The Physician's Hourglass: Maximizing Time for Better Healthcare

JIMGS Volume 2 (02) September 6th, 2023 Editorial Journal for International Medical Graduates The Physician's Hourglass: Maximizing Time for Better Healthcare Hassaan Tohid MBBS 1, Surmai Shukla MBBS 2, Divyanshu Dhamija MBBS 3 Journal for International Medical Graduates Abstract Time management constitutes a skill that can be acquired. Worldwide, experts have articulated numerous time management techniques through written and spoken discourse. In this article, we shall delineate the top seven time management skills. Embracing these competencies stands to benefit fledgling doctors, not only in their capacity as medical practitioners but also within the realms of their personal lives. Research indicates that the practice of effective time management serves to diminish stress levels and enhance performance, both among students and professionals alike. By immersing oneself in the acquisition and cultivation of these time management aptitudes and habits, one not only attains a gratifying sense of achievement but also attains mastery over the orchestration of one's life. Furthermore, this endeavor may yield improvements in overall workplace performance, mitigating workplace stress and thereby bestowing upon the individual a profound sense of selfsatisfaction. Introduction Each individual aspires to attain success in both their life and career, irrespective of their chosen path. Within us lies an inherent inclination and fervor to achieve accomplishments. As Abraham Maslow articulated in his hierarchy of human needs, the aspiration for selfactualization resides within us all [1]. However, only a select few manage to transform their dreams into reality and unleash their fullest potential. The primary obstacle often stems from a lack of awareness regarding the mechanics of success, the intricacies of how things truly operate. Embedded within the pursuit of success are fundamental principles that we must all embrace to excel in our chosen endeavors. Among these principles, one stands out prominently: the art of prudent time management. When one scrutinizes the cadre of professionals who excel, a common thread emerges among them — the art of 'Time Management.' But what is time management? The distinguished speaker of the last century, Earl Nightingale, once imparted wisdom to Bob Proctor, stating, 'We cannot govern time; we can only oversee our activities.' This assertion hardly exaggerates; indeed, we possess no dominion over time itself, for it flows inexorably, heedless of our existence. However, as we marshal our activities, we discover the path to a harmonious and triumphant life, realizing that time is no longer squandered. Time management, in its essence, constitutes a lifemanagement skill. Mastery of time begets mastery over life itself, endowing us with unwavering dominion over our most precious resource. For countless physicians traversing their careers, the quandary of time management looms large amidst the relentless demands and exhaustive work hours. Sadly, the rigorous crucible of medical education seldom imparts the art of efficient and effective time management [2]. It becomes a solitary endeavor, thrust upon students throughout their lifelong journey. Struggles ensue, time is perceived as squandered, and the ominous specter of overwhelm and stress descends [3–4]. This inimical trajectory not only cultivates burnout but also casts a pall over both personal and professional spheres, relegating life and work to mediocrity. In the pages that follow, we shall explore pivotal time management techniques, tailored to empower young physicians, offering them the keys to unlock the fortress of time. Let it be known that while we cannot halt the relentless march of time, as physicians, you can embrace these habits and techniques, steering your life's course with mastery, asserting, 'I am the custodian of time, and my moments are no longer wasted.'" Now, let's dive into the seven time management techniques we've selected for this article, chosen for their ease of adoption and potential to empower physicians and young clinicians in their quest for effective time management. 1- Embracing 'Eat the Frog': Among the myriad of time management philosophies, 'Eat the Frog' stands as a beacon of wisdom—a concept initially immortalized by Mark Twain and later expounded upon by esteemed authors, none more Journal for International Medical Graduates. 