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I was flabbergasted to learn that only 2.5% of people really have the ability to multitask. And for the rest of us, we're just shifting back and forth between tasks. Who knew? It was not long ago I was struggling to be known for my area of expertise, feeling like my contributions were lost in the shuffle and unsure how to advance my career.
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I spent a lot of time juggling tasks that didn't quite align with my goals, and I missed out on a lot of precious moments with my family. But I've had my aha moment, and now I'm all about channeling my energy into activities that truly propel me forward and bring me happiness. I'm Stacey Ishman, and I'm the host of the Medical Mentor Coaching Podcast.
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I became a full professor in 2016, and I built clinical, research, and administrative programs while mentoring and coaching young academic physicians from medical school through their first 10 years of practice. Join me as we dive into all things career advancement, finding your niche, and working towards that elusive work-life integration. Welcome back to the Medical Mentor Coaching Podcast.
I'm Stacey Ishman, and I'll be talking to you today about the hidden cost of context switching. Now, if you don't know what context switching is, probably we should talk about that first. And it's really this concept of shifting back and forth between tasks.
Now, if you want to think about this in real terms, you're writing a patient note, someone comes in and asks you a question, your phone rings because they're asking you about a lab value that they need to give you a critical lab value. And as you turn back to start working on your patient note, it turns out, you know, somebody walks in the room and asks you a question, and then all of a sudden there's a ping on your computer, and there's an email that says it's urgent, and you look up and you start looking at it. You haven't gotten anything done.
So as we deal with these competing priorities and multiple responsibilities, we talk about multitasking. What is staggering to me is that research suggests that only 2.5% of people really have the ability to multitask. I can't tell you how many times I've been told that this is the way I'm supposed to get everything done, but it turns out 98% of us don't have the skill.
So it's terrible advice. And even if you're just teaching 100 people, only two are going to be able to do it. So it's important for us to really come up with other strategies that reduce context switching.
I'm going to talk to you today about the hidden cost of constant context switching, which can significantly reduce your productivity, your research output, your patient care quality, and your overall well-being. Now, the first thing that's interesting is that this fact that multitasking isn't always the option. So if you think about it, we've all been in the situation.
You're working on a talk, you're trying to get your clinical duties done, your pager goes off, there's a consult request, or hopefully you don't have a pager anymore, it's your phone, and your inbox is filling up, and there's research reminders, and you have a resident waiting for a complex case. I'm sure it sounds familiar. Now, while we pride ourselves on our ability to handle multiple tasks, context switching has actually been shown to reduce productivity by 20 to 40 percent.
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And it takes an average of 23 minutes to fully return to an original task after an interruption. You can't just jump back in the zone. And we look at primary care physicians, they experience 5 to 23 interruptions per hour during office visits.
So think about that. In the best case, in an eight-hour day, you get interrupted 40 times. But in the worst case, let's say it's 20 times an hour.
That's 160 times. How do we get anything done? And so what these statistics really highlight is the importance of creating focused work periods. And these can either be done in blocks, or they can be done in longer periods.
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But by minimizing your interruptions, you could really boost your productivity and your effectiveness, and quite honestly, hopefully get out of work earlier and enjoy your life. Now, this can be challenging, and this is a lot of time management, and oftentimes might be a cultural shift. Maybe people need to understand if it's urgent, they don't ask you every time there's a question, or they don't send you an urgent email if it's something that could all be batched and done in the 30 minutes before lunch or the hour at the end of the day.
And so think about strategies like that to protect your time. Now, the other thing can be really useful is just uninterrupted time to do things like research or presentations or even patient notes. So if this means delegating non-urgent matters to colleagues or setting up a system where they're triaged based on urgency, this might be something to consider.
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And I also recommend grouping similar tasks together. Now, whether this is doing all your results reviews at the same time or trying to do all your charts at the same time, or it's making all the phone calls you have to make back, it's going to be important. And let's be honest, you can't eliminate all interruptions.
That's going to be impossible. But try and create some more structured periods where people know not to interrupt you for some set period of time. And it doesn't have to be three hours.
