Smarter not harder
In Practice
By Victoria Houghton, managing editor, March 1, 2019
Dermatology World talks to Jennifer Gardner, MD, assistant professor of medicine and dermatology at the University of Washington School of Medicine, about best practices for effective time management.
Dermatology World: Your bio on the UW website says you “enjoy figuring out new ways to work smarter, not harder.” Where does your passion for work efficiency stem from?
Dr. Gardner: Things typically came pretty easy for me for most of my life, so I didn’t need a real system. I could pretty much keep track of a lot of stuff in my head. Then, I took on more responsibilities — I was starting a family and building a career. It just became too much. I think there was that point of maximal pain where change happens. I thought, well, maybe I’m getting old or I’m just not as good as I used to be’ — whatever it was, I had this feeling that I couldn’t get it all done the way I used to. I thought maybe it’s me, but maybe it’s also my system. When I started looking at it, I realized that I had just fallen into this modern-day trap of trying to do it all — multitasking — which I’m not good at, and I think most people aren’t good at either. I decided to work from that place and truly make some changes. It was hard. Change is always hard. However, once I did, it made a big difference.
You often talk to physicians in all stages of their career about best practices for time management. What are the basic tenets of your time management advice?
Dr. Gardner: The first thing that I tell my residents, or anyone else looking for advice, is to take some time to meditate on your own core values: What is truly important to you and where are you trying to go in this life? Most people don’t systematically work through their core values. Also, most don’t get brutal about getting rid of the good — and really good — stuff, and just focusing on those three to five core values that make them who they are. You must also realize that priorities and life stages change over time, so these core values can change, and you must repeat this process.
Essentially, what that does for you is that it defines your yeses’ and then very quickly you can realize your nos.’ People have a very hard time saying no to things, but it’s really important to learn how to say no very politely and also say it quickly. If you know the answer is a no, let that person know right away so then they can move on. If you say yes, and you’re overwhelmed and can’t get it done, that’s where you’ll start to feel bad about not honoring your commitments, which is a bad place to be.
What advice do you have for getting through some of the big, often overwhelming, tasks that physicians often face?
Dr. Gardner: Generally, as humans we tend to underestimate how much time it’s going to take to do a given task. Just knowing yourself is at the core of all of this. Be honest with yourself and give yourself that time and space to really focus. Otherwise, you’re just doing yourself a disservice. That’s one of the biggest mistakes people make. Also, many people don’t understand the difference between a project and a task. For example, if you have an hour, you may think you might be able to write a paper. Then you’re really upset that you didn’t get it done in an hour. Really, you just didn’t realize that the paper is a project and what you really needed to do was break that project down into a bunch of tasks and then just tackle those in little blocks of time.
What do you do personally to ensure that you’re managing your time appropriately?
Dr. Gardner: I work in an academic setting, so for me the most important thing is recognizing that I’m either in clinic or not in clinic. When I’m in clinic, I block out the time and I commit to not getting anything else done during that time, except taking care of the patients who walk through my door. I think people think they’re just going to slide in this other work between patients in this block of time that’s already devoted to patients. What they really need to be doing is putting on their calendar other blocks of time for that other work, like email, for example. You may want to block out a couple times a day or maybe you have a couple email days where you’re going to get caught up.
I think it’s human, but 98% of us are single taskers. We are not multitaskers. I think identifying that has been important to me. I’m in clinic right now and I’m going to be mindfully present for this work. Then I will be doing email in a different time slot, and I’m not going to do anything else.’ You’re going to be most efficient and most productive at that one task. Studies have shown that if you’re multitasking, you’re really just serially single-tasking and task-switching, which makes your brain really tired. If you’re doing that throughout the day, by the end of the day you’re going to have nothing left and you’ll be on empty. If you’re really present and mindful and do the task at hand and do it as best you can, and then be done with it, I think that can be really uplifting and energizing in some ways, even though it’s the same amount of time that you’re doing that work.
Physicians have so much on their plates today, in addition to patient care — particularly administrative tasks. What should physicians do to ease that burden?
Dr. Gardner: You have to say, Okay, maybe it’s not important to me, but it has to get done.’ There are lots of those things in our jobs and our lives. Ultimately, you must ask yourself, Am I the person who needs to be doing this?’ and Am I the person who does this best — even if I like to do it and don’t mind doing it?’ If the answer is no to those questions, I think it’s worth spending some time looking into delegating or outsourcing that type of work, so that it gets done but you’re not going to be running into a time issue. You can then spend your time doing the things that you have to do, or that you do really well — patient care.
How can technology help with time management? Can it hurt?
Dr. Gardner: I do think technology is here to stay, but we have the choice to figure out how to make it work best for us. That, I think, is the essential part of this. We must decide: How is this actually going to help me? Do I have to use this? How do I get this to work best for me? The tech settings, when it comes out of the box, may not be the ones that work best for you, but you have the choice to go in and learn the system and put in the settings that work best for you and to keep the distractions out.
That is important: Everyone has a smartphone these days and they have, arguably, made a lot of things easier and better. However, more than not, they’ve distracted us and taken us away from productivity. That is not a weakness of any one person. I think that is exactly how they’ve been designed to work. I also think you need to be careful of shiny object syndrome or FOMO [Fear of missing out]. You don’t need to invest in every new piece of tech that comes out, and don’t assume it’s going to be the one tool that’s going to solve all of your productivity problems. You just need a system and a very small handful of tools that work great for you and the way you work, and just run with it. If you do that, you don’t need all the other stuff. It just becomes more stuff.
Which Academy resources are helpful to you in terms of managing your time?
Dr. Gardner: I love the prior authorization appeal letter generator (staging.aad.org/practicecenter/managing-a-practice/prior-authorization-assistance/patient-letter-template). I think it’s genius. It’s so helpful for us when we see a patient and we’re having a hard time getting a treatment approved. With the letter generator, I know I don’t need to go back and reinvent the wheel. That kind of resource is wonderful in a busy clinical setting when you just want to get what you need for your patients.
I also love the Academy guidelines. I teach to those with my residents and look to them to make sure I’m on track. Also, the Academy’s educational modules are wonderful, and I often direct my residents to those resources.
Overall, why should physicians spend time focusing on time management?
Dr. Gardner: It’s basic stuff that I wish I had been formally taught in medical school or residency. Now it’s one of my passions, because I think it’s very important for people to take a step back and take time to learn these things. It may feel like you’re taking time away from the work to figure out how to be more productive, but it’s so important going forward. It makes all the difference in the world.
