TLDR Book Review: Deep Work – Rules for Focused Success in a Distracted World | MED-TAC International Corp.

Do you struggle when you try to focus on one task for a prolonged period? When you’re reading or writing a paper, are you frequently tempted by social media, a click-bait HuffPo article, or what the latest Instagram celebrities have been doing? Most of us are not used to spending large periods of time doing deep work. Like any skill, the ability to focus is something that we have to develop and train. This book, Deep Work, by Cal Newport will explain why it is so critical to develop our ability to focus deeply, and how to do it.

Newport defines deep work as “professional activities performed in a state of distraction-free concentration that push your cognitive capabilities to their limit. These efforts create new value, improve your skill, and are hard to replicate.” You are doing deep work, for example, when you are completely focused on one idea or task. This could be writing a grant or paper, planning a lecture, or (if done without distractions) performing a challenging clinical procedure. You are stretching yourself to the limit of your cognitive and intellectual abilities.

Shallow work is “non-cognitively demanding, logistical-style tasks, often performed while distracted. These efforts tend to not create much new value in the world and are easy to replicate.” Many knowledge workers spend much of their day doing shallow work with fragmented attention, frequent interruptions, and regular task switching from emails to texts, to internet searches, to distractions such as social media. With this shattering of the attention and focus, he argues, we feel busier, and we mistake this busyness for productivity. A frightening supposition he makes is that as we do more shallow work, we get used to it and forget how to do deep work.

“Spend enough time in a state of frenetic shallowness and you permanently reduce your capacity to perform deep work.”

Part 1: Deep work is valuable, rare, and meaningful.

Deep work is valuable. In the current economy, Newport identifies 2 core abilities for thriving:

The ability to master hard things.
The ability to produce at an elite level in terms of both quality and speed.

To be able to do both of those things, we have to be able to work deeply. Imagine trying to learn advanced ECG interpretation. This would require focused attention and time. You could try learning advanced ECGs while also watching Game of Thrones, but you would ultimately find it only minimally effective, and in the long term, your learning would probably take more time as you would have to repeat everything you had done while distracted. The kicker is that as you sit watching TV, scrolling on your phone, and holding the ECG book open, you may feel a false sense of productivity.

Here is the magical formula for productivity:
High quality work produced = (time spent) x (intensity of focus)

In order to produce more high-quality work in a day, you can either increase the hours you work, or increase the intensity of focus.

Intense focus requires not just minimizing distractions, but also minimizing task switching. Newport describes the idea of the attention residue. If you start on task A, and then switch to task B, for some time while working on B, you have an attention residue that is still thinking about task A and is sapping the intensity of your focus. Lab studies in which individuals are forced to switch tasks before the first one is complete show that they perform worse on the second task.

Think about how this may play out in the ED. While you are charting on patient A, a nurse asks you for an order for something on patient B. You switch to patient B’s chart to order it, then completely forget what you were doing in patient A’s chart, and find yourself in patient C’s chart looking for something else. 30 minutes later you realize you forgot to go back and finish what you were writing in patient A’s chart. There is a frequent, frenetic, and potentially dangerous rate of task switching from task to task before a given task is complete. Anders Ericsson has researched and popularized the idea of deliberate practice and says “diffused attention is almost antithetical to the focused attention required for deliberate practice.”

Deep work is rare.

Many of us spend hours a day moving information around through emails and text messages. While some of this may be necessary to accomplish certain goals, move projects forward, or keep our jobs, often the emails just breed more emails. Responding to emails, completing charts, and doing shallow work is often necessary, but it is not sufficient to truly accomplish high quality work. He argues that often it is easiest to just spend time responding to emails because it is the easiest thing to do. It is much harder to close a browser and finally work on writing that paper you’ve been meaning to get to for 2 years. When we are busy, frantically typing out emails or doing other shallow work, we feel as though we are being productive. However, he argues that “In the absence of clear indicators of what it means to be productive and valuable in their jobs, many knowledge workers turn back toward an industrial indicator of productivity: doing lots of stuff in a visible manner.”

Deep work is meaningful.

“There is a gravity and sense of importance inherent in deep work.” Newport argues that we can find meaning and significance through doing deep work, as we are challenging ourselves to our intellectual limits. In addition, when we are intensely focused on whatever we are working on, it leaves no space for distraction or negativity. There is also a psychological argument for doing deep work. The Hungarian psychologist, Csikszentmihalyi did experiments in which he had people record responses to questions about what they were doing and how they felt at intervals when a device they carried beeped. He found that “the best moments usually occur when a person’s body or mind is stretched to its limit in a voluntary effort to accomplish something difficult and worthwhile.” In other words, we are happier when we are doing deep work! Deep work is not only more enjoyable in the moment than shallow work, but it helps us accomplish things that give us a longer term sense of meaning and satisfaction.

Part 2: The Four Rules

Newport gives 4 rules for helping do more deep work.