It could be 25 minutes. I have this 25 minutes, and then I have five minutes at the end. I have this 25 and five minutes at the end.
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What it's known to do is enhance the quality of your work and reduce your errors. You're going to do a better job and not have to go back and redo things. Now, the reason some of this is important also is patient safety.
There is a critical link between focus and our care. Whether you're new to an institution or new to your career, we're often eager to prove ourselves. And this is often means making strides in education and research.
However, if we're switching back and forth, this can have a significant impact on patient safety. And here's some of the numbers. So research has shown that interruptions during medication-related tasks increases our error rate by almost 13%, and that each interruption is associated with a 12% increase in procedural failures and a 13% increase in clinical errors.
In addition, this high cognitive load, which you get from switching back and forth and from multiple requests, is linked to a 30% to 40% decrease in diagnostic accuracy. So all this says, as we switch back and forth, we're not as good at making a diagnosis. We're not as good at doing the procedure.
We're not as good at ordering the medications. And we make errors at a significant rate. And so these are really important as you think about how you balance your clinical responsibilities and your academic pursuits.
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And I can tell you, I used to have my research meetings in the operating room between cases. I'd have people in there talking to me about my clinical stuff while I was operating, while I was trying to do orders. I have no idea how many errors I might've made that could've been avoided had I tried to really do one thing at a time.
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And as you try and juggle multiple pieces of information, you risk overlooking crucial details. Now, as academic physicians, we're not just responsible for individual patient care, but also setting the standard for the next generation. And what I think is critically important is we need to treat our trainees, residents, fellows, medical students, and junior colleagues, the importance of working toward a safer hospital environment.
And if that is as simple as paying attention to a task until you finish it, that's what we should be teaching. I can tell you it's been mind opening to me as I started working with some of my residents and medical students in my clinic. And I said, instead of trying to do part of the note and writing it on a piece of paper and maybe typing it later and writing a path and seeing the next patient and coming back, I want you to use my template.
It includes all the questions I want you to ask. And then I want you to do it while you're in the room, because this is how you learn you're going to do it in the real life, down the road when you're making the money. And then I want you to finish the note so that you don't do anything else.
You don't see another patient. You just get that done and then move on to the next one. And this teaches you to finish the task and how much more quickly you're going to get things done if you do them in continuity.
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Now, the next thing I want to talk about is cognitive load and decision-making. The constant pressure to switch between duties, whether that's different clinical notes or questions in clinic or research in a conference preparation, it doesn't just affect your productivity, it impacts your cognitive abilities. I mean, who hasn't had a writing session where you got so many interruptions that by the time you had the time to go back to it, you no longer had the mental capacity to continue writing.
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And this frequent context switching has been shown to increase cognitive load, which leads to mental fatigue. It's also associated with the decreased ability to make decisions, something you don't want in the middle of a long call day. And this mental strain affects your ability to process complex information, a crucial skill in medicine of any kind.
So by managing your cognitive load effectively, you can maintain the mental sharpness necessary for high level clinical thinking, whether that's research analysis or teaching responsibilities or seeing the next patient in the ER. And this is really important, especially for those of you who take call, and I'm jealous of anybody who doesn't. But when you think about complex cases or designing research protocols or preparing lectures, and it's really a vital strategy to protect your mental acuity.
So creating time blocks for deep work and using mindfulness techniques to sort of reset between tasks can be really critical to help you move forward and reset the brain. Now, as a physician in academic medicine, you also have to worry about burnout prevention and career development. You want to safeguard your future.
There's likely pressure to excel at multiple areas simultaneously, but context switching or switching between tasks can lead to a sense of never truly mastering anything. And it can potentially undermine your confidence in your job satisfaction. I have absolutely finished a day and felt like I didn't get anything done.
I got half of this and half of that. And I couldn't really point to anything that made me feel accomplished. And this can spill over into your personal life.
It can affect your relationships. It can definitely affect your overall quality of life. And these constant interruptions can contribute to physician burnout with 42 to 50% of physicians reporting burnout symptoms.
