Focus on Physicians:
Insights, Ideas, and Strategies
How to Manage Interruptions and Limit Attention Residue: A Guide for Physicians
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 significantly decrease your cognitive performance and make it harder to focus. And once you’re interrupted, no matter whether the issue was urgent or trivial, it’s easy to switch over into another unrelated brain drain, such as checking your email or social media, rather than returning to the task at hand.
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 practice.
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
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.
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.
If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.
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Getting Unstuck: How a Simple Mind Shift Can Move Your Life Forward
If you’re a physician, you’re probably balancing patient care, administrative work, and personal responsibilities like a pro. But when you start craving something more, whether professional growth, personal renewal, or a completely new path, it can feel daunting.
As a physician coach, I see this often. From the inside, the obstacles feel huge. But there’s always a way through, and it starts with understanding what’s holding you back.
In this article, I’ll share the most common reasons physicians get stuck, along with practical strategies to help you move forward with clarity and confidence.
An earlier version of this article appeared on this website in April, 2024
If you’re a physician, you’re probably juggling patient care, administrative tasks, and personal responsibilities like a boss. But when you feel the need for something beyond the daily routine, whether that’s professional growth, personal renewal, or a new path, it can feel daunting.
Maybe you’re wanting to learning a new procedure, launch a research project, carve out space for self-care, or perhaps you’re even considering a major career move. These big leaps can seem daunting. So despite your motivation to move forward, it’s common to feel caught in a loop—busy but stuck in place, like a hamster on a treadmill.
As a physician coach, I see this often. From the inside, the obstacles can feel huge. But there’s always a way through, and it starts with understanding what’s holding you back.
In this article, I’ll explore common reasons that physicians feel immobilized, and I’ll offer you some strategies that will get you moving forward with purpose.
Break the Cycle of Habit Loops
The issue may not be a lack of action. Instead, you may find yourself defaulting to actions that feel safe and predictable in the moment, but don’t truly move you forward. It’s a common trap. Whether it’s procrastinating on notes, sidestepping difficult conversations, or saying yes too often, these autopilot habits can hold you back from the progress you want.
➡️Strategy: Notice your default loops and interrupt them. Swap one unhelpful behavior for something small but different. That could be finishing one note before checking email, setting a five-minute timer to reflect before agreeing to a request, or committing to learning something new each week. Even tiny pattern shifts break the cycle and let in some light.
Stop Overthinking and Start Moving
Other times, the problem isn’t repetition, it’s hesitation. You know that you need to make a change, but fear of making the wrong choice or endless analysis of your options keeps you frozen. You tell yourself you’re “waiting for the right time,” but in reality, you’re letting opportunities slip by while the decision sits untouched.
➡️Strategy: Embrace the concept of “progress, not perfection.” Understand that inaction is also a decision, and sometimes the most costly one. But creating your future doesn’t have to mean leaping into the great unknown. Choose a single, manageable step aligned with your goals. Build momentum gradually, and your confidence will rise with each action you take.
Handle Challenges Before They Grow
Unresolved problems don’t vanish. They tend to grow tentacles and multiply. Whether patient-related, administrative, or personal, ignoring nagging issues drains your energy and makes forward motion harder.
➡️Strategy: Be proactive. That doesn’t mean you solve everything on the fly. Instead, put each issue in its place: delegate it, schedule time to address it, or even decide to say no. Building this habit can turn obstacles into action points instead of lingering stressors.
The Weight of Incomplete Tasks
Unfinished notes and half-done tasks are a huge mental burden. For physicians, this irritating backlog is not only stressful but can compromise patient care. It’s a constant source of attention residue that saps your brainpower and makes you less efficient.
➡️Strategy: Get that stuff done. Use templates, smart phrases, and to-the-point documentation practices to streamline charting. Tackle your inbox with a “touch it once” mindset: respond, delegate, or delete. Time-management tools like time-blocking or the Pomodoro Technique can keep you on track and reduce overwhelm. You might even schedule a “chart date” with a friend, making a pact to get your unfinished work done together.
Reclaim Your Value
You know your work matters. Your patients count on you, and you make a difference in their lives. Yet it’s common for physicians to undervalue themselves. When that happens, you may find yourself stuck in toxic environments, missing out on opportunities, or saying yes to projects that drain your energy and don’t serve your best interests.
➡️Strategy: Practice self-reflection and affirmation to strengthen your sense of worth. Journaling can be a very useful exercise. So can revisiting a folder or a box with notes of appreciation from patients and colleagues. When needed, work with a coach to clarify your values and goals, and build confidence. If the burden feels especially heavy, consider scheduling time with a therapist.
Stop Living by Other People’s Expectations
From family expectations to workplace culture, many physicians find themselves following someone else’s script. Over time, this can leave you in roles that don’t align with your values.
➡️Strategy: Define success on your own terms. Take time to reflect on what success means to you, both personally and professionally. Living authentically creates momentum and fulfillment that external definitions of success never will.
