Clinical, Featured, Housestaff Wellness, Intern Year, Ophthalmology
Leave a comment

Punctuality Permits Presence

It’s only 7:15 a.m.? I can finish folding my clothes before I have to leave for clinic, I thought to myself. Though the day was young, I had already been quite productive — I started the laundry, made myself breakfast, picked up around my room, and even found time to journal briefly about the day before. Surely I could check one more thing off my to-do list.

Unsurprisingly, folding my laundry took more than the five minutes I allotted, so I hurried out the door to catch the shuttle for my 8 a.m. By the time I made it to clinic, I was rushed and stressed, with little time to pre-chart. My abbreviated chart review led to significant holes in the history that I presented to my attending, and frankly, I felt foolish as I repeatedly answered “I don’t know” to each of her clarifying questions. I had no one to blame but myself — these were the consequences of my own actions.

I would love to say that this morning was a one-off or seldom occurrence, but this was the epitome of my mornings before work. I am constantly confident that I can fit in one more thing before I leave. I would rather rush and arrive right on time to avail myself of every precious minute at home. I suspect I’m not the only one who feels that idling around is wasted time, especially as a resident whose personal time is scarce.

Though much of this morning was typical for me, one noteworthy difference was that I happened to be listening to an episode of “No Stupid Questions,” a podcast by economist Stephen Dubner and psychologist Angela Duckworth. Ironically, the topic of the episode was lateness and our tendency to put things off until the last minute.

In this episode, Dubner and Duckworth discussed many of the influences that lead to our miscalculations with respect to time. For example, I often fall victim to the “planning fallacy,” a concept posited by Nobel Prize-winning economist Daniel Kahneman and psychologist Amos Tversky, wherein we underestimate the amount of time a given task will take despite prior knowledge that suggests otherwise. Dubner and Duckworth elaborated that the planning fallacy is typically tied to an optimistic view of the future, wherein we imagine the best possible outcome rather than a more realistic one that accounts for any number of interruptions.

Another common contributor to my tardiness is the problem of “one more thing” — that task that you erroneously think will take you a miniscule amount of time and thus can fit anywhere. Oftentimes these tasks are small, like answering an email or putting a few dishes in the dishwasher, but when they compound, those negligible amounts of time add up to tardiness.

In addition to identifying reasons that we are late, Dubner and Duckworth also discussed how Kahneman, their mutual