Rule 1: Work Deeply

This seems obvious, but to do it requires a plan. All day long we are faced with temptations that can tempt us off track. Distractions could be positive, negative, or neutral things, such as: emails, knocks on the door, a plate of cookies in the call room, a little notification indicator on our social media platform of choice. In other words, we are facing temptation all day long. The book Willpower presents data that our willpower is fixed, and we use it across different systems. If you drain your willpower resisting the warm cookies on the table, you will actually have less willpower to focus on a math test right afterwards. In order to avoid the distractions and practice deep work, we need “routines and rituals” so that we minimize the amount of willpower that it takes to get ourselves to do deep work.

He presents several models for how to perform deep work. The first model is the monastic. People who employ this method take actions to radically reduce their shallow work and distractions. He describes writers and thinkers who holed themselves away for weeks at a time to do deep work. One writer put a message on his website rather than any contact information, reading: “Persons who wish to interfere with my concentration are politely requested not to do so, and warned that I don’t answer email.” This would probably not go over well as an away message for you, and unless you have the ability to truly isolate yourself for long periods of time to work on one thing, the monastic approach is likely not an option for most of us.

Second is the bimodal approach to deep work. Thinkers like Carl Jung would take periodic retreats to spend chunks of time thinking, reflecting, and working on a problem or writing with little interruption. Then he would return to town and continue to run his busy clinic, do research, and teach. This may be a viable option for certain large projects. For example, it could mean secluding yourself for a day or two from all distractions while deeply working on a grant, paper, or talk.

The third model is the rhythmic approach. In this model you make a habit of deep work by scheduling it regularly or even daily. Routine and rhythm, rather than stifling creativity allow designated times when creativity can flourish. In addition, whenever something is regularly scheduled and habitual, it exhausts less willpower to perform. This method may work better for people who can’t take full days off to focus as in the bimodal or monastic approaches. Many artists, authors, and scientists have used this method. They set aside the a set time period, such as the first 90 minutes of the day to write, study, read, or create.

The final model is the journalistic philosophy. This is derived from the ability that some journalists have to quickly switch from doing shallow tasks to doing deep work when either interviewing or writing. They may only have 30 minutes between interviews or obligations to write something, but they manage to quickly enter the state of deep focus, and to fit in times for deep work in between other agenda items in their over-filled schedules. This method can work for the busy academic, but also requires willpower! For example, it would be very natural, easy, and require less willpower to just respond to some emails or scroll through Twitter during a 30-minute time period between meetings. It requires a plan, determination, and trust in your own abilities to focus to instead sit down and get deep work done.

Whichever model of deep work you choose, it is a good idea to build in a specific plan for your time. For example, decide beforehand where you will work, how long you will work on it, and what you will do. Having to decide that in the moment depletes your willpower. Maintain some metrics or make goals. For example:

How many words do you hope to have written by the end of your deep work time?
How many articles do you want to have read?
Which section of the grant do you want to have completed?

Newport recognizes that it is all very well and good to know what to do and it is a different thing entirely to know how to do it. To this point, Newport references the book The 4 Disciplines of Execution. One discipline is to “focus on the wildly important.” The book argues that “the more you try to do, the less you actually accomplish.” This reminded me of an even more extreme statement by another writer, John Maxwell in Leadership 101: “You cannot overestimate the unimportance of practically everything.” The core idea is that you have to focus your deep work on the few, wildly important projects and activities that are in line with your values and your big life goals. Another discipline argues for keeping score. For example, keep track of how many hours per week you spend on deep work, or how many words you have written, or papers read, etc. Tracking measures both provides insight and clarity, and motivates you to improve.

Not all of your life should be work, however. Ericsson’s studies suggest that novices can perform focused, deep work for about 1 hour per day, while an expert can deeply focus for up to 4 hours straight. This leads us to Rule 2. Newport argues that you work best when you have space to think and reflect without distraction, and that we should allow time for our minds to wander.

Rule 2: Embrace Boredom

The ability to do deep work and concentrate intensely is a skill that, like any other skill, takes time to develop and train. Once you are used to constant distraction, you become less skilled at doing deep work and less able to filter out irrelevancy. To improve our capacity for deep work, Newport suggests we actively and deliberately limit distraction such as surfing the internet or social media sites. If your work requires that you respond to emails quickly, then rather than responding to a new email every 5 minutes while trying to work on writing a paper, spend a focused block of time writing with your email browser closed, and then plan the time you need to respond to emails. He argues that to continue our concentration training, we should follow similar rules at home, and minimize our web-surfing and mindless smartphone use.

Our minds do need breaks from deep work to reset and refocus. However, mindless shallow work does not provide that rest. Instead, Newport suggests we perform other activities that restore our focus and provide recreation but do not impair our ability to focus. This could be things like going for a walk, exercise, time with family or friends. Another practice he recommends is productive meditation, which can be employed during times when we are physically busy but not mentally engaged, such as driving, showering, walking, or exercising. We can give our minds a task or problem to meditate on while we are physically occupied, rather than channel surfing or drowning out our thoughts with distractions. You can structure your meditation by first identifying the important variables in play for solving your problem. Then determine the next step questions you need to answer. Finally, consolidate what you learned or gained after each session of productive meditation.

