How to Manage Interruptions and Limit Attention Residue: A Guide for Physicians

An earlier version of this article appeared on this website in July, 2024

It’s not just your imagination. It really is more challenging than ever to maintain your mental focus at work.

💉 EHR alerts

💉 Phone notifications

💉 Interruptions from staff

💉 Attention sapping apps

💉 Email

All of these and more conspire to make staying focused a daily struggle for many physicians, regardless of specialty.

Repeated interruptions and the lingering effects of shifting attention, known as attention residue, can severely hamper not only your effectiveness and productivity, but also your personal well-being.

Resolving the current state of disorder in healthcare will require systemic change, including a fundamental shift in the functionality of many EHRs. But protecting your headspace now is a critical skill that can help you stay above the fray.

In this article, we’ll explore strategies that you can use to retake control of your mental focus, manage interruptions, and minimize attention residue in your daily life and practice.

Understanding Attention Residue

Attention residue happens when you switch tasks, but a part of your mind remains stuck on the previous task.

The little breadcrumbs that remain can jumble up your thoughts and make it harder to focus. And once you’re interrupted, no matter whether the issue was urgent or trivial, it’s easy to drift over into another unrelated brain drain, such as checking your email or social media, rather than returning to the task at hand.

Realistically, interruptions have always been part of life in most medical settings. But the challenge has intensified due to

💉 EHR systems that promise constant accessibility

💉 Increasing patient complexity

💉 Expanding administrative burdens

💉 Widespread staff reductions

💉 Growing supervisory responsibilities for non-physician staff

Except for the small but growing number of forward-thinking healthcare systems, the current environment is a near-perfect recipe for attention residue.

With every interruption, you are forced to take a mental reset, which costs time, effort, and focus. Ultimately the outcome is not only decreased productivity but also greater stress and higher rates of burnout.

This isn’t just theoretical. Studies show that interruptions from a broad range of sources may happen more than every 6 minutes in busy medical environments like the Emergency Department. It’s no surprise that these repeated interruptions can seriously degrade your ability to remain focused and aware.

How to Reclaim Your Mental Focus

Ideally, healthcare leaders will recognize the need for systems and workflows that reduce unnecessary interruptions. Some organizations are already making meaningful progress in this area. But even under the best of circumstances, interruptions are going to happen. Here are a few ways that you can limit the mental drain.

Prioritize and Plan

This can be a difficult step for physicians, since we don’t always have control over the way the day might go. But simply outlining your top priorities can help by giving you a focus and a “north star” for the day.

Start by outlining your top priorities. Whenever possible, focus on these high-impact tasks when your mental energy is at its peak. For many people, that is the first thing in the morning.

Use tools like the Eisenhower Matrix (also known as the Time-Priority Matrix) to strategize your urgent and important tasks, and mitigate those less important time-wasters.

Time Blocking

Consider setting aside specific time blocks for different types of tasks. For example, set aside uninterrupted time to study for your boards, or for administrative work. If you have some control over your schedule at work, scheduling similar patient visits can be helpful, so that your mental flow is less likely to be interrupted.

Communicate your schedule and your plan to create these focused blocks of time to your team (or your family) to minimize unnecessary interruptions. Getting buy-in from your schedulers and administrative staff can help to make time blocking work for you.

Mindfulness and Meditation

Mindfulness is more than a catch-phrase. Techniques like deep breathing, meditation, or yoga can sharpen your ability to focus and help regulate stress. These are tools that can help you to strengthen your cognitive resilience in the face of a demanding clinical environment.

Meditation in particular has been found to be helpful in improving attention, focus, and memory and reducing stress. Just like medication or physical therapy, consistency matters. In one study, it took 8 weeks of regular practice before the impact of meditation was clear.

Taking a mindful pause before and after each patient, study, or procedure is a great way to mentally reset. In many cases, even this very  brief break can improve your efficiency and help you to regain a sense of control.

Limit Multitasking

Multitasking was once considered a badge of honor, and something to aspire to. But now we know that when people multitask, they often make more mistakes.

Research shows that multitasking also leads to longer completion times and greater mental fatigue. This is especially true when both (or more) tasks require cognitive effort rather than simple rote actions. In reality, tackling one task at a time is usually faster and far more effective.

So what’s the alternative? When you're faced with a task that’s too large to complete in a single sitting, try breaking it down into smaller, more manageable steps. Each sub-task becomes its own achievable goal, which can help reduce overwhelm and maintain your momentum. Writing these steps out and checking them off as you go can boost motivation and give you a sense of progress, even during busy or fragmented days.

As you knock out these smaller to-dos, you’ll build a sense of accomplishment. That feeling of progress can help quiet the mental clutter and reduce the attention residue that builds up when unfinished work lingers in the background.

Set Boundaries

Not only are they annoying, but interruptions increase the likelihood of errors, directly impacting patient safety. What’s more, these unwanted intrusions also impact your own mental well-being and your relationships by triggering heightened levels of anxiety and annoyance. That’s why setting boundaries is a crucial skill.

Whenever possible, set clear boundaries around your availability with colleagues, staff, and patients. Visual cues such as a closed door or a sign that reads “Do Not Disturb Unless Urgent” can signal your need for focused time without seeming unapproachable. And if you’re in the operating room or in a procedure, be sure that the parameters for interruptions are very clear.

When you're engaged in cognitively demanding work like surgery or a procedure, reviewing charts, developing treatment plans, or reading studies, it’s a good idea to minimize social or nonessential conversation. Let your colleagues know when you're in a focused work mode so they understand that any delay in response is intentional, not personal. Over time, this kind of clear communication builds mutual respect and helps foster a team culture that supports protected time for high-concentration tasks.

It can also be helpful to set expectations with patients and staff that non-urgent in-box messages will only be addressed during or after certain hours of the day.

Reclaiming Your Focus

Maintaining mental focus requires practical, intentional strategies and consistent follow-through. By experimenting with the time-tested approaches I’ve offered above, you’ll strengthen your ability to concentrate, reduce attention residue, and better manage the inevitable interruptions in your day.

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