Moving Forward
Feeling stuck doesn’t have to be a way of life. When you begin to recognize what’s keeping you in place and apply intentional strategies, you can shift from stagnation to forward motion.
Anchor yourself in your values, trust your resilience, and let small actions become stepping-stones toward change. As you shift your mindset from simply accepting the status quo to creating space for growth, you’ll begin to notice opportunities opening where you once only saw obstacles.
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If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.
And if you’d like to schedule a complimentary introductory meeting with me, click the link below.
Master Your EHR: Proven Strategies to Take Back Your Time
Physicians spend nearly 6 hours in the EHR for every 8hours of patient care. That’s nearly a full workday dedicated to documentation, order entry, inbox management, and other digital tasks. While awareness of this issue is leading to new and innovative solutions, the reality is that EHRs will remain a significant drain on your time and attention for the foreseeable future. So what can you do to mitigate the pain and to make it work for you? Here are 5 essential tactics to keep your documentation under control.
I still remember my first day in clinic as a cardiology attending. I was eager, definitely a little nervous, and determined to provide the best care possible to my new patients.
Back then, we were still using paper charts. They were far from perfect, but in hindsight, those analog files had their advantages—no endless clicks, no after-hours inbox, just a straightforward way to document and move on. But I digress.
That day, one of my more seasoned colleagues pulled me aside and gave me a piece of advice that, over time, became ever more valuable:
"Whatever you do, don’t let your charts get out of control."
At the time, I didn’t fully grasp the weight of his words. But it didn’t take long to understand.
Fast-forward to today, and the electronic health record (EHR) dominates medical practice. It’s here to stay, but it comes at a cost. A study of over 200,000 EPIC users found that physicians spend nearly six hours in the EHR for every eight hours of patient care. That’s almost an entire workday devoted to documentation, order entry, inbox management, and other digital tasks.
While awareness of this issue is growing, and new tools are emerging to help, the reality is clear: the EHR will continue to demand a significant share of your time and attention. You may not be able to escape it, but you can take control of it. The key is to be intentional about the way you use your time.
Six Essential Strategies to Keep Your EHR Under Control
Here are six key strategies that have helped me, and many of my clients, take control of the EHR. I hope they’ll help you do the same, freeing up more time for what matters most.
Make a Plan And Stick with It
Your EHR workflow should be intentional. Whether it’s blocking dedicated time for documentation, setting clear start and stop times, or batching tasks, having a structured plan prevents endless charting after hours.
While you can’t control every aspect of your day, deciding in advance when and where you will complete documentation keeps you on track.
Minimize Task Switching
It’s tempting to juggle patient care, inbox messages, and documentation all at once, but constant switching fragments your attention and slows you down. This is what is known as attention residue.
Instead of struggling to do everything at once, try to dedicate specific blocks of time for notes, messages, and testing review. Batch similar tasks together, even if you’re only spending 15 minutes on them.
When possible, set clear expectations with your staff and patients about response times to minimize interruptions. You might also include setting a defined limit on the number of back-and-forth messages you exchange with patients. After a specified number within a given time frame, consider if an office visit or tele-visit is required.
Setting aside time to tackle your in-basket before or after clinic can also make a big difference. When you handle these tasks during these quieter times, you’re less likely to get interrupted. You’ll also be protecting your time at home. Even a focused 30 minutes per day will help you to stay on track while lessening the impact of work on your personal life.
Use Smart Phrases and Macros
Most EHR systems allow you to create shortcuts for frequently used phrases, reducing typing and dictation time and improving efficiency. Develop smart phrases for common explanations, patient instructions, and standard findings to streamline your workflow without sacrificing quality.
If you have access to a “super user”, or an EHR specialist, make use of them. These individuals can help you navigate the fine points of your EHR and make your work more efficient.
Make Templates Work for You
Templates are invaluable for structuring your notes efficiently. Whether you modify existing ones or create your own, templates ensure consistency, save time, and reduce cognitive overload. By having a template, your notes will make sense and you’ll ensure nothing is left out.
Keep in mind that a good template should be readable, relevant, and concise. No one benefits from pages of repetitive text or unnecessary jargon. And since patients have access to your notes, including unclear verbiage can trigger more messages in your inbox.
Create a Problem List
One important aspect of your EHR strategy is an accurate and updatable problem list. By keeping the list complete and up to date, you will save yourself untold hours of frustration. That’s because repeatedly scrolling through a chart trying to cobble together a current history is a waste of precious time, both during office visits and when trying to put test results into context.
When you use a well-curated problem list, you’ll also inspire greater confidence. When you have all the relevant information at your fingertips, it will be clear to your patients that you are up to date on their health concerns, testing, and any surgeries or procedures.
An important caveat: you can’t always depend on the EHR to generate a factual or relevant problem list. This is something that may require some work on the front end.
Explore AI and Automation
If your EHR offers AI-powered documentation tools, voice recognition software, or automation features, consider incorporating them into your workflow. While technology won’t solve every issue, it can significantly reduce time spent typing and organizing information.
