Recapturing time: a practical approach to time management for physicians Craig E Gordon, Steven C Borkan Renal Section, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA Correspondence to Dr Craig E Gordon, Renal Section, Boston University Medical Center, Boston, MA 02118, USA; craig. gordon@bmc.org Received 4 April 2013 Revised 17 January 2014 Accepted 14 February 2014 Published Online First 5 March 2014 To cite: Gordon CE, Borkan SC. Postgrad Med J 2014;90:267–272. ABSTRACT Increasing pressures on physicians demand effective time management and jeopardise professional satisfaction. Effective time management potentially increases productivity, promotes advancement, limits burnout and improves both professional and personal satisfaction. However, strategies for improving time management are lacking in the current medical literature. Adapting time management techniques from the medical and non- medical literature may improve physician time management habits. These techniques can be divided into four categories: (1) setting short and long-term goals; (2) setting priorities among competing responsibilities; (3) planning and organising activities; and (4) minimising ‘time wasters’. Efforts to improve time management can increase physician productivity and enhance career satisfaction. INTRODUCTION Maintaining work–life balance as a physician necessitates learning how to improve efficiency and effectively manage the limited resource of available time. Indeed, pressures on physicians have recently increased, partly due to changes in physician reim- bursement and a decrease in the availability of funding to support scholarly and patient-centred endeavours. Physicians currently manage a growing number of increasingly complex patients in less time, deal with a larger volume of administrative paperwork, and are more easily accessible via email, pagers, mobile phones and other techno- logical advances, all factors contributing to high rates of professional burnout. 1–6 As a result, physi- cians increasingly report major challenges in man- aging time demands. 1378 However, few medical publications directly address the problem of how to improve time management (TM) skills for physi- cians. 7 9–11 Although business, industry and the legal professions acknowledge the importance of TM training, there are few current TM training seminars available to physicians. Although some highly successful physicians appear to have limitless time, it is actually the man- agement rather that the absolute amount of time that varies. Simply stated, physicians must identify effective TM approaches to promote their profes- sional success and personal satisfaction. Without these, all aspects of one’s career are adversely affected, including clinical productivity, success as an administrator or teacher, and meeting important deadlines. Lack of success in these areas impedes growth within an institution or practice, slows pro- motion and undermines recognition, ultimately diminishing physician job satisfaction. The resulting stress impacts the physician’s personal life, further undermining the overall sense of satisfaction and increasing the risk of burnout. 12 It is well recog- nised that physicians experience high rates of depression and suicide, as well as burnout, 4 13 perhaps partly related to poor TM practices. On a broader scale, academic medical centres, national professional organisations and the public should pay attention because each of these entities benefit greatly from effective and successful physicians and therefore might be expected to assist physicians in developing effective TM skills. Paradoxically, there are few published studies in the medical literature to assist physicians in improving TM techniques. To identify TM techniques for this review, we performed a Medline search using the terms ‘time management’, ‘physician’, ‘burnout’ and ‘career development’. With this approach ( figure 1), 5624 studies were identified and reviewed by title and abstract. Of these, 5412 studies were excluded as unrelated to TM for physicians. Although most of the remaining 212 studies alluded to the import- ance of developing effective TM skills to manage stress or burnout (45) and in early career faculty development (41), and suggested that effective TM is a competency for physician excellence (26), few published studies provided specific recommenda- tions for implementing effective TM skills. Indeed, only 15 publications, books or electronic references described TM techniques for physicians. These publications provided the evidence base for this review. We combine resources from the medical and non-medical literature to identify TM techniques appropriate for the medical profession. If imple- mented, these principles are likely to improve phy- sicians’ management of professional demands, increase career satisfaction and improve work–life balance. Effective TM strategies can be separated into four distinct principles: (1) setting short and long-term goals; (2) setting priorities among com- peting responsibilities; (3) planning and organising activities; and (4) minimising ‘time wasters’. We propose specific strategies for physicians to imple- ment for each category. A discussion of the import- ant topic of effective TM techniques in the clinical arena is beyond the scope of this review. SETTING SHORT AND LONG-TERM GOALS One common practice of highly effective profes- sionals is to frequently set and revise goals. These goals can be divided into short and long-term aims. Experts define short-term goals as achievable within 1–3 years, whereas long-term goals typically require 5–10 years. 14 One common physician error is to allow long-term goals to be dominated by more immediate and urgent short-term time Editor’s choice Scan to access more free content Gordon CE, et al. Postgrad Med J 2014;90:267–272. doi:10.1136/postgradmedj-2013-132012 267 Original article on June 12, 2020 by guest. Protected by copyright. http://pmj.bmj.com/ Postgrad Med J: first published as 10.1136/postgradmedj-2013-132012 on 5 March 2014. Downloaded from