The Power of the Pause: Creating Engagement and Presence

An earlier version of this article appeared on this website in November 2023.

If you’re a surgeon or proceduralist, you already know the power of a timeout. That intentional pause before a procedure—where the entire team stops to confirm the plan, clarify roles, and ensure nothing has been missed—is more than a safety checklist. It’s a brief, structured moment of presence.

What if you took the concept of taking a pause out of the OR or the lab and into the other demanding parts of your day? Taking a moment to come up for air between office visits, meetings, or complex patient care could help to clear your mind and reset your focus. But my guess is that very few of us actually do this.

Backed by Data: The Power of a Brief Reset

Research from Microsoft's Human Factors Lab supports the idea that taking a personal pause can not only help you to reset but may even improve your engagement with your next patient or procedure.

Since this was Microsoft, the study looked at the way people engaged in meetings. The 14 subjects were tasked with wearing an EEG while participating in video meetings. Each meeting lasted 30 minutes. On one day, they took part in four back-to-back meetings, without a break. On the other, each meeting was followed by a 10-minute pause. Instead of simply checking their phones, the participants meditated with the Headspace app.

The results were striking: analysis of brain wave activity revealed that even a short meditation pause led to increased engagement in the meeting that followed.

Conversely, with no pause, there was EEG evidence of greater stress during the next meeting.

We often equate productivity with hours slogged and logged. But this study—and others like it—suggest that sustained engagement may be a more meaningful, and healthier, metric.

The business world may embrace concepts like mindful pauses, but applying them in healthcare can be more challenging. Between the unending inbox, your dwindling support staff, and the push to do just one more thing, the pace can feel relentless.

But that’s exactly why building in brief, intentional moments of stillness—even just a breath between tasks—can be so powerful. These moments give you a chance to regather and reharness your energy and your focus.

Practical Strategies for Pressing Pause

How can you begin to practice taking a pause? It’s not always practical to take a 10-minute break for meditation in the middle of a busy day. But even a few mindful moments can help. Here are a few practical tips that can help you to create a little breathing space for yourself and to be more present for your patients:

Breathe Mindfully

Take a few deep, intentional breaths before going in to see a difficult or complex patient. Focus on the sensation of the breath entering and leaving your body. This simple act can help anchor your awareness to the present moment.

Body Scan

Conduct a quick body scan to release tension. Start from the top of your head and gradually move down to your toes, paying attention to any areas of tightness or discomfort. Allow these areas to relax, even if it’s just a little.

Mindful Observation

Take a moment to observe your surroundings without judgment or reactivity. Notice the colors, textures, and sounds in your environment. This brief shift in attention can provide a mental break and promote a sense of calm.

Name What You’re Feeling

Before moving on to the next patient or task, pause to mentally name what you’re feeling. That could be anything. Perhaps it’s overwhelmed, focused, frustrated, or calm. It doesn’t really matter whether it’s positive, negative, or neutral. This brief check-in helps increase your emotional awareness and gives you a chance to reset before shifting gears.

Feel Your Feet

As you’re walking down the hall or in from the parking lot, take a moment to bring your awareness to the sensation of your feet on the ground. Feel the pressure and the contact as your shoes connect with the floor. This small act of grounding can quickly bring you back to the present.

Set an Intention

Before a meeting or procedure, pause for a few seconds and mentally set an intention. Perhaps it’s “Stay focused,” “Listen with awareness,” or “Lead with presence.” A clear intention can shape how you show up, even in high-pressure moments.

Hand Over Heart

If you’re feeling overwhelmed or scattered, place your hand over your heart and take a few deep breaths. This simple gesture engages your parasympathetic nervous system and can create a sense of grounding and self-compassion.

From Personal Practice to System Shift

Taking a mindful pause is not just a momentary escape from a hectic schedule. By taking a few moments of stillness to reset, you access a powerful way to recharge your energy, sharpen your focus, and deepen your connection with the people you care for. Over time, these brief pauses become an investment in your well-being and in the quality of your presence.

It’s time for healthcare organizations to embrace what companies like Microsoft have already realized: sustainable performance requires space to pause. These moments can’t just be the responsibility of the individual—they must be supported by the system. When organizations stop trying to fill every second and instead allow time for reflection and reset, they empower physicians to stay engaged, energized, and able to deliver their best care.

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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 coaching discovery session, click the button below.

