Portal de Periódicos da CAPES

Tuesdays to Write … A Guide to Time Management in Academic Emergency Medicine

2009; Wiley; Volume: 16; Issue: 2 Linguagem: Inglês

10.1111/j.1553-2712.2008.00337.x

1553-2712

Steven R. Lowenstein,

Innovations in Medical Education

Arnold Rice Rich, who served as professor of pathology at the Johns Hopkins University School of Medicine from 1919 to 1958, observed that, in his day, medical school faculty could enjoy "the element of repose, the quiet pursuit of knowledge, the friendship of books, the pleasures of conversations and the advantages of solitude."1 There is a general consensus among medical school faculty that those times are gone.2 Today, faculty members face relentless pressures to generate revenues from patient care or grants.2–4 It is becoming more difficult to find time to teach, balance family and career, keep up with advances in medicine and science, gather with colleagues, and engage in meaningful scholarship.2 Feeling more like hamsters than professors, faculty members work hard to meet the demands of the laboratory, classroom, clinic, and health care system, but increasingly they are challenged by time, which is in short supply. Few can enjoy the quiet repose that Professor Rich described. This article is about time management. It includes six simple recommendations that can help faculty members protect a few extra hours each week—hours that can be used for writing, study, self-renewal, or the "quiet pursuit of knowledge." As you consider these time management tips, keep in mind that it is not enough to simply "manage the clock." You also need a personal mission statement that contains a clear statement about your priorities. What do you envision for your academic career? What do you value? What do you hope to accomplish (and when)? The priorities you list should address "all facets of your life, not simply work."5 The key, according to one Howard Hughes investigator, "is to identify what matters to you in terms of interests and values, and then to apportion your activities throughout the week … to address them all."6 Successful people tend to be efficient. They have evolved practices to create blocks of uninterrupted time for "brain work." 6 Too often in academic life, the "tyranny of the urgent" sets our day-to-day priorities.7 We spend too much time attending to meetings, committee work, e-mails, telephone calls, and office chatter. The key to effective time management in academic medicine is weekly planning, in which you set aside a block of time every week, or every other week, that you protect for writing. Weekly planning is the secret; daily planning is frustrating and unpredictable, while planning by the month or year is unrealistically vague.8 I recommend a technique called Tuesdays to write, in which you use your calendaring program (such as Outlook) to reserve blocks of time for writing. For example, label the hours from 7 am to 12 noon every other Tuesday for "writing and projects." Then, protect this time: it is now unavailable for walk-in visits, phone calls, or rogue meetings. No one in your office may double book it. Tuesdays to write are your "microsabbaticals;" they are also the heart and soul of time management in academic medicine. Can't make this happen? Consider whether you have any alternatives. Should you postpone your writing until the day when you magically have more time? Do you prefer to just "wing it," looking for time to write only after all the meetings, phone calls, and e-mails are done? Faculty members who claim they do not have time to write should first ask themselves, Is it because I do not have time to write, or is it because I have not made writing a priority? The Tuesdays to write strategy pays other dividends. For example, it will be easier to justify spending all day Monday returning phone calls, catching up on e-mails, holding office hours, and attending meetings, if you know you have reserved Tuesday to write. Moreover, you can use this strategy (and the enforcer, Outlook) to help manage, protect, and properly integrate your personal and professional responsibilities. We all need tools to help us manage our time as a mother, father, spouse, coach, room parent, or active citizen. Good time managers accomplish more with less stress, both within and outside of academic medicine.9 Multitasking refers to a mythical activity in which people believe they can perform two or more tasks simultaneously as effectively as one … It [may be] a skill necessary in the modern world, but to believe it is an equivalent substitute for single-minded focus on one task is incorrect." 10 Working on an airplane or in a hotel room is always "more productive than time in the office;"11 there are no phone calls or interruptions by students, colleagues, or assistants who need "just a minute of your time." The hotel room, with its clean desk and ready room service, is particularly conducive to writing. Back at the office, try to simulate the isolation of the airplane or hotel. Write at the library or at home. If you prefer to write at the office, guard against time-robbing intrusions:5 turn off e-mail alerts, forward the phone calls, and refuse all interruptions, whether in-person or electronic. Do not accept cell phone calls, except from your family. Some may argue that you must "establish a presence" in the office; true, but it is equally vital that you establish your absence.6 E-mails, according to a New York Times columnist, are "incessant distractions" that have become the "bane of [our] professional lives."12 E-mails "interrupt thoughts, sap productivity, and undermine our ability to concentrate at work."13 It simply is not possible to plan a morning of scholarly writing if you are staring at an in box that contains 