2023. JIMGS Volume 2 (02) September 6th, 2023 Editorial Journal for International Medical Graduates prominently than Brian Tracy in his influential tome, 'Eat That Frog' [5]. So, what precisely is the 'Eat the Frog' philosophy? This ingenious technique proposes that we confront our most formidable task as the sun rises, liberating our mental faculties for the challenges that lie ahead. Picture a day filled with myriad responsibilities—both professional and personal. Amid this assortment, there lurks one task that is the most formidable, the one we loathe or anticipate as an energy and time devourer. That task, dear reader, is the 'frog.' Dive headfirst into your 'frog' as the morning rays illuminate your path. Commit to it unwaveringly, from inception to triumphant completion. Why, you might wonder, is it imperative to see this endeavor through to the finish? The answer lies in focus. By dedicating your full attention to one task, you thwart the siren call of distraction that beckons from other unfinished ventures. Succumbing to the allure of shifting from one task to another yields a harvest of unfinished business, a surefire recipe for stress and overwhelm. However, when you persevere through the trials of your 'frog,' you emerge not merely victorious but also imbued with a profound sense of accomplishment. The very act elevates your confidence, imbuing you with serenity and a heightened self-esteem. Consider, for instance, the hospital setting. What might be the most formidable challenge confronting a doctor or fledgling physician? Is it the treatment of the most complex patients or the laborious paperwork following rounds? Whatever you deem your 'frog,' address it promptly, your unwavering focus never straying. In so doing, you not only experience a surge of contentment and vitality but also earn the distinction of being the hospital's most dependable asset. A reputation thus forged paves your path to unprecedented heights of success in the future. the grand tapestry of life outcomes, a staggering 80 percent of our achievements are borne from a mere 20 percent of our efforts. This pattern is omnipresent, echoing throughout the planet [5]. For our aspiring physicians, this principle serves as a compass for enhancing time management prowess. Begin by meticulously assessing and identifying the 20 percent of tasks that yield an astounding 80 percent of your desired results. Once this clarity is attained, relentlessly focus on these paramount tasks. The transformation you will witness in both your personal and professional life will astonish you. Now, a question may arise as you ponder this paradigm shift: 'What of the remaining 80 percent of tasks? Will neglecting them render me incompetent or unproductive?' The resounding answer is a firm 'No.' In fact, the 80/20 mindset propels you toward greater competence. By directing your energy towards the crucial 20 percent, you inherently produce 80 percent of the results, catapulting you into the echelons of the top 5 to 10 percent of industrious physicians. Furthermore, you'll discern that the remaining 80 percent of tasks often lack urgency or immediate consequences, leading you to realize their relative insignificance. We habitually overestimate the importance of all tasks, obscuring the fact that the 20 percent holds the true essence of our productivity. Understanding and embracing the Pareto Principle empowers you to scrutinize your surroundings and discern that which truly matters—the 20 percent of tasks that shape your destiny. By focusing on this vital fraction, you not only prioritize effectively but also wield your time with greater efficiency. The end result? You emerge as a consummate professional, a skilled physician, and a master of your own time. 3- The Pomodoro Technique: The origins of the Pareto Principle, also known as the 80/20 rule, can be traced back to the pioneering insights of Italian economist Vilfredo Pareto in 1896. Pareto astutely observed that 80 percent of the land in Italy was possessed by a mere 20 percent of its populace. This revelation soon transcended the realm of landownership, revealing itself as a universal truth. We are all acutely aware that sustained focus on a single task can be an arduous endeavor. It's entirely natural, and indeed, common to experience burnout, particularly when grappling with demanding and time-consuming tasks, such as the meticulous paperwork that physicians encounter or navigating the labyrinthine Electronic Medical Record (EMR) software. Enter the Pomodoro Technique, an ingenious strategy advocating the division of your task into manageable intervals— typically, 25 minutes of concentrated work followed by a brief, rejuvenating 5-minute respite. Following four such cycles, a more extended break is granted. In various facets of existence, the 80/20 rule manifests its influence [5]. Consider this: 80 percent of global wealth finds its way into the hands of a select 20 percent of the world's wealthiest individuals. Likewise, the joys we derive from life stem predominantly from a mere 20 percent of our activities. In the context of health, 80 percent of weight gain can be linked to 20 percent of our dietary choices, while 20 percent of our lifestyle choices lead to 80 percent of our weight loss. Even in This technique brings to mind the adage often proffered by psychologists and coaches—the 'How to Eat an Elephant' philosophy. If tasked with consuming an elephant (metaphorically, of course), how would you approach it? The answer, strikingly simple: 'You eat an elephant one bite at a time.' The essence lies in dissecting the monumental task into bite-sized portions, proceeding incrementally. In the process, you'll find that what initially appeared as an insurmountable challenge 2- The Pareto Principle (80/20 Rule): Journal for International Medical Graduates. 