Making Early Decisions for a Successful Retirement: My Podcast Appearance on Michael T. Swartz’s “Health and Wealthness”

I thoroughly enjoyed my conversation on Michael T. Swartz, CFP®, PDC's Health and Wealthness podcast.

Michael has created a fantastic series for physicians called The Physician’s Guide to Retirement. Retirement is different for all of us. I retired after nearly 30 years in practice in order to pursue other passions and interests. Others may practice decades longer, and some may make the choice to retire earlier. No matter how retirement looks for you, you’re likely to find this series valuable and inspiring.

As an invited guest, I shared my personal experience and my ideas around ways that physicians can create a sustaining and exciting life after retirement from medical practice. This is the first of two episodes. If you're curious about what life might look like on the other side, take a listen!

Michael is not only a Certified Financial Planner, but he is also a Certified Physician Development Coach, so he understands the particular needs of physicians who are looking towards retirement. As we discussed in our conversation, it’s never too soon to start thinking about your future. Setting aside even a little money regularly beginning in your 30s will provide you with so many more opportunities as you begin to contemplate retirement in your 50s or 60s.

My podcast appearance on Health and Wealthness

The Myth of Multitasking: Why It May Be Hurting Your Efficiency and Patient Care

Multitasking is often considered an essential skill for physicians and others in high-stakes professions. From my earliest days in medicine as an intern on the HIV wards in the late 1980s, those who could juggle the most tasks at any one time were considered the true heroes. And those who balked at the notion were considered dinosaurs or even slackers, out of touch with the reality of modern medicine.

Like many doctors, I embraced the challenge during the years and decades that followed. With ever-growing patient care demands, constant interruptions, and endless inbox messages, doing more things at the same time seemed like the only way to keep from stalling out. It was a point of pride, and it gave the illusion of intense focus and efficiency.

It’s now clear that the reality is starkly different: multitasking often leads to increased errors, inefficiency, and heightened stress.

A study of Australian emergency physicians found that ER doctors are interrupted nearly 10 times per hour. In this study, the more physicians were interrupted or attempted to multitask, the more medication errors they made. This effect was even more pronounced when the physicians were sleep-deprived. The researchers found that below-average sleep led to a disturbing 15-fold increase in clinical errors.

As you would expect, the ER is an ideal place to study the impact of multitasking, and other studies in theses settings have come to similar conclusions.

The same phenomenon plays out in the hospital. Picture this:

You’re on rounds in the CCU. A critically ill patient just had a rhythm change, your phone buzzes with a consult request, and you’re simultaneously reviewing morning labs, finalizing a discharge summary, and answering a staff question about another patient’s medication dose. You’re flipping between screens in the EHR—labs, imaging, notes, inbox, and back again—trying to keep up. Then suddenly, you realize… you almost signed off on the wrong discharge med for a different patient. Sound familiar?

In that moment, one thing—the critically ill patient—needs your full attention. The other tasks are important, but they are not urgent. Yet, the mental overload from constant task-switching makes errors more likely, slows you down, and increases stress.

Why We Think We’re Good at Multitasking

Physicians are trained to process multiple inputs under pressure—responding to pages while reviewing labs, answering questions during procedures, thinking three steps ahead during a patient encounter. It feels like multitasking, and you probably get praised for doing it well. But research shows that what we call “multitasking” is actually task-switching, and this constant shifting leads to cognitive overload and more mistakes.

The illusion of productivity masks the toll it takes on your attention and performance. Over time, this constant mental shifting can erode not just your focus, but also your well-being and sense of control.

Practical Strategies to Reduce Multitasking and Increase Focus

While we can acknowledge the harm it may cause, the truth is that multitasking is not going to completely disappear. In healthcare, where dealing with the unexpected is part of the job, it’s not realistic to think that you can avoid multitasking completely. But you can limit it, and you can plan ahead so that the impact is minimized and your focus is protected. Here are some ideas to get you started.

✅ Complete Before Moving On

Before EHRs, a common efficiency tip was: “Touch each piece of paper only once.” Although paper charts are long gone, the same principle applies in today’s digital world. It means that whenever possible, close out one task before moving to the next. Protecting your attention in this way reduces mistakes, improves your workflow, and most importantly, helps you stay fully present for your patients.

• Click it, complete it, close it. Whenever possible, finish one task before starting the next.

• Batch related tasks to stay in flow. Group similar activities—like reviewing imaging, responding to messages, or finishing notes—into dedicated blocks of time to minimize context switching and boost efficiency.

