Is It Possible to Be More Productive in Less Time?

Raise your hand if you join me in becoming increasingly annoyed at the following instruction: “Don’t work harder (or longer), work smarter.” Despite this admonition, I am working more intensively and spending more hours working than ever before. My friends in a variety of occupations and my colleagues at my institution are too. It is not just a mirage; from 1970 to 2000, average workers in the United States added nearly 200 hours of work per year to their schedules.¹ That’s a whole extra month! And this is not just logging more hours at work. These hours also are more hectic with fewer breaks and many more demands. Unfortunately, more hours at work does not necessarily translate into getting more work done. There is good evidence to show that once our working day stretches beyond 8 hours, our cognitive performance and our productivity decline.^2,3

I am feeling the squeeze, and I know you are too. Is it possible to be more productive in less time? In the reading I did to answer this question I found 4 major themes: (1) single task, (2) plan downtime, (3) schedule priorities, and (4) manage procrastination.

As a full-time clinician and a single mother with 4 children, a dog, 2 cats, and a house, I admire those who can multitask; however, experts now conclude that multitasking is not productive. People doing 2 tasks at once took up to 30% longer and made twice as many errors as those who completed the same tasks in sequence.⁴ Frequent interruptions had the same effect. A study found it took employees 15 minutes to fully regain their train of thought after they were interrupted by an email, even if they did not reply to the email.⁵ Instant messages produced a lag of 10 minutes. In addition, habitual multitaskers take longer to switch between tasks, probably because of losing the ability to focus.⁶ Those of us who think we are great multitaskers are the worst at it.⁷ The ping of the new email or text is exciting and can become addictive. To counteract the interruptions, batch up related tasks (eg, electronic medical records in-box, emails, telephone calls) and remove distractions. Smartphones can be programmed to announce loudly and specifically when our 12-year-old child texts but not announce other texts and calls that can be retrieved later. Slip a small notebook in your pocket or use your smartphone to record free-floating ideas to come back to at another time.

As soon as we wake up in the morning, we start making decisions. Some of the simple moment-to-moment choices have been automated; most of us rarely have to decide to brush our teeth or make coffee. Then a day of constant decision-making starts, which means finding options, evaluating the pros and cons, comparing the possible sequelae, and then determining a course of action. The more decisions we ask our brain to make, the less able we are to concentrate and make nuanced assessments, and the more our decisions exhibit less insight and forward thinking.^8,9 However, rest periods improve task performance. As seen in brain imaging studies, rest allows the brain to continue processing and set up new connections.¹⁰ To prevent decision fatigue, plan downtime even if it is for just a few minutes of deep breathing or stretching against the wall every 90 minutes or less. An ideal time is between batches of tasks. Longer reflection time after a meeting is key before the next activity, solidifying the events of the meeting.

I know that on the occasions when I get up in the morning and focus on what is most important to do that day, I generally get it done, as well as other items on my to-do list. If I made prioritizing and planning a deliberate daily habit, it would allow for much greater productivity. It often is recommended that a list be made of all the activities and tasks to be done that day or week and then to compare it to a list of primary goals. Pay attention to the important items and not just the urgent ones. Urgent items can fill up the day but some of them may have little relationship to our primary goals. Those that are urgent but not important can be delegated, deferred, or even purged. Rank the important tasks and schedule the highest priority in defined blocks. This kind of deliberate prioritizing requires repeated monitoring and revisiting of goals and tasks but ensures that what is most important gets done.

Most physicians are perfectionists, which can be a good thing. I want my doctor to be a perfectionist when he/she is examining me or writing me a prescription. But perfectionism also has a high price. It makes delegation of a task difficult because of the perception that the other person might not do the task as well as you can. It also can cause us to put off doing a task because we do not have enough time now to do it well enough. Later we feel stressed because it is still undone, and then we panic and become overwhelmed at the thought of tackling this task, which now has an even bigger emotional load. Being productive means learning to manage procrastination. Brian Tracy has 21 great ways to stop procrastination in his book Eat That Frog,¹¹ but you really only need 3 of his rules: (1) If you have to eat a frog, eat it first thing in the morning. (2) If you have to eat 2 frogs, eat the bigger one first. (3) If the frog is too big to eat, cut it into bite-size pieces.