How I Work Smarter: Luz Silverio, MD

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.

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.

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.

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.

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