✅ Prioritize Tasks by Urgency and Importance
Emergencies deserve immediate focus. Everything else? It can often wait. Develop the habit of quickly categorizing tasks so you can allocate your mental bandwidth accordingly.

✅ Break Large Tasks into Smaller Steps
A massive to-do list creates overwhelm, increasing the temptation to multitask. Instead:

• Focus on one completable step at a time.

• Track your progress to build momentum and reduce unfinished-task anxiety.

✅ Delegate When Appropriate
Trying to do everything yourself leads to burnout and inefficiency. For example, one of my coaching clients, a highly skilled proceduralist, was constantly behind on his work—not because he lacked skill, but because he spent too much time checking his staff’s work instead of delegating. His inefficiency put his job at risk, and it frustrated his staff. Learning to delegate strategically got him back on track. When done right, delegation builds trust and camaraderie while freeing up your cognitive resources for what matters most.

• Delegate lower-stakes tasks that don’t require your expertise.

• Trust but verify—educate your team, give them a reasonable degree of autonomy to carry out their assigned tasks, but maintain a structured review process.

✅ Use Time Blocking to Protect Deep Work
Scheduling dedicated time for specific tasks—such as charting, reviewing imaging, or preparing for boards—helps maintain focus and reduces cognitive switching costs.

• Communicate your schedule with your team or family to minimize unnecessary interruptions.

• Create a “protected time” window for deep work whenever possible. Turn off notifications, put hard limits on your social media use, set boundaries, and commit fully to the task at hand.

Final Thoughts

Multitasking isn’t a badge of honor—it’s a hidden drain on your performance. In a busy medical practice or an intense hospital environment, it can’t always be avoided. But by prioritizing effectively, reducing task-switching, and implementing strategies like delegation and time blocking, you can work smarter, reduce your stress, and improve both efficiency and patient care.

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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 coaching discovery meeting, click the button below.

When Physicians are Disrespected: My Guest Appearance on the Podcast by KevinMD

If you’re a physician, or anyone active in healthcare today, you have probably heard of Dr. Kevin Pho and his KevinMD podcast and website.

Not only does he offer a curated selection of articles tailored to physicians and others in healthcare, Dr. Pho also hosts a podcast for thought leaders in the medical field. I was honored to be invited back as a guest.

In this episode, which originally aired in October 2023, we talk about the epidemic of disrespect faced by physicians today, and clear steps you can take to advocate for yourself and reclaim your dignity.

This is a topic I wrote about in Preventing Physician Burnout: Reclaiming Your Dignity. An earlier version of the article also appeared on the KevinMD website.

When physicians and others in healthcare are treated respectfully, the practice of medicine becomes more sustainable and more inclusive.

My podcast appearance discussing disrespect on the Podcast by Kevin MD.

Thriving Amidst Chaos: Prioritizing Health, Self-Care, and Mindfulness

An earlier version of this article appeared on this website in October 2023

When your days are busy and your evenings are full, making time for your own well-being can sometimes feel like just another thing to check off your endless to-do list. If you’re like many physicians, self-care often falls by the wayside.

The truth is that you need to recharge and refresh in order to be the best version of yourself. And, as important as it is to care for your own health and happiness, it’s not just about you. When you care for yourself, you’ll be better equipped to care for those who depend on you.

In this article, we’ll explore why self-care matters, including the impact of self-care on stress management. Next, I’ll give you some simple steps that will help you to put these ideas into motion. By caring for yourself, you’ll be empowered to thrive amidst the daily storm of medical practice.

The Impact of Stress on Burnout

It’s common to think of stress as harmful and something to be avoided. But stress can affect your health positively as well as negatively.

Positive stress (or eustress) happens when you face a challenge or a deadline that you know you are capable of meeting. It might be a stretch, but you know it’s possible. And importantly, there is a reward waiting on the other side.

While positive stress can propel you towards your goals, negative stress (sometimes called distress) can lead to frustration and burnout. Negative stressors are those forms of stress over which you have no control. A boss (or spouse) who is never happy, a job for which you are never rewarded or thanked, and escalating demands at work without adequate time off to rest and reset are all forms of negative stress.

Constant and unrelenting stress can lead to burnout. The World Health Organization defines burnout as an “occupational phenomenon.” Burnout is characterized by

• Exhaustion and loss of motivation

• Cynicism and negativity

• Inefficiency

Given the current state of healthcare, it’s no surprise that nearly half of physicians reported at least one manifestation of burnout in 2024.

