When you were in high school, did you ever do the experiment of caring for an egg or a bag of flour for a period of time to simulate caring for a baby? It’s a powerful metaphor for a huge responsibility, and the delicate and fragile nature of the item that is being cared for has the potential to teach a deep lesson.
Imagine if we had a way to teach a similar lesson with regard to caring for our time.
I am obsessed with time management and getting the most out of my time. I can’t pinpoint when it started for me, but I know that it has been with me for a long while. I remember getting a digital watch for my eighth birthday, and becoming acutely aware of how long everything took. I quickly started attempting to make my dreaded chores faster, more efficient, over with sooner. Without realizing it, I began a process improvement journey that remains with me to this day.
In medicine, perhaps more so than other fields, time is seldom on our side. Having a good handle on how we manage our time is essential, but we are rarely shown how to do so effectively. There is no lesson that we simply don’t learn; more typically, we are thrown into the deep end and either sink or swim. The nonclinical tasks keep piling up: big things like meetings and little things like messages in the EHR system, constant things like lab results and less frequent things like peer-to-peer reviews. The creep of indirect clinical work into our clinical lives is constant and erodes a sense of control; it’s no wonder so many clinicians are feeling burnt out.
I talk with a lot of people about time management. I think that the biggest misunderstanding is that the management of time is the work to be done. It’s actually deeper than that; time management isn’t the skill, it’s the result of developing and utilizing a cluster of skills related to how you view time, how you respond to threats and opportunities to your time, even your simple awareness of time.
We can’t control the decisions made by our employers. We can’t control how sick our patients are when we meet them. We can’t control the depth of the administrative burden that we face. But we can control our approach. Time is a finite resource, and it can’t be replenished. How I choose to spend the amount of time I am allotted (a 24-hour day, a seven-day week, a 40-hour work week), or that I give myself (five minutes to write a note following a visit) is honoring the sanctity and scarcity of time.
If I were teaching a lesson about time management, I would say this: To get better control and results with the time you have available, turn your focus to all of the things that present threats to your time. These are wide and varied and encompass external and internal factors. Administrative burden, complex patients, inadequate support, and clunky EHR systems — these are external factors, and the amount of influence that you have over them may vary. Note them and how they impact your use of time, but don’t get too bogged down trying to change them.
The higher yield comes from looking at internal factors, the things that are within your control. Your priorities for your time, your boundaries when it comes to your workload, the amount of time that you are willing to devote to tasks. Thinking about these things informs your philosophy when it comes to time. Tools or skills that you have for managing your time can be gained, refined, improved, adapted to fit the situation and your philosophy.
When I worked in an outpatient, appointment-based setting, I had my time management on lock — setting appropriate boundaries with patients, delegating to staff, signing most notes before I went to see the next patient. Patient with suspicion of UTI? I went into the exam after the patient was roomed and the urine sample was dipped; it made the visit much more high yield and that “free time” was spent checking off other tasks, like resulting labs. In that setting, I was done every day by 5 p.m., with 97-100% of my notes closed and signed.
Then I switched to an inpatient setting, rounding on patients. No appointments, no defined length of time, much less structure. I felt like everything was taking forever — my first warning sign. I tracked my time for major categories of tasks (patient-facing time, charting, other administrative work) for two weeks and reviewed the results. Things were not actually taking as long as it seemed. My overall time management goals were on track; I was done by 4 p.m. daily with all of my notes signed. I didn’t love the dictation system that I was using, and the data showed that it was taking more time than I was OK with. I started dictating immediately after every visit instead of at the end of the day; that cut down on time waste and I felt better about how I was using my time. Recognizing the problem, getting data, and then applying my tools to the circumstance gave me the result that we’re all searching for: adequate time management.
You can do this too. Ask yourself the following questions:
- When does work end for me each day? When do I want it to end?
- What is standing in the way of me being in better control of my time? How can I address that?
- How much time do I want to spend on (fill in the blank)? What changes need to be made for that to be my reality?
- Who can help me realize these goals? Who else would benefit from me having better control of my time? What tools are available (scribes, AI, assistants) that could help me meet my goal?
Remember: time management is the result, not the process. Identifying what you consider acceptable, the skills that you have (or want to get) for managing your time, the personal systems that you want to set up to make your time work for you — putting deliberate focus on these things is the way to get to the result of improved satisfaction with the management of your time.
How have you learned to manage your time efficiently? Share in the comments!
Jessica Reeves is a nurse practitioner as interested in the well-being of her fellow clinicians as that of her patients — and she's on a mission to make the work world a better place to live. She writes, works, and lives in the town that holds the world record for most lit jack-o-lanterns (really). Follow her at jessicareeves.net. Jessica was a 2023–2024 and 2024–2025 Doximity Op-Med Fellow.
Illustration by April Brust