Just be mindful that AI isn’t perfect, and it’s no substitute for clinical judgment or personal attention. Always review its output carefully before sending it out into the world with your signature.
Take Back Your Time
EHR-related burnout is real, but it isn’t inevitable. By implementing simple, consistent strategies, you can regain control over your documentation.
You’ll free up valuable time for patient care and enhance your professional fulfillment and joy. Plus, you’ll break free from the cycle of late-night charting, creating more space for rest and balance. Instead of feeling tied to your screen, you’ll have more time to recharge and be present for yourself and for the people that matter most to you.
What strategies have helped you manage your EHR workload? Drop me a note. I’d love to hear from you!
If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.
And if you’d like to schedule a complimentary coaching discovery meeting, click the button below.
Bike Shedding for Physicians: Avoiding Trivial Time Wasters
Your time is precious. You have a demanding and consuming professional life. In all likelihood, you're juggling multiple priorities at any given time. Sometimes the most trivial issues seem to claim the most attention. But as a physician, it's important to be able to focus on the things that really matter, and to avoid getting dragged down into the weeds.
It’s useful to consider the phenomenon known as bike shedding. In a nutshell, bike shedding is a term used to describe the tendency to spend disproportionate amounts of time and energy on relatively minor issues, while neglecting more important but complex concerns.
An earlier version of this article appeared on this website in August, 2023
Your time is a precious commodity, but if you’re like many physicians, you give it away freely. In all likelihood, you're juggling multiple priorities at any given time, trying to get it all done while striving to stay on schedule and keep your patient satisfaction scores high.
Sometimes it’s the most trivial issues that seem to claim the most attention. But as a physician, the work you do has value, and your best work often takes time. Protecting your attention is critical. That’s why it's important to be able to focus on the things that really matter, and avoid getting dragged down into the weeds.
In thinking about the way you use your time, it can be helpful to consider the phenomenon known as bike shedding. The concept isn’t new, but it may be unfamiliar if you don’t hang out with business gurus. The term was coined by C. Northcote Parkinson, a British management expert and naval historian, in the 1950s. In introducing the idea of bike shedding, he described a committee meeting that is called to discuss a specific financial agenda. On the agenda is:
a nuclear power plant costing tens of millions of dollars
a bike shed for the plant costing a few hundred dollars
a coffee budget amounting to about twenty-five bucks
The nuclear power plant is way out of anyone’s comfort zone, and no one wants to look ignorant or ask too many questions. So they quickly approve the budget and proceed to focus on the more familiar topic of the bike shed. After extensive discussion, argument, and finally compromise and agreement, they complete the deliberations over the bike shed with a feeling of satisfaction. They round out the meeting with an hour-long debate over the coffee budget, a topic on which they all have a strong opinion.
How Doctors Fall Victim to Bike Shedding
In a nutshell, bike shedding is a term used to describe the tendency to spend disproportionate amounts of time and energy on relatively minor issues, while neglecting more important but complex concerns. If you’ve spent any time in hospital committee meetings, you can probably relate to this phenomenon. Issues such as EHR functionality and staff management can sometimes fall into this category.
But bike shedding can also happen in your personal life. For example, you might spend hours researching the perfect running shoes, instead of focusing on your training plan. Or you might spend days agonizing over the color scheme of your living room, while putting aside more important but complicated family issues at home.
It’s natural to want to escape from stressful decisions by focusing on things that don’t really matter. And the importance of taking time to step away from the chaos of the day cannot be overstated. But spending that precious time perseverating over things that are not meaningful can be counterproductive.
The bigger problems are still looming. What’s worse, these are the issues that tend to build up steam the longer they are ignored. Eventually you may find that you are pushed or dragged into action, whether you feel ready or not.
From Spinning Wheels to Forward Motion
So how to shift gears and get back on the road? Here are some tips to help you identify and avoid bike shedding, whether at work or at home:
Identify your priorities
🚳What's most important to you? Once you know your priorities, you can make decisions more easily and avoid getting bogged down in trivial matters and unnecessary conflicts.
Delegate
🚳If you can delegate tasks, do it. Delegation is important both at home and at work. This will free up your time so you can focus on the things that matter most
Remember the big picture
🚳When you're feeling overwhelmed, take a step back. What are your long-term professional goals? What do you want to achieve in your personal life? How can you break that down into achievable steps? Keeping your goals in mind will help you to stay focused on the important things.
Set boundaries
🚳It's important to set boundaries so that you spend your time purposefully. This could mean saying no to extra work commitments with little upside so that you can make time for yourself and your loved ones. Or it could mean giving up your spot on the neighborhood committee that causes you stress and lost sleep, when you’d really rather be gardening.
It’s natural to default to bike shedding. It’s a way of avoiding stress and putting off difficult questions. But it's something that you can learn to recognize, navigate, and redirect.
If you find yourself getting caught up in bike shedding, tap the brakes and ask yourself if it's really worth your time and energy. If not, let it go and move on.
If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.
And if you’d like to schedule a complimentary coaching discovery session, click the button below.