It’s important to remember that burnout is not your fault. By definition, it is a symptom of a dysfunctional system or workplace. Perfectionists, people-pleasers, and so-called workaholics seem to be more susceptible. Not surprisingly, these personality types are common for physicians. But developing some tools to help you get through tough times can lessen the impact and improve your overall happiness and wellbeing.

Self Care and its Benefits

Self-care is not just about pampering yourself. It's about taking care of your mental, emotional, and physical well-being.

Committing to self-care can enhance your focus, improve relationships, lower stress, and mitigate burnout. Acknowledging the mind-body connection is often the first step towards effective self- care.

Nutritional Psychiatry and Stress Management

The new field of Nutritional Psychiatry focuses on the growing body of research that strongly connects what you eat to how you feel. Without a doubt, mental health is complex and multifaceted. Diet is only one part of the big picture.

But when you’re famished and pressed for time, the quickest options can undermine you, sabotaging your best intentions and sapping your energy.

As it turns out, those ultra-processed foods that often pass for nutrition in the doctor’s lounge or office snack machine can raise your risk of anxiety, sleep disturbance, depression, food addiction, alcohol use disorder, and increased inflammation. Artificial sweeteners in particular have been linked to a greater risk for depression.

Instead, consider switching in simple elements of the Mediterranean diet like fruits, nuts, whole grains, olive oil and fish. You probably know that the Mediterranean diet supports heart health and may reduce the risk for certain cancers. But this diet is also linked to improved symptoms of depression and better mental health and well-being. There’s also emerging evidence that a Mediterranean diet can improve perceptual performance.

It might take a little planning, but going Mediterranean doesn’t have to be complicated. Simply packing a nourishing lunch or advocating for healthier options at work can make a difference.

Exercise and Health

You already know that regular exercise will lower your risk for heart disease, cancer, bone disease, and dementia, among other dreaded conditions.

But research has also shown that exercise can reduce anxiety, improve sleep, and improve immune function. It doesn’t take a lot of exercise to reap the benefits. A brisk 15 minute walk a few days a week is a great way to get started.

Mindfulness and Self-Care

"Mindfulness is the awareness that arises when we nonjudgmentally pay attention in the present moment.” These are the words of Jon Kabat-Zinn, PhD., Professor of Medicine Emeritus at the University of Massachusetts Medical School, and the godfather of mindfulness in healthcare.

Put even more simply, mindfulness is undistracted attention.

Practicing mindfulness has a wealth of benefits, some of which you might not anticipate, including

• Healthier lifestyle choices

• Less stress and anxiety

• Greater parasympathetic tone

• Better cardiovascular health

• Improved immunity.

If it all sounds a little woo, know that mindfulness doesn’t have to be about practicing yoga or meditating. You don’t need a special cushion or a meditation app, although those can be nice. Instead, it’s about being undistracted, nonreactive, and fully present in the moment.

Getting started with mindfulness isn’t complicated. Simply set aside 3-10 minutes of quiet time each day to observe the present moment. Notice your thoughts and let them go, returning to the present when your mind wanders.

It is this practice of continually returning to the present moment that develops the “mindfulness muscle.”

When you practice mindfulness, you may find that your presence, and hence communication, with patients and colleagues becomes easier and more engaged.

Create an Action Plan

Creating an action plan will help you to set realistic goals and track your progress. Write out the steps that you need to take to commit to your self-care. And develop a plan that is realistic and actionable.

Consider enlisting a partner or friend with whom you can share accountability to help you to stay committed. Something as simple as a daily reminder on your phone may also keep you on track.

The ripple effect of taking your own self-care to heart will show up in your energy level, creativity, and relationships. You may notice a greater sense of self-compassion and equanimity. And in time, your path forward toward the goals that matter will become more clear.

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.

References

Adan, R. A. H. et al. (2019). Nutritional psychiatry: Towards improving mental health by what you eat. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology, 29(12), 1321–1332.

American Medical Association & American Medical Association. (2024, July 2). Physician burnout rate drops below 50% for first time in 4 years. American Medical Association. https://www.ama-assn.org/practice-management/physician-health/physician-burnout-rate-drops-below-50-first-time-4-years

APA Dictionary of Psychology. (n.d.). https://dictionary.apa.org/eustress

Brulé, G., & Morgan, R. (2018). Editorial Working with stress: can we turn distress into eustress? ResearchGate. https://www.researchgate.net/publication/324531212_Editorial_Working_with_stress_can_we_turn_distress_into_eustress

Davidson, R. J. et al. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic medicine, 65(4), 564–570.