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Now, this not unsurprisingly leads to decreased job satisfaction and can potentially impact your career advancement. In addition, these inefficient work practices can really limit your time in order to do the things you want to do, whether that's research or publications, it can limit or delay career progression. And this can make it so that academic medicine doesn't seem like fun anymore and just doesn't seem like the right career.
So implementing strategies to keep yourself from getting interrupted is not just about improving your immediate productivity. It's an investment in your long-term success and well-being. Focused work periods can help you manage your cognitive load effectively and allow you to prioritize your tasks.
So do the easiest things all in a row or prioritize the hardest thing first and make sure that you have a good 30-minute block to do it. And this can enhance the quality of your clinical care, your research output, and your teaching effectiveness. Now, I have some tips and tricks for managing switching.
And the goal of this is to get things done most efficiently. I recommend you try one or two or try all of them or even figure out what works for you and what doesn't. Now, I really enjoy time blocking.
And part of that's because I know that I am the smartest first thing in the morning. So I want to take a deep dive into whatever it is that's my top priority. This may be a research paper, this may be a talk, this may be finishing operative note.
But it's also great to do a lot of short little tasks and have some great quick wins. And this may be best for you to set and follow a short time block schedule where you can do 25 minutes and then five minutes off, 25 minutes and five minutes off. It gives you that dopamine hit as you check things off your list and makes you feel good about getting everything done.
And some strategies for this include the Pomodoro technique. And in this, they recommend dividing tasks into 25-minute focused work sessions. Use a timer so that you don't have to worry about interruptions and let people know that these are uninterruptible times.
Then unless there's a really huge emergency, you're going to be free in 25 minutes. So interrupt you at that point, take that five minutes, take those breaks. And then if you need to, you can do some necessary context switches between sessions.
I also recommend creating smarter to-do lists and I'll have more on this next week. But the goal is to focus on quality over quantity. I am terrible at this.
I can tell you I make every intention. I'm going to make a smart to-do list. It's only going to have three to five items.
And the next thing you know, I have 14 on my list. So what you really want to do is pick the top three priorities and understand that there's 14 things that need to be done this week, but maybe not 14 things that need to be done today, unless they're 14 really quick things that you can check 10 of them off really quick. So pick three high priority items and oftentimes try and span these across your priorities.
So if you have clinical things, if you have research things, if you have personal responsibilities, it's okay to have one of each. Or if today is really all about research, then have three of those, but start with your most challenging tasks so you can build momentum. Or like I said, do the quick checkoff list.
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I also recommend batching similar tasks and group activities that require similar mental processes, whether that's all your patient follow-ups or all your data analysis, or just making slides. And this minimizes cognitive shifts and improves efficiency. Now the last might sound a little weird, but it's to practice intentional context switching.
And by this, I mean, when you are going to switch tasks, take a moment to mentally prepare. And one of the things I was advised, and I thought it was crazy, but I actually find it useful is to briefly talk to yourself out loud about the switch you're about to make. They called it a prep talk instead of a pep talk, but it can help your brain transition more smoothly between tasks.
So if you know like, Hey, I'm going to go from research to patient notes. It might literally be it. I did this the other day.
Okay, next we're going to work on patient notes. I'm going to start with the ones from yesterday and work my way through to the end. And then I switched.
Now remember the goal isn't to eliminate all interruptions. I mentioned this before, but I don't think it's possible, but it is to have more structured periods of focused work to try and improve your outcomes, to reduce your errors and to move your career ahead more, more quickly. But most importantly, to have some personal satisfaction.
Everybody feels better if you can finish a task. I find it so frustrating when I have four half done things and I know I did some work, but there is nothing I can check off. No dopamine hit that makes me feel accomplished.
Now this may require some difficult conversations about workload distribution, some talks about boundaries with the people that you work with, and you may need to learn to delegate more effectively. But the long-term benefit is that your career will be more on track and there'll be better quality of life. If any of these tips or tricks resonates with you, I encourage you to give them a try and send me a message to let me know how they worked.
Thank you so much for joining me this week on the Medical Mentor Coaching Podcast. And I look forward to talking to you next week. While you may know that the benefit of coaching for physicians includes decreased burnout, improvement in job fulfillment, enhanced self-compassion and better sleep.
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