So Much To Do, So Little Time: Managing Your Time Effectively

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So Much To Do, So Little Time Managing Your
Time Effectively

• Scott M. Strayer, MD, MPH
• Associate Professor
• Departments of Family Medicine and Public Health
  Sciences
• University of Virginia
• Department of Family medicine
• Uniformed Services University

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Why is it important?

• Suicide rates among physicians 28-40/100,000 vs.
  12.3/100,000 in general population1
• It would take 1-2 average-sized graduating
  classes annually to replace the number of
  physicians who kill themselves
• These rates are higher than other professions2

1Council on Scientific Affairs Results and
implications of the AMA-APA Physician Mortality
Project, Stage II. JAMA 1987 2572949-2953
2Rosenberg HM, Burnett C, Maurer J, et al
Mortality by occupation, industry, and cause of
death 12 reporting states, 1984. Monthly Vital
Statistics Report, Centers for Disease Control
and Prevention 1993 421-64
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Other psychosocial problems

• Divorce rates are 10-20 higher than the general
  population1
• Depression is high among interns (27-30)2, 3
  with 25 of interns reporting suicidal ideation3
• Depression in practicing physicians not as well
  studied

1Sotile WM, Sotile MO The Medical Marriage A
Couple's Survival Guide. New York, Carol
Publishing, 1996 2Clark DC, Salazar-Grueso E,
Grabler P, et al Predictions of depression
during the first six months of internship. Am J
Psychiatry 1984 1411095-1098 3Valko RJ, Clayton
PJ Depression in the internship. Dis Nerv Syst
1975 3626-29
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Substance abuse

• Alcohol and illicit drug use is similar to
  general population, but higher risk of
  prescription drug abuse1
• Strong link between suicide and both depression
  and substance abuse
• 40 of physician suicides are associated with
  substance abuse, 20 with drug abuse2

1O'Connor PG, Spickard A Physician impairment by
substance abuse. Med Clin North Am 1997
811037-1052 2Ross M Suicide among physicians
a psychological study. Dis Nerv Syst 1973
34145-150
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An equation for balancing time

• X clinical work, Y military responsibilities,
  admin, etc., and Z family, friends, fun, life
• XYZ Total Time (all there is and there aint
  no more . . . )
• If you change X without changing Y, or vice
  versa, Z also changes.

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Which should I choose?
FAMILY
WORK
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Creating a job description to manage time

• Account for all responsibilities during a given
  year
• Clinical time
• Admin time
• Military time
• Deployments
• Committee work
• QI
• Others?

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How much total time do I have?

• ( of weeks in year leave days 30) X of
  hours worked per week
• E.g., 52 weeks 4 weeks 48 work weeks. Assume
  60 hours/week, so 60 X 48 total work time
  2880

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Now for the hard part

• Allot time for each activity and calculate
  percent spent on that activity (clinic should be
  pretty easy, what about the other stuff?)
• E.g., USAFP TDY5 days, 8 hours/day
• So, 40 hours/28801.4

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How does your equation look?

• What will you do next?