Ezzatvar Y, Ramírez-Vélez R, Izquierdo M, et al. (2022). Physical activity and risk of infection, severity and mortality of COVID-19: a systematic review and non-linear dose–response meta-analysis of data from 1 853 610 adults. British Journal of Sports Medicine 56:1188-1193.

Gilbert, D., & Waltz, J. (2010). Mindfulness and health behaviors. Mindfulness, 1(4), 227–234

Lane, M. M. et al. (2022). Ultra-Processed Food Consumption and Mental Health: A Systematic Review and Meta-Analysis of Observational Studies. Nutrients, 14(13), 2568.

Loucks, E. B.et al. (2015). Mindfulness and Cardiovascular Disease Risk: State of the Evidence, Plausible Mechanisms, and Theoretical Framework. Current cardiology reports, 17(12), 112.

Martinez-Gonzalez, M. et al. (2019). The Mediterranean Diet and Cardiovascular Health: A Critical Review. Circulation Research 124:779-787

Munoz, M.A. et al. (2009). Adherence to the Mediterranean diet is associated with better mental and physical health. British Journal of Nutrition. 101 (1821-1827),

Samuthpongtorn C et al. (2023). Consumption of Ultraprocessed Food and Risk of Depression. JAMA Netw Open. 2023;6(9):e2334770. doi:10.1001/jamanetworkopen.2023.34770

Shanafelt, Tait D. et al. (2022). Changes in Burnout and Satisfaction With Work-Life Integration in Physicians During the First 2 Years of the COVID-19 Pandemic. Mayo Clinic Proceedings, Volume 97, Issue 12, 2248 - 2258

Stubbs, B. et al. (2017). An examination of the anxiolytic effects of exercise for people with anxiety and stress-related disorders: A meta-analysis. Psychiatry research, 249, 102–108.

World Health Organization: WHO. “Burn-out an ‘Occupational Phenomenon’: International Classification of Diseases.” World Health Organization, 28 May 2019, www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases.

Yin, W. et al. (2021). Mediterranean Diet and Depression: A Population-based Cohort Study. International Journal of Behavioral Nutrition and Physical Activity, 18(1). https://doi.org/10.1186/s12966-021-01227-3

Young, H. A. et al. (2022). Mediterranean diet, interoception and mental health: Is it time to look beyond the ‘Gut-brain axis’? Physiology & Behavior, Volume 257.

Journaling for Physicians: Find Balance, Gain Clarity, and Envision Your Future

Journaling can help you to perceive the lines that connect the dots. Through this accessible and time-tested form of self-reflection, you can build stronger connections with what and who matters most, At the same time, a writing practice may help you to give name to the obstacles that may be keeping you from living a life aligned with your values and goals.

In previous articles, we’ve explored the way that journaling can help you think through challenges, reflect on the present, and see yourself through your own words and dreams. In this third and final set of journaling prompts for physicians, I offer prompts that you can use to explore your own definition of balance both now and for the future.

As you gain clarity on the ways the diverse branches of your life intertwine, unexpected or creative ways to bring harmony to your work, your personal life, and your passion projects may emerge. Through journaling, you'll gain a deeper understanding of how you want to shape the life you envision. You may even rediscover a path that you lost sight of years ago and find that it is ready to be explored once again.

Finding Balance

1. How do my work, personal projects, family, and relationships influence each other? Are they currently in harmony? If not, what might need to change?

2. What does a balanced and fulfilling life look like to me? How close am I to that vision? What small steps might I take to start the journey?

3. Are there areas of my life (work, personal projects, family, or relationships) that I feel are receiving too much or too little attention? How can I redistribute my time and energy?

4. How do I prioritize between competing demands from work, personal projects, and loved ones? Is this system serving me well?

5. What is one thing I could change this month to better integrate work, personal projects, family, and relationships?

Creating Alignment

1. How do my work and personal projects align with my values and the type of life I want to build for myself, my family and/or my relationships?

2. What shared values or goals do I want to cultivate in my family and/or relationships, and how can my work and personal projects support these?

3. Are there ways I can involve my loved ones in my personal projects or bring my personal passions into my professional life?

4. Are there personal projects that I enjoy or aspire to that could open the door to new and sustaining relationships or communities? If so, how might that look?

Evaluating Impact

1. How does my work affect my personal projects, family, and relationships? Are these effects positive or negative? What adjustments could I make so that the impact is positive and sustaining?

