Thomas S. Bottiglieri, D.O.

Navy SEAL teams say slow is smooth and smooth is fast. In my day-to-day activities as a physician I can feel this in my bones. Methodically I turn the door knob and remind myself over and over that, “every moment is a new adventure” to reset my mind and treat each encounter with the uniqueness it deserves. With patience and efficiency my team and I conquer our busy clinical days. Patients seem happy and there is joy in a job well done.

Administrative days on the contrary do not always feel like this. It can seem as if there is a never-ending barrage of stuff. Just one thing after another that amounts to just more todo items. Every email sent leads to two more coming back in. Every form filled, check deposited, regulation updated, IRB approved, patient request filled, calendar invite accepted leads to a sense of drowning in a sea of tasks.

How can we shift gears from the busy clinics at which we thrive, to our creative and productive selves in the management of our time and output outside of patient-care?

Many times I get lost myself trying to remember how it was that I got through past moments in which there was this sense of overwhelm. Any successful doctor can recall moments when completing a presentation, writing a paper, answering the emails, or getting ready for the next meeting seemed to be out of reach. As if looking back at the CV and seeing one’s accomplishments that someone else was driving the car. Or that somehow, now, things are just too much, and time is even more limited.

There is an underpinning of momentum that builds with success. Just like in sports when you can feel the energy balance change for a team that was losing, but suddenly there’s a play, and another, and another. Not the big, heroic effort, but rather the small things they know they can do well again and again. When you see that on a field of play – that grit and determination are miraculous to watch as the underdog finds a way to keep fighting, and sometimes even win against previously perceived insurmountable odds.

On days like this I remind myself of the efforts that did not always work out in my favor. Sometimes doing battle on that field of play ended in a loss. I can remember those games as if they were happening in this very moment. The clock winds down, and you’re out of time. All it seems one can do is look back and wish things went differently.

It is one thing to lose when you play your best game. It is another to find yourself overwhelmed and feeling hopeless in your professional life. Engaging in desperate attempts to catch-up outside of one’s own skills is a common mistake. The knee-jerk response to failures only further deepens the deficit as it is as if you are now defeating yourself as well. A team that forgets its strengths is doomed. An individual overreaching and forgetting the basics is lost.

If sports are a reflection of life, we can use the analogy to frame our days differently. There just might be an insurmountable obstacle. Maybe that job is for someone else. Ask for help. Find a way to engage other stakeholders to work together. Know your strengths and weaknesses and be willing to be vulnerable. You might build a meaningful relationship in the process.

Recount the small wins. What worked for you in the past? Set the stage for success. Map out your day. What really matters? Which tasks can be removed and which need to be done now? Set reasonable expectations and count the wins. Sometimes when overwhelm sets in it can be challenging to see the small victories starting to pile up in real time. Write them out. Take solace in completing even small, mundane tasks.

Set a clock. Put a timer on your day. Longer hours do not equal greater productivity. In fact it can actually lead to quite the opposite as we fill the empty space with wasteful energy. Limit yourself to a specific start and end so as to prevent your mind from wandering. Understanding there is a boundary on your effort will focus your mind.

Time is perception.

“Days are long and years short.”

You have more time that you think but not as much as you’d like.

These sayings all resonate in regards to finding the productive path.

The next time that sense of overwhelm kicks in remember these lessons. Losing momentum and finding one’s self lost in the weeds is not uncommon. For doctors, patient-care consumes so much of what we are. It can seem silly to unplug from the flow state at the “top of one’s license” to engage in seemingly mundane tasks. But we must take on creative tasks & self-management if we wish to maintain autonomy.

Dedicate 20% of your schedule to investing in yourself. Think of it as personal R&D. And if things are really bad, take a break, stop wasting time ruminating, and go for a walk outside. Ask yourself, “what is really important and requires my attention?” Then get back to work.