“Free you mind and the rest will follow”
Prince – Free your mind
If you’re anything like me you will have become increasingly irritated with the amount of advice that’s thrown around suggesting that GPs should address their workload crisis by working smarter – rather than tackle the real problem of not having enough staff or resources in primary care.
But while on holiday this summer my wife bought a book from the airport called How to Have a Good Day by Caroline Webb. I’m not sure it was exactly what she had in mind but it was a fascinating read – “a central toolkit for a productive day at work and beyond”.
In fact, it did have lots of very sensible advice about how we can be more productive at work. It is evidence based from clinical research, rather than the usual bright ideas, and much of it was relevant to our general practice workload.
Thinking fast, thinking slow
Daniel Kahnman in his Nobel Prize winning book Thinking Fast and Slow noted that our brains work in two different ways. A quick reflex system for quick decisions, known as “effortless intuition” and a slower system for more complex thoughts, or “deliberate reasoning”. It is important that we use the right system for the right decision and make time for the complex ones.
Single tasking NOT multitasking
One key thing was multitasking, something that we do a great deal of in primary care. I believe this contributes significantly to our fatigue, as our brain continually flips between clinical, managerial, medical, psychological and social problems, minor and more serious, throughout the day. If we can find some way to separate these tasks it is easier to focus more appropriately, be more productive and less tired.
It is possible to separate admin tasks. I’ve found the “do not disturb button” on my phone and have turned off any email prompts so that I’m not distracted. The evidence is that just the alert is enough to distract you from your task. We can have the same varied workload but in a planned way. It would be interesting to do the same within clinical work e.g. separating acute illness from chronic disease management.
Turn on the DND on the phone. Turn off email prompts. Have a fixed time for fixed tasks. Check email at certain times of day, four times a day. Complete all similar tasks at the same time. Clear your desk. Allow time for proper thinking and planning.
Learn the four Ds of email management. Delete, delegate, deal with, delay.
I have implemented most of these since I have returned from holiday and have been surprised at the effect it has had.
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