2. How do my personal projects enrich my work, family life, or relationships? Are there new projects I could pursue to strengthen these connections?

3. When was the last time I felt deeply connected to both my professional and personal life simultaneously? What factors contributed to that feeling?

Fostering Connection

1. How do I make space for meaningful connections with my family and/or relationships despite work and personal project commitments? Is there one thing I could do this week to foster a deeper connection?

2. What specific actions can I take to ensure my loved ones feel valued and supported while I also pursue my work and personal goals?

3. How can I communicate my professional and/or personal aspirations and priorities with my family and relationships in a way that strengthens our connection?

Reframing Challenges

1. What challenges arise from balancing work, personal projects, family, and/or relationships? How can I view these challenges as opportunities for growth?

2. How do I handle moments when one area of life feels overwhelming and starts to impact others? What strategies or boundaries might help?

3. Are there sacrifices I’m making in one area of life for another? Are those sacrifices necessary or avoidable?

4. Is there something that I should let go of in order to give space for other opportunities, or for my relationships?

Visioning the Future

1. What would an ideal day look like if I seamlessly integrated work, personal projects, family, and/or relationships? What steps can I take toward that vision?

2. How do I want my work, personal projects, family, and relationships to evolve in the next 5-10 years? What specific actions can I take to guide this evolution?

3. Imagine celebrating a major milestone in my personal or professional life with my loved ones. What does that moment look and feel like, and how can I create more of those moments?

Reflecting on Fulfillment

1. What brings me the deepest sense of fulfillment? How can I prioritize those elements so that it encompasses the people and things that matter the most to me?

2. How do I ensure that my successes in work and personal projects don’t come at the expense of meaningful relationships and family life?

3. What legacy do I want to leave behind in my career, personal life, and relationships? Are my current efforts moving me toward that legacy?

I hope that you’ve enjoyed this journaling series. If you have any prompts that you’d like to share, 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 session, click the button below.

Bike Shedding for Physicians: Avoiding Trivial Time Wasters

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.

Journaling Prompts for Physicians: Rediscovering Your Personal Life

In an earlier article, I explored the way that journaling can help you to reconnect with your inner wisdom, helping you to find a path forward when you feel stuck or uncertain. In that article, I delved deeper into the practical mindfulness of journaling, and the benefits of writing by hand, whether in a conventional notebook or a handwriting tablet .

Journaling has been called the “paper mirror.” It reflects back to you, the writer, what you might not see of yourself. Yet unlike a true mirror, the journal’s mirror is private and personal. Given this introspective aspect, it’s not surprising that studies of people engaged in journaling have reported evidence of improvement in both psychological and physical well-being.

Of course, journaling can also resurface unpleasant thoughts and memories. That’s not always bad. Some people find the safe space of their notebook to be a perfect container for catharsis. Getting the words out of your head and onto the page can be uncomfortable, but the process may allow you to let go of those thoughts and fears that are holding you back, freeing up mental space. If it feels right, you might even want to ceremonially destroy your journal once the “bad” stuff is out.

But if it feels overwhelming or resurfaces trauma that you’ve suppressed, then journaling may also be the nudge you need to begin working with a therapist who can help you process complex memories and emotions.

In this article, I am offering prompts that will give you space to dive into your life outside of work. Let them be a scaffolding that helps you to explore the ways that personal projects, family, and relationships might intersect in your life. By intentionally putting your thoughts on paper, you may uncover ideas for mindful action that begin to align these aspects of your life with your ideal self.

Exploring Family Through Journaling

1. How do I currently nurture my relationships with my family? What more could I do?

2. What values do I want to model for my family? How can I live those values more fully?

3. What are some of the most meaningful moments I’ve shared with my family recently? How can I create more moments like those?

4. If I could describe the ideal dynamic I want with my family in one sentence, what would it be?

5. Are there any unresolved tensions or conflicts in my family relationships? How might I approach them with compassion?

6. How does my professional life affect my family life, and are there changes I could make that might bring greater harmony?

7. What are some small ways I can show appreciation to my family this week?

Journaling to Strengthen Relationships

1. Which relationships in my life feel most nourishing? What makes them important to me? How can I deepen those connections?

2. Are there relationships that feel draining or misaligned with my values? What boundaries might I need to set?

3. What does a fulfilling relationship with a romantic partner look and feel like to me? How about a friend? How do my current relationships align with that vision? How can I create more of that?