2023. JIMGS Volume 2 (02) September 6th, 2023 Editorial Journal for International Medical Graduates becomes progressively more manageable. If weariness sets in, a brief 5-minute respite serves as a conduit for revitalization. After several cycles, a more extended intermission beckons before you recommence your task, persisting until it stands completed [6]. Table 1: Shows the strategies of Time Management Time management techniques The gravity of this responsibility demands a written checklist, leaving no room for crucial steps to be overlooked [5]. In the realm of medicine, clinicians find themselves in a similar crucible, where patients' lives hinge upon their performance. To discharge this duty with utmost diligence, we, too, must wield the power of checklists. It is not merely a tool for error avoidance; it is a time-saving marvel. Description 1. Eat the frog. Tackling your most challenging task first thing inthe morning. 2. Pareto Principle (80/20) Rule Focusing on 20% of the tasks that yields 80% of the result. 3. Pomodoro Principle Breaking the tasks into intervals. 4. Time Blocking Plan your day into blocks of time assigned for specific activities. 5. To-do lists Writing the list of everyday tasks. 6. Two-minute rule Tasks that can be done in two minutes should be done immediately. 7. Zeigarnik Effect Resolve to fulfill a task on hand first until it’s done completely instead of taking more tasks. 4. Time Blocking: Time blocking, a formidable strategy in the arsenal of time management, has the power to optimize your efficiency and help you navigate your daily tasks with finesse. The premise is straightforward: you segment your day into designated blocks of time, each dedicated to specific tasks or activities or you can also say it is synonymous with scheduling [7]. This method serves as a bulwark against the insidious pull of multitasking, which can dilute your focus and compromise the precision of your efforts. Imagine you have a heap of paperwork awaiting your attention, intertwined with other pressing responsibilities at work. Enter time blocking: you allocate a defined period, say from 1:00 pm to 3:00 pm, exclusively for tackling that paperwork. During this interval, you commit to singularly focusing on this task, eschewing all distractions. This, in essence, is the essence of time blocking. By mastering this technique, you gain the prowess to seamlessly juggle multiple critical responsibilities in a single day, effectively enhancing your productivity and alleviating the burdens of both professional and personal life. Extend this practice to your personal life, where you can allocate, for instance, 90 minutes or 2 hours of dedicated family time. This not only enriches your personal life but also engenders a harmonious, balanced existence. This approach has also been discussed by various time management experts like Brian Tracy before as well. 5. To-Do Lists: To illustrate the potency of this technique, let us turn to aviation. When a pilot takes to the skies, they rely upon a meticulously crafted checklist to guide them through each step of the journey. The stakes are monumental, as a minuscule oversight or the inadvertent omission of a checklist item could spell catastrophe, imperiling not only the pilot but also the lives of countless passengers. Consider the surgical theater, where the staff's adherence to their respective to-do lists underpins the precision and efficiency of each procedure. Whether it's an anesthesiologist, scrub nurse operating room (OR) nurse, or attending surgeon, the checklist guides each step, leaving no room for error. The implementation of checklist-driven time management is simple yet transformative [8]. Each day, you craft a checklist encompassing all your tasks [8]. Yes, a new checklist every day. Some tasks may be recurring, while others may fluctuate. Some tasks may carry greater import, while others bear less weight. Once your checklist is in hand, you proceed to organize it according to task importance—a reflection of the 'Eat That Frog' philosophy. Numbering items as 'A,' 'B,' or 'C' tasks provides the clarity needed for prioritization. Completing a task warrants a satisfying strike-through, fostering a sense of accomplishment and imbuing you with a victorious spirit. In adopting this method, you not only master time management but also elevate your self-esteem, self-concept, and self-image. 