350 unread e-mails. You could purge your in box and start over (a technique known as "declaring e-mail bankruptcy").12 But for most of us, it is better to define an "e-mail–free zone" in which to work. Therefore, for the 4 hours (or other time block) that you have set aside to write: 1) do not log on to Outlook; 2) do not permit the "new message" signal to flash; and c) vow to catch up on the e-mails later in the day, when you are tired and less productive. According to one time management consultant, people use answering their e-mails as an escape from completing more difficult tasks. Even if you completely empty your in box, it is "a false sense of accomplishment."14 Real accomplishments include writing a scientific abstract, a grant, the draft of a manuscript, or an innovative lecture or syllabus. Here are three additional e-mail management tips that are frequently overlooked. First, do not send or reply to e-mails unnecessarily; that is, avoid "ensnaring your self in long chains of electronic courtesies and illusory urgencies."13 Second, insist that you and your colleagues will never hit "reply to all." Co-workers are the second biggest source of unwanted e-mails, after commercial spammers.15 As columnist Erica Heath wrote recently, "reply to all" is the "convenient little button that brings down the levee every time."15 Third, it is not time-efficient to attempt to respond to individual e-mails at the moment they arrive. Time management specialists advise that you "keep your e-mail software off, except for twice-a day checks, replicating the cadences of twice-a-day postal deliveries" of the early 20th century.12 Stross adds, "We can handle more e-mail than we think we can, but we should do so by attending to it only infrequently, at times of [our] own choosing."12 Task forces and committees can be honorable and important work, leading to new friendships and a sense of "connectedness" to the broader university. However, there are attendant dangers. Many committee assignments and meetings are, like e-mails, distractions that waste our time and deplete our energy. Unproductive meetings and service assignments should be jettisoned, freeing up hours each month for scholarship. Someone once advised, Learn to say 'no' or, if that is too difficult, learn to say 'yes' less often. For guidance in accepting or rejecting meetings and committee assignments, consult your mentor and your mission statement. Nobel laureate Thomas Cech advised, "Volunteer for something you care about or that will benefit you … for example, the admissions committee or an education task force. Then, use these assignments as a reason to decline other opportunities for committee work that come along."6 It is usually advisable to decline new opportunities for committee work or other administrative tasks if: 1) there are unrealistic deadlines, 2) the project is unimportant or poorly conceived, 3) you lack the necessary qualifications or cannot do it effectively, or 4) it is not in your area of focus.5 Roger Fisher's acclaimed book, Getting to Yes, has sold more than 2 million copies, but getting to "no" is just as important. As theologian Barbara Brown Taylor recently observed, "Learning to say no is how we clear space [in our professional lives] for a few fully planted yes's to grow."16 To make the most out of [the modern] world … a person must learn how to do what matters most first … Otherwise, you will bulldoze over life's best moments." 10 Hard-working, goal-oriented faculty members never want to give up. However, sometimes to achieve balance and professional calm, we have to walk away from a project, even one that once seemed vitally important. Sometimes a goal proves to be unattainable, our efforts are failing, or an even more important project appears before us, or as Hallowell outlined in his book, Crazy Busy, we may need to renounce a goal simply because we are "overstretched, overbooked and about to snap."10 W.C. Fields once advised, "If at first you don't succeed, try, try again. But then quit. There's no point in being a damn fool about it."17 Psychologists, more generously, talk about the importance of "disengaging from goals … as a natural and indispensable part of personal self-regulation."18 Setting deadlines is a prerequisite for living up to your dreams. Failing to set deadlines ensures that your time will be consumed by other tasks that require less effort, but bring fewer rewards. Therefore, establish timetables for your work. "Goals without deadlines are known as dreams; and dreams rarely come true."5 The real thing—genuine, human connection—is still available, but it's best to book it into our schedule. What isn't booked often doesn't happen. 10 As you consider these six time management skills, do not lose sight of the big picture. First, remember the importance of active career planning: setting priorities and time management go hand in hand, and neither is likely to be successful without the other. Second, these time management tips are designed to help us find time to write. However, the purpose of time management is not solely to improve our publication rate, nor to care for our curriculum vitae. Time management skills also help us find order, integration, and balance, as we care for our broader lives.6 Time management, wrote Perina, "is the ultimate wellness tool."5 Finally, the goal of time management is not simply to be more efficient at unrewarding and unimportant tasks. It is not enough to return home at the end of the day, pleased at how hard we worked. It is the quality of our day that matters. Sure, on a given day we might feel the frustration that comes from fending off scores of meetings, pages, phone calls, e-mails, and other attacks. Some days are like that. But on Tuesdays …