4. When was the last time I expressed gratitude or love to someone important in my life? How did it feel?

5. Who do I turn to for support, and how can I show them appreciation for being there for me?

6. Are there people I’ve lost touch with who I’d like to reconnect with? What’s one small step I can take this week to reach out?

7. What qualities do I bring to my relationships that make them stronger? How can I lean into those strengths?

8. How can I better communicate my needs, desires, and feelings in my closest relationships?

Empowering Personal Projects

1. What personal project excites me the most right now? What about it feels important or meaningful to me?

2. Are there projects I’ve set aside that I would like to revisit? What’s holding me back?

3. How do my personal projects reflect who I am and who I want to become? Where might they lead me?

4. Is there a skill I’ve been meaning to learn, a book I want to read, a trip I want to take, or something else? What small step can I take this week to make progress on something that I care about?

5. If I had unlimited time and resources, what would I pursue? Why? How might that change my life?

6. How do my personal projects bring a sense of balance to my life, and how can I prioritize them more effectively?

7. What have I learned about myself through my personal projects? What strengths or interests have I uncovered?

Integrating Self, Family, and Community

1. How do my personal projects, family, and relationships influence each other? Are they in harmony or competition?

2. How might the personal projects that inspire me connect me more deeply with people who share my passions and values?

3. What would it look like to balance meaningful work, personal growth, and rich relationships all at once?

4. What’s one thing I can do this week to bring these aspects of myself into greater alignment?

5. How do I want the people closest to me to remember me, and what can I do now to honor that vision?

I hope this list has inspired you. In the next article in this series, I’ll provide you with a series of prompts that will help you go deeper into creating balance, fostering connections, reframing challenges, and envisioning the future.

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My Podcast Interview with Livia Robic of Withings for BeamO

I recently spoke with Livia Robic of Withings about the BeamO device for the TechLink Health podcast. This handheld consumer device includes a pulse oximeter, a thermometer, a mini-ECG and an electronic stethoscope.

BeamO is designed to help physicians take better care of their patients remotely, and was named one of Time magazine's "Best Inventions of 2024". This was such an interesting and engaging episode, and I can imagine a number of scenarios where this device could make a difference for patients with chronic disease or those recovering from surgery. I’m excited to see what the future holds for BeamO!

You can find our conversation anywhere you listen to podcasts, or through the Spotify link below.

My Podcast Interview with Peter Adams for Vielight Inc.

As a podcast host for TechLink Health, I had the opportunity to interview Peter Adams with Vielight Inc. This is a fascinating new technology integrating photobiomodulation for brain health.

The device is already being used by athletes, including former NFL players, for brain recovery protocols. Leading medical centers including UCSF and Harvard, have published research on Vielight, as has the Veterans Administration.

I thoroughly enjoyed our conversation, which you can find anywhere you listen to podcasts, or through the Spotify link below.

Coaching for Healthcare Leaders

As a member of the American College of Cardiology’s Physician Well-Being Working Group, I am fortunate to be part of the change that’s happening within cardiology and healthcare in general.

Coaching is increasingly recognized as a way to support and retain physicians, an aid for reducing burnout, and a tool that can improve the healthcare environment for physicians, staff, and the patients that we serve.

The first in a series of webinars put on through the ACC was presented in early 2024. You can watch it here, or maybe take it along with you and listen during your commute to work.

My Podcast Interview with Cyber-Security Expert Anand Naik

We all know that cybersecurity is crucial in healthcare to protect sensitive patient data, ensure the integrity of medical devices, and maintain the overall trust in healthcare systems. Whether in the role of physician or patient, we depend on the people and systems working behind the scenes to keep us safe.

As a host of the recent episode of Techlink Health Podcast, I learned a lot from Anand Naik, including how advancements in IoHT/IoMT security and AI-driven protection are being harnessed to safeguard the future of connected health.

For tech-savvy physicians looking for alternatives to clinical medicine, or side gigs in the healthcare sphere, cybersecurity might be an area that could use your expertise and insight.

My Podcast Interview with Dr. Kevin Smith

This was such an interesting conversation with facial plastic surgeon and ENT Dr. Kevin Smith for TechLink Health! I was fascinated to learn about the link between migraines and nasal health. Dr. Smith’s journey from college athlete to cutting edge surgeon gives him a unique perspective, which he shares on the podcast.

Dr. Smith's story shows how the combination of clinical excellence, curiosity, and persistence can impact patients' lives in meaningful ways and spark new innovations.

