Banishing Busy: Part 3

Medical professionals are busy people and exist in a constant state of “being busy.” How do we resolve chronic “busy-ness”? How do we manage our time effectively? In her recent talk at the CORD Academic Assembly 2020, Dr. Christina Shenvi, EM Physician and Associate Residency Director at UNC, provided 5 key actions to help us be productive, complete our work effectively, and strive for work-life balance. Dr. Shenvi recorded her lecture again to be shared with the ALiEM Faculty Incubator. This series of posts breaks down her talk into 3 sections in order to summarize her key points and to help us “Banish Busy” from our lives. This third post will address how to take control of our time.

Managing Our Minds

What is Metacognition?

Metacognition is thinking about our thoughts as separate from ourselves. Agency about our thoughts gives us the ability to manage our thoughts and our time. If we can actively manage our thoughts, we can change the perception of our current circumstance, which will result in the production of positive and adaptive emotions, rather than negative emotions. Positive emotions will result in productivity.

These are the steps we have to take in order to take control of our emotions and manage our thoughts:

• Awareness (of emotions):
  • By having self-awareness and self-management, we can manage our emotions and our actions. Additionally, it is important for us to have awareness of others’ emotions and to manage our relationships with others [1].
• Intentionality:
  • Deliberately choose sequential, believable, new thoughts. If we have persistent negative thoughts, they become ingrained. It can take time to get out of this vicious thought cycle!
  • Ingrained negative thoughts and emotions lead to the development of “Thought Pits.” These deep, dark spaces can feel impossible to escape. To get out, we can create a “thought ladder.”
  • Replace negative thoughts with something that is believable yet positive. With each negative thought, think about 1 positive thing that is happening and the next thing that will happen. This creates the “rungs of a ladder” to get us out of the pit. We want to move from negative thoughts to positive, and move from external motivation to internal motivation
• Internal locus of control:
  • This is created from the Attribution Theory or the Self-efficacy Theory: We are in control of what we think, and therefore of how we feel, and subsequently what we do.
  • Internal motivation results in more ownership, unlike external motivation
• Grace:
  • It takes a lot of time and practice to turn negative thoughts into positive ones
• Perseverance:
  • Keep going!

Do a 168-Hour Inventory

We can’t be successful in managing our time if we don’t know where it is going! We should take stock of how we allocate out time and effort. By taking inventory of where we spend the hours of our week, we might be surprised where it is actually going compared to where we think it is going. Can we be more intentional where the hours are going [2]?

Stay in the deep end and drain the shallows

The goal is to spend more time doing work in a focused way. High quality work is a combination of time spent and intensity of focus. There are 2 types of work: deep work and shallow work [4].

What are deep work and shallow work?

Deep work tends to bring joy and fulfillment. Deep work is focused, distraction free, involves deep thinking and planning, revolves around developing ideas or strategies, and is spent thinking ABOUT things, not just OF things.

On the other hand, shallow work is classified as short, often interrupted, with little creativity or deep thought. It is usually neither fulfilling nor rewarding. It is often required to keep our job, such as administrative responsibilities. It doesn’t tend to bring joy.

By frequently performing only shallow work, we can actually decrease our ability to perform deep work. Even during mundane times, instead of flipping through something mindlessly, like email, we should spend that time thinking about a problem instead [3].

Task switching between deep and shallow work can lead to shallow work and may impair our ability to do deep work in the long term.

How do we do more deep work?

We should schedule deep work time in our calendar, and protect it as if it was a shift we had to work. Plan ahead about how we will use it. By assigning a task to a predetermined time in the future, it allows us to stop thinking about it during the day, effectively off-setting our cognitive load.

How do you commit to doing deep work while addressing shallow work?

There are several tips on how we can complete shallow work efficiently so it doesn’t infringe on the time we have to do deep work.

Open loops are the enemy of productivity and deep work. If a task is an open loop, our minds will believe it is never really done and therefore will continuously use brainpower to address it. We need to capture these open loops so that they aren’t constantly running in our minds. To do this, we can start by using David Allen’s rubric from Getting Things Done [4]:

• Do: If the task takes 2 minutes or less, do it! If it takes longer, post-mark it for later
• Delegate: Outsource the shallow work, as much as we can
• Defer: do it later, especially if the task is more deep work material
• Decline: is the task at hand in-line with our values? If it is not, decline it
• Delete: This is not part of Allen’s framework, but deleting as many things as we can quickly will help keep our actual and our mental inbox clearer.

Create systems to tag the tasks at hand to free up our cognitive load:

• Capture and organize our thoughts and to-do items
• Organize our paper files and folders
• Organize our email files and folders
  • Attempt to have a zero inbox with folders marked for deep work, folders for future events with subfolders for conferences, and separate folders for each project
  • If your current inbox is too full to feasibly organize as above, create a time stamped folder for all previous emails and start the system from that point onwards [4].

Summary

There are 5 key actions we can take to help us decrease our personal and professional business:

1. Practice value-based scheduling: How do you want to be spending your time? What is important to you?
2. Avoid self-sabotage: What barriers are keeping you from getting a task done? Try to motivate yourself based on what you’ve decided your values are.
3. Manage your mind: Your feelings about your task matter! Be intentional about your work and reframe setbacks as part of the learning process.
4. Do a 168-hour inventory: Take a look at how you’re spending your time right now, and evaluate how that lines up with your values.
5. Stay in the deep and drain the shallows: Now that you’ve done some reflection, get to work and keep yourself on task! Banish your busy!

References/Recommended readings:

1. Bradberry T and Greaves J. Emotional Intelligence 2.0. San Diego, CA : TalentSmart; 2009
2. Vanderkam L. I Know How She Does It: How Successful Women Make the Most of Their Time. New York: Portfolio/Penguin; 2017
3. Newport Cal. Deep Work: Rules for Focused Success in a Distracted World. New York: Grand Central Pub; 2018
4. Allen, David. Getting Things Done : the Art of Stress-Free Productivity. New York: Viking, 2001

Author information

Brian Barbas, MD

Assistant Professor & Clerkship Director
Department of Emergency Medicine
Loyola University Chicago – Stritch School of Medicine

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