6. The Two-Minute Rule: In the realm of time management, the Two-Minute Rule reigns as a succinct yet potent guideline: If a task demands two minutes or less to complete, tackle it immediately—no procrastination allowed [7]. This straightforward approach not only prevents the accumulation of minor chores but also attends to numerous small yet vital tasks. However, let us not forget the guiding principle of the 80/20 rule, which teaches us that not all trifling tasks merit our energy and time. Thus, we must analyze and assess. If your evaluation deems a two-minute task valuable, then act. But how do you discern importance? The 80/20 rule extends its wisdom: a task bears significance if its neglect carries substantial consequences [5]. In such cases, heed the call of 'Just do it!' 7. The Zeigarnik Effect: The Zeigarnik Effect, a formidable force in the realm of time management, unveils a profound truth about human psychology: we remember incomplete tasks more tenaciously than those we've completed. How can we harness this phenomenon for superior time management? Because the specter of unfinished business lingers, it is imperative not to shoulder additional responsibilities until you have vanquished the incomplete task. Venturing into new commitments while neglecting this unfinished duty invites procrastination Journal for International Medical Graduates. 2023. JIMGS Volume 2 (02) September 6th, 2023 Editorial Journal for International Medical Graduates and burdens you with unnecessary stress, for the unfinished task haunts your thoughts incessantly. Another valuable lesson from the Zeigarnik Effect underscores the importance of completion. As the adage goes, 'Never take a job that you can't finish.' When entrusted with a task, make an unwavering commitment to see it through to its conclusion, especially if multiple commitments weigh on your shoulders. By adopting this habit, rooted in the potent Zeigarnik Effect, you not only surmount important tasks but also bask in the glow of accomplishment. In turn, this fortifies your standing as a responsible physician. Moreover, effective time management can elevate overall job satisfaction and enhance personal contentment [9]. While numerous other time management techniques—such as goal setting, meticulous planning, and minimizing time-wasting habits—merit exploration, we reserve these for future articles [9]. (SEE TABLE 1) References 1. Healy K. A Theory of Human Motivation by Abraham H. Maslow reflection. Br J Psychiatry. 2016;208(4):313. doi:10.1192/bjp.bp.115.179622 2. Pitre C, Pettit K, Ladd L, Chisholm C, Welch JL. Physician Time Management. MedEdPORTAL. 2018;14:10681. doi:10.15766/mep_2374-8265.10681 3. Aeon B, Faber A, Panaccio A. Does time management work? A meta-analysis. PLoS One. 2021;16(1):e0245066. doi:10.1371/journal.pone.0245066 4. Zangerle CM. Two tactics for time management and stress reduction. Nurs Manage. 2021;52(4):6-8. doi:10.1097/01.NUMA.0000737784.64810.4b 5. Tracy B. Eat That Frog!: 21 Great Ways to Stop Procrastinating and Get More Done in Less Time. 2nd edition. San Francisco: Berrett-Koehler Publishers; 2007. Conclusion Time management is tantamount to life management. Mastery of time translates to mastery of life itself. A skilled physician is, at the core, a proficient time manager. This article serves as our endeavor to equip clinicians worldwide with the tools and strategies to do just that. Time management, a skill within reach, lends not only a sense of accomplishment but also enriches the quality of personal and professional life. 6. Mandal A. The Pomodoro Technique: An Effective Time Management Tool. The NICHD Con. 2020;1(120):6. Available at: https://science.nichd.nih.gov/confluence/display/newsl etter/2020/05/07/The+Pomodoro+Technique%3A+An +Effective+Time+Management+Tool 7- Tracy B. Productivity Tips – Be More Productive With Less Effort. Available at https://www.briantracy.com/blog/timemanagement/productivity-tips/ 8. Schrager SB. Improving Time Management Through Modern-Day To-Do Lists. Fam Pract Manag. 2022;29(1):5-6. 9. Gordon CE, Borkan SC. Recapturing time: a practical approach to time management for physicians. Postgrad Med J. 2014;90(1063):267-272. doi:10.1136/postgradmedj-2013-132012 Hassaan Tohid MBBS 1, Surmai Shukla MBBS 2 , Divyanshu Dhamija MBBS 3 Corresponding Author’s Email: [email protected] Affiliations: 1. California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA. 2. Qingdao Medical College, Qingdao University; Qingdao, China. 3. Government Medical College Amritsar; Amritsar, Punjab, IND. Journal for International Medical Graduates. 2023.