My Podcast Interview with Mastek’s Ritwik Batabyal

I enjoyed this conversation with Mastek's Ritwik Batabyal and David Sanchez, RN. It was a great reminder of how integral sophisticated behind-the-scenes technology is to providing optimal health care.

Rightfully, there is a lot of trepidation around the use of AI in healthcare and health technology, but the truth is that it’s already here. By understanding and optimizing the ways that we as physicians use AI, we will ensure that we have a say in the way it changes our landscape and the ways that care is delivered.

TechLink Health Podcast on Heart Smart Mindfulness

I often host the TechLink Health podcast, a show devoted to exploring the gamut of new technologies and innovations in health care. I began this journey as a guest on the podcast in 2022. The interview went so well that I was subsequently invited to host.

It’s been a lot of fun, and I always learn so much from our guests. My experience is a great example of what can happen when you take chances and say yes to opportunities that align with your purpose, even when you don’t know exactly what will happen next.

This week I’m re-sharing my first episode. The conversation ranges from insights on maintaining heart health with a busy lifestyle to the role of mindfulness on outcomes in healthcare, and the importance of addressing issues that lead to burnout in physicians and others. We also discussed the ways a creative practice can help physicians and others in healthcare.

If you’re interested in accessing some of the resources we discussed, I’ve linked to them below.

📗 The Bullet Journal Method

📙 Real Change

📲 Insight Timer: The #1 free app for sleep, anxiety and stress

📲 The Waking Up App

📲 Headspace

📲 Calm

📲 Yoga: Down Dog

A version of this article originally appeared on this website in November, 2022

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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.

My Podcast Interview with Digital Diagnostic’s John Bertrand

Artificial intelligence is making its way into healthcare at a rapid pace. By harnessing its benefits while at the same time recognizing its limitations, we have an opportunity to improve and expand access to care for a wide range of people.

This was a thought-provoking podcast conversation with John Bertrand of Digital Diagnostics about the practical and potentially life-changing uses of AI for early detection of diabetic retinopathy. The beauty of the process is the fact that it can be used virtually anywhere, and does not require a highly skilled technician to acquire the data.

My Podcast Interview with AI Pioneer Dennis Cogan of Caresyntax

It’s no secret that artificial intelligence (AI) is rapidly becoming a powerful tool in healthcare and medical science.

As a TechLink Insights podcast host, I enjoyed this very forward-thinking and inspiring conversation with Dennis Kogan of Caresyntax, a company pioneering the use of AI in surgical practice.

It’s normal to feel uneasy about these new technologies. But AI is already here, and it’s up to physicians and others in healthcare to guide its implementation and develop reasonable safety rails to protect our patients. Having met with a number of pioneers in this space through the podcast, I believe that the future looks bright for innovations in care when AI is applied thoughtfully and collaboratively.

My Podcast Interview with Tax Expert Alexis Gallati, MBA

I really enjoyed my conversation with Alexis Gallati, EA, MBA, MS Tax, CTS for TechLink Health. This was such a practical and well explained deep dive into tax strategies for physicians.

Alexis is married to a surgeon, so she has seen firsthand how little education most of us have in financial strategies, and how this lack of knowledge can hurt us and leave us vulnerable to bad advice.

This podcast addressed financial strategies related to side gigs, managing independent practices and more. Alexis is an engaging speaker and shares a wealth of practical insight.

My Podcast Interview with Health Tech Expert Shanil Ebrahim

Shanil Ebrahim is on the cutting edge of healthcare technology, with expertise not only as a scientist but also with meaningful experience in the fields of AI and health equity. His insights are timely and thought provoking.

As a frequent host of the TechLink Health podcast, it's always such a pleasure and a privilege to meet with leading innovators in the health and tech space. The industry is moving at warp speed, and it's great to have a front row seat!

You can listen to the podcast at TechLink Health as well as Spotify and Apple Podcasts.

My Podcast Interview with Grenville Thynne of Neuroflex

I recently had a fascinating conversation with Grenville Thynne for the Techlink Health Podcast. We discussed his work with the trailblazing Neuroflex company. Neuroflex’s portable technology can quickly detect evidence of concussion on site, which makes it especially valuable to athletes of all types.

The technology is also being studied in aging and neurodevelopmental disorders, and has the ability to provide objective measurements of brain function that can be tracked over time.

This was one of my favorite podcasts of the year. I hope you enjoy it.