Rule 3: Quit Social Media

Social media platforms are designed to be addictive, distracting, and time consuming. While they certainly provide some benefits, such as entertainment and connectivity, these come at a cost. He argues that we need to weigh the cost and benefit to determine their ultimate value. In Newport’s framework, the constant task-switching and shallowness inherent in social media can re-wire our minds to be less able to do deep work.

He recommends doing the following:

Identify your main personal and professional goals.
Write a short list of specific activities or actions you can take to meet those goals.
Assess for each of your social networking or internet activities, whether the use of the internet tool has a positive, negative, or little impact on your identified goals and activities.

For some people, use of Twitter or Facebook could have a positive impact on their goals. However, he argues that for most people, there is a significant negative impact. He suggests giving up social media use for 30 days and then asking whether those 30 days would have been “notably better if I had been able to use this service?” and whether anyone cared that you were not present on social media.

He doesn’t only recommend quitting social media, but also avoiding addictive click-bait sites that draw you in and then somehow have you doing a quiz about what kind of potato you are when you had planned to spend time with your family, go to the gym, or do something else meaningful. If you give up these things, you do not have to replace your distracted leisure time with work. Instead, he recommends that you “put more thought into your leisure time… when it comes to your relaxation, don’t default to what catches your attention at the moment, but instead dedicate some advance thinking to the question of how you want to spend you day.”

Newport quotes a writer named Bennett from his 1910 book How to live on 24 hours a day regarding leisure, and says “One of the chief things which my typical man has to learn is that the mental faculties are capable of continuous hard activity: they do not tire like an arm or a leg. All they want is change – not rest, except in sleep.” This supports the idea that our mental faculties will be best re-charged and re-invigorated not by mindless, semi-conscious distraction in the form of rapidly changing entertainment that we watch while also scrolling Instagram and answering text messages, but rather that we can recharge best by doing interesting and meaningful activities that are different from what we have done during the day.

Rule 4: Drain the Shallows

We all have many “shallow” things we have to do in a day. This includes much of the time spent in meetings, logging of hours, chart completion, submitting reimbursements, completing peer reference forms, and most emails. Since most people at the expert level cannot do more than 4 hours of true deep, focused work in a day, this still leaves many hours for shallow work. However, if left unchecked, the shallow work tends to overrun its boundaries and impinge on the deep work time.

To keep the shallows from taking over, he makes several recommendations.

Schedule your whole day. You can include breaks or lunch, required meetings etc, but in the time that you have discretion over, block off deep work time and write in what you will be working on.
Then, add in blocks to deal with your shallow work. To do this, you have to quantify the depth of each activity. For example, most emails are shallow, requiring you only to read them or reply briefly. Others contain deep work, such as requests to review a manuscript, write a letter of recommendation, or edit a paper.
Schedule overflow blocks to allow you to finish work that you couldn’t complete in their allocated times. This contingency planning helps you not run into problems when several days’ work keeps overflowing into the next day’s schedule.

Finally, he gives a number of very specific recommendations for how to make your shallow work more efficient, for example by being specific in your email requests. These are worth reading in full. I would also recommend the book Getting Things Done, which presents a highly popular personal productivity system for how to manage the shallow work, including emails, materials, and scheduling. Draining the shallows allows you to devote more time on meaningful deep work.

My personal implementation

For the last year, I have been personally pursuing deep work in several ways that have transformed how I think and work. First, despite an exceedingly large number of demands on our time, my work partner and I block off 8 hours every 3 weeks that we spend together off campus doing deep work. This time allows us to focus on the big questions, move big projects forward, and do honest, deep assessments of performance of prior plans. It gives us an open, comfortable space to dream, throw around crazy ideas, and truly think deeply. During my work-week, I schedule and try hard to protect a few hours of deep work, to work on papers or reading, and I specify in my calendar what project I will work on. I also schedule in shallow time in between meetings to catch up on emails, submit reimbursements, and do other necessary but unfulfilling paperwork tasks.

If you have implemented deep work strategies in your own life and practice, please share on Twitter and tag us at @ALiEMteam and @clshenvi.

Summary

Deep work refers to focused, intense, distraction-free work on activities that are critical for reaching your goals and completing projects.
High quality work produced is the product of the time spent on it and the intensity of the focus. In order to spend less time on our work, we need to increase the intensity of our focus.
To do deep work, we need to have insight into which of our work is deep, and we should intentionally make space for it in our schedules.
Your capacity to focus is increased by doing more deep work. On the other hand, distracted work or distracted entertainment can leave us less able to do deep work.
Allowing yourself to be bored, doing something relaxing but meaningful, and engaging in productive meditation are better ways to reset your focus while maintaining your deep work capacity than frenetic, semi-conscious work or entertainment.
Scheduling your deep work and your shallow work, and keeping track of your deep work hours can help develop you develop the habit and routine of deep work that make it easier to do.