is going to make you more productive.
  • Optimize your workspace. Try to set up a space with natural light, a view of nature, and a green plant. If this isn’t possible, switch it up, find a place with a hotspot and WFA.

References:

  1. McMains S, Kastner S. Interactions of top-down and bottom-up mechanisms in human visual cortex. J Neurosci. 2011 Jan 12;31(2):587-97. PMID: 21228167
  2. University of Exeter. “Why plants in the office make us more productive.” ScienceDaily. ScienceDaily, 1 September 2014.
  3. ​​Dijkstra K, Pieterse ME, Pruyn A. Stress-reducing effects of indoor plants in the built healthcare environment: the mediating role of perceived attractiveness. Prev Med. 2008 Sep;47(3):279-83. Epub 2008 Jan 26. PMID: 18329704.

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 |2021-08-31T22:49:02-07:00Sep 8, 2021|1440 Doctor|

How I Work Smarter: Katie Holmes, DO FACEP

One word that best describes how you work?

Hustle

Current mobile device

iPhone 12 Pro

Computer

Macbook Air

What is something you are working on now?

Updated Curriculum for our EM Clerkship, VSAS, Conference Material, Intern Orientation planning, and more

How did you come up with this Idea/Project?

We are always trying to improve our curriculums to make them better based off of feedback from previous years!

What’s your office workspace setup like?

My kitchen counter or my office at the hospital.

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

Keep a To Do list and divide into “right now” and “ideas for later”.

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

Start with the longest sitting email and work your way up, but always respond quickly to urgent emails, even if it’s to recognize you saw it.xt

What apps do you use to keep yourself organized?

iPhone To Do lists, Notepad shared with my team, Google Docs/Sheets

How do you stay up to date with resources?

Twitter, podcasts, subscribed emails

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

Epic’s Work space, Updating ED Course frequently, Epic messaging, multitasking constantly

ED charting: Macros or no macros?

Minimalist Macros unless I have a complex patient, then it’s story time with M-Modal

Advice

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

    Always make time for the things you love. Travel hard. What you do matters. Don’t engage difficult people. Don’t take yourself too seriously… you just have to laugh it off sometimes. Take care of patients passionately. Encourage others around you always. Work can and should be enjoyable, if it’s not… you’re doing something wrong.

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

We have the best job in the world, but you must truly love what you do to sustain a long and happy career in medicine.

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

Surrounding yourself with motivated, helpful and kind people who are passionate about what they do is the best thing you can do in this demanding job! I don’t know what I would do without my people.

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

  • Dr. Anant Patel, DO  @anantpatels

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

By |2021-07-28T04:41:51-07:00Jul 28, 2021|How I Work Smarter, Medical Education|

How I Work Smarter: Gus M. Garmel, MD, FACEP, FAAEM

gus garmel how i work smarter

One word that best describes how you work?

Compassionately

Current mobile device

iPhone

Computer

MacMini

What is something you are working on now?

Multiple projects, presently Microaggressions & Civility in the Workplace, Communication and Success in EM, and Coaching/Mentoring in EM.

How did you come up with this Idea/Project?

These are important topics; not a lot of information is available about these topics related specifically to EM despite the need.

What’s your office workspace setup like?

Standing wrap-around adjustable desk with good lighting, multiple computer monitors, and sufficient space to work so that I can keep needed materials close and accessible in my work area. I have few distractions in my workspace, which allows me to focus best on the work I am doing.

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

Limit distractions and work on one thing at a time, which reduces inefficiencies and errors that often occur with multitasking.

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

I have several tips, although I have found that turning off email notifications and checking email infrequently (or on YOUR schedule when time allows) are perhaps the best recommendations I can share (again, this relates to multitasking inefficiencies, limiting distractions, and error prevention).

What apps do you use to keep yourself organized?

Ical, Notes, and email all help me stay organized. I also use SUPER-STICKY Post-It notes. They come in a variety of colors if you purchase them in bulk, which some people use to help with organization through color-coding (I don’t use this strategy, but it is a good one).

How do you stay up to date with resources?

Staying current and updated (medical and non-medical) is challenging and takes time. I have a few key websites bookmarked, and still get some materials through the mail on paper. I schedule time for keeping up. Some aggregated links direct me to articles of interest, and I receive TOCs directly from society journals (EM and non-EM). I make a conscious effort to keep up, and spend very little (or no) time on Facebook, Twitter, and other social media platforms.

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

Always think DISPOSITION (every patient needs one). I teach that if you don’t have a good idea about a patient’s disposition, you should ask more targeted questions and do a better physical examination before leaving the room. I recommend planning for test results that can only be normal, abnormal, or indeterminate. Imagine what you would do for (and with) each patient if the test results are all negative (or normal). Have a plan for indeterminate results, for positive findings, or what to do if there is a worsening in the clinical course (including persisting pain, dizziness, vomiting, shortness of breath, etc.). I also think and teach to consider what information is necessary before it is appropriate to call a consultant that I or the patient needs anyway. Often consultants appreciate hearing about a patient “early” even before all the results return (especially if it is near the end of their day while they are still in the hospital).

ED charting: Macros or no macros?

Macros, but only after I see the patient and with attention to modifying the EMR as necessary. I am meticulous about adding detail and removing anything that is incorrect from the Macro. I never use Macros in my free-text HPI.

Advice

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

    FOCUS – that’s key. Make every minute (or moment) count. Whenever possible, try to “finish” one task before starting another, which keeps your “to do” list as short as possible and prevents errors and inefficiencies related to multitasking or task switching.

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

My best and most frequent advice to all physicians (especially new physicians) is to work hard (and smart), be a team player at all times, show compassion and demonstrate empathy as often as possible (always is best), and strive to improve your communication and professionalism skills. Clinical knowledge is expected. Your efficiency will improve with experience and with practice. Be kind to as many people as you can as often as you can. These are important strategies for professional success, patient satisfaction, and personal wellness.

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

Enjoy your career in EM, which will be challenging yet extremely rewarding. Strive to achieve Joy and Meaning in Medicine by working with purpose. Use people’s names frequently and correctly (patients, staff, consultants, colleagues), and express genuine interest in them as people and professionals. Learning something personal about your patients and colleagues (in and outside of EM) is a sign of respect. Expressing gratitude and saying “thank you” with sincerity are always beneficial.

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

Anyone who has demonstrated consistent long-term success in EM, and is able to share his or her successes, failures, and strategies in a clear manner.

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

How I Work Smarter: Christopher Lloyd, DO

One word that best describes how you work?

Opportunistically

Current mobile device

iPhone 12 Pro

Computer

iPhone Xr

What is something you are working on now?

Qualitative analysis on resident perceptions of feedback

How did you come up with this Idea/Project?

As a program we are continuing to look at how feedback is being delivered to residents, when it is happening, how it is received/implemented, etc. This project grew from a desire to explore the resident perspective on these topics so as to understand better where we are effective with our feedback techniques and practices and where we can find areas to improve.

What’s your office workspace setup like?

Currently I’m sitting on my back patio while my three kids are across the yard in their hammock cocoons. I’ve never been much of a desk person, and I always am more comfortable and productive when I vary my environment. Kitchen table, living room by the window, backyard, or, preferentially, a local coffee shop – although that’s less frequent recently #thanksCOVID. Really the only constant to my workspace is my computer and a cup of coffee. Occasionally just a notepad and the cup of coffee. Always the coffee though.

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

Don’t wait until your sitting down for intentional work to start a to do list! You’ll spend the first 30 minutes of what could be some productive time thinking about what you should be doing. Find a method that works for you to collect your tasks (I’ve used a bunch…topic for another day) and have a plan for when you start to work. I mentioned working opportunistically above. There is no set schedule in our house. Both my wife and I are emergency physicians. I usually look at the week ahead and pick out where my blocks of work are going to be and then look at my task manager and pick out what/where I want to accomplish anything. Its rare that I sit down with an hour or two to work and don’t already have a plan. Second part of that is matching task management with energy levels. Say its 9am after two straight 5pm – whenever shifts (you know the one….the shift that technically has an end time but you never leave at that time). I know that after two nights of crummy sleep that I shouldn’t be trying to do any deep focused work so I’ll plan on doing lighter tasks that are quick and require less concentration. Save the stuff that takes more time and focus for days that you know you’ll be working with a full cup:) I tend to label these with either squirrel or zombie (Some call this the ‘mind is mush’ mindset) tags on my task manager so I can get a quick filter of either one depending on how I’m feeling.

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

Check it twice a day at the most. This is hard, and I fail regularly, but email is the single biggest time sink we have and the more time you spend out of email the better. The argument I hear is ‘what if it’s something important from my chair/medical director/PD?!’ Here’s the thing…if you only check it twice a day you set that expectation for others. Thankfully those people in my life know that if something is mission critical/needs addressed now they’ll call/text. Set aside this time once or twice a day, reply to the stuff that only takes 2 min or less, and add the other stuff to your task manager. I’m an inbox zero person, but I know that’s not for everyone.

What apps do you use to keep yourself organized?

I use Todoist for task management. That’s really it.

How do you stay up to date with resources?

Feedly is a RSS feed that I use to capture articles. I try to keep up to date with EMRAP and EMA because I know the residents are in that space regularly and I want to be able to speak to the topics that is on the forefront of their minds.

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

Unless someone requires a life saving intervention never get more than 2 charts behind. What will take me a minute or two to dictate now will take 2-3 times that after my shift or later on and it adds up fast. Also dragon dictation. If my dragon is broken you will find me curled up in the fetal position under the desk.

ED charting: Macros or no macros?

Macros for physical exam – but make sure its your typical physical exam so you don’t need to change it often. Other wise dragon dictation for everything else. Not a fan of macros for medical decision making documentation. Too many times its obvious that its a macro and as such starts to diminish the credibility of the note.

Advice

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

    Work life balance implies that you have to give up one side to balance the other. I preach and practice work life integration.

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

Sit down with patients and listen to them. You’ll save more time here than at your desk charting. Find what’s important to you and intentionally make time for that. Wellness is different for everyone.

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

How I Work Smarter: Miguel Reyes, MD

One word that best describes how you work?

Comfortable

Current mobile device

iPhone 12 Pro

Computer

Macbook Air

What is something you are working on now?

Wound Care article, REBEL EM CME content, Journal Reviews

How did you come up with this Idea/Project?

It was an opportunity that presented itself during the fellowship. It’s a collaborative effort with other faculty members to pull together this large review article, its a lot of work and effort but I think it’ll be worth it. As for the REBEL content, I’ve been working with Salim for a little bit and this chance came up so I decided I wanted to help upload the content to be made into CME.

What’s your office workspace setup like?

Well, it used to be the Kitchen Counter (NYC apartment doesn’t offer much space) but recently got a little desk and chair in our bedroom so I sometimes use that.

 

 

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

Close all distractions and put away your phone. When working on a project consider it your “deep work” time and focus your energy on that.

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

Check it only twice a day. Once in the morning and the other time in the afternoon.

What apps do you use to keep yourself organized?

Strides – My habit tracker for things I want to improve on, studying EM topics

Todoist – Great app for being able to break down large daunting projects into smaller manageable tasks while keeping it all organized. Since downloading this app I’ve become significantly more productive.

How do you stay up to date with resources?

Feedly – News aggregator website. I simply link all the FOAM sites I really like to it so when a new article comes out I’m interested in I can read it there.

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

When you dispo the patient, finish the chart, and every time you stand up from your seat try to do at least 3 tasks before sitting back down.

ED charting: Macros or no macros?

Macros, otherwise I’d be charting for ages and there isn’t enough Great British Bake Off to numb that kind of pain

Advice

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

    Discipline equals freedom – Sounds trite but its transformed my outlook. The more disciplined I’ve become with social media and focused work time has allowed me to be more present with my family and loved ones for the time that really matters.

    Dr. Bove one of our staff at St. Joes gave us what I thought was great efficiency advice. If you wanna be good and have a good flow in the department every time you stand from your seat to do a task, do as many as possible before sitting back down.

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

Don’t rush the outcome. The fun in this is not the destination but the journey in getting there so try to enjoy all the twists and turns along the way.

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

  • Marco Propersi, DO

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

By |2021-05-31T15:34:38-07:00Jun 2, 2021|How I Work Smarter, Medical Education|
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