Time and your Values
Time is my most valued commodity. Starting in medical school, it felt like my time didn’t belong to me, and there were always competing demands on my time. In residency, there are weeks in which you work 80 hours, and that leaves hardly any time for the very basics of sleep and eating. Finally, as attendings, we gain some autonomy back in our lives. It may not feel like it, but we do have choices about how we spend our time. Most time management programs emphasize efficiency, and by the time we finish residency, few physicians struggle with efficiency. Rather, we need new approach to time that center on our needs and values.
During med school and residency, most of us do not get the sleep, nutrition, or exercise we need to truly be healthy. Most of us in medicine would say that we value health, including our own. Yet, we often do not construct our lives to support the foundational requirements to health. Most people, including doctors, need 7-8 hours of sleep. Most of us walk around with severe sleep dept. Not sure if you have sleep debt? How long do you sleep if left uninterrupted? During residency, that was always 9-10 hours for me. Now, after prioritizing my sleep, I rarely have sleep debt, and usually can only sleep for max 8 hours.
As a physician, we have a lot of options about how we spend our professional time. What mix do you want to be clinical and non-clinical? For me, Jim Collins’s formula for his ideal breakdown of his work resonates with me: 50% creative, 30% teaching and 20% other
I have adapted this to: 50% creative (writing, podcasting, research), 30% teaching and 20% clinical. Currently, this is more of an aspirational breakdown of time, and I’m more 50% clinical, 30% teaching, 20% creative. Now I have a clear goal of how I want to be spending my time, and I’m refining how to get this ideal ratio.
In addition, Jim Collins keeps meticulous records on his daily satisfaction. He scores each day as a -2, -1, 0, 1+ or 2+. I have started to do this as well. I print my electronic monthly calendar at the top of the month, and then I score each day, ideally at the end of the day so I’m not biased by my recollection. At the end of the month, I look for trends, specifically what days were 2+ (really good) and which days were -1, -2 (bad, very bad). I look for ways to maximize my time working on projects and with people that were associated with 2+ days and minimize interactions with workplaces/people/projects associated with -1 and -2. For more on Jim Collins approach to time, listen to Brene Brown’s interview with him on the Dare to Lead podcast.
One of the challenges in emergency medicine, and increasing number of specialties moving to shift work, is that we don’t really have a regular schedule. It took years for me to develop an approach that provides some regularity in my irregular schedule. It’s important to oscillate between a big picture and granular view on your schedule. Each year I look at my top goals and I break them out into quarterly objectives that drive my priorities.
Here’s my approach to my schedule:
-When I look at my monthly schedule, the first thing I do is block at least one day per week for rest. REST. No meetings, no emails, zero, zilch, nada. This is a day reserved for sleeping in, walking my dogs, eating delicious food, hiking, swimming, or paddle boarding and spending time with my husband. My goal is two days per week for rest, but admittedly, sometimes I do work (writing, podcasting) I enjoy for a half day in the mornings on a second day of the week. Do not, I repeat, do not skip the rest day. This day provides the fuel you need to be at your peak performance for the rest of the week.
-Each month, I look at my top priorities, and estimate how much time each will take. Then, I plan which days that month I can work on those items, with protecting time for sleep and rest.
-Each Sunday, I look ahead to the upcoming week and increase the granularity of my priorities and when I will accomplish the necessary tasks.
Other tips:
-On days that I work clinically, I minimize other meetings/work. I have noticed over the years that if I shove a bunch of meetings and work prior to a clinical shift, I show up to my clinical shift already drained and then my clinical shift is less enjoyable which contributes to burnout.
-On weekdays in which I don’t have a clinical shift, I try to finish my day by 4 or 5pm. This allows for an evening workout if I missed it the morning, time to read, spend time with my husband, rest and restore.
-For many of us, medical school and residency created an obsession in which we strived for productivity nearly every hour we were awake. I highly recommend reading the book Burnout: The Secret to Breaking the Stress Cycle. In the chapter on time management, they advise that we need about 42% of our day devoted to rest and sleep. Rest is different than sleep. Rest includes restorative activities like reading, connecting with loved ones, all the activities that fill your cup.
-My goal is to have more time to do the deep work related to creative and research endeavors. Deep work requires protected time to allow for concentration. This is when we can enter a flow state and really do meaningful work. I do employ as many time savers as possible I can to increase time for this deep work. For instance, I noticed I was spending 3-4 hours per week cleaning my house. Hiring a housekeeper was a huge time saver. Strategic outsourcing of tasks can really save you time for what you really need and want to do.
We only have this one life. Time is a valuable commodity. While you may feel you have a lot of external demands on your time, you do have control over how you spend your time. Instead of being reactive, it is time to be proactive on how you approach your time. Revitalize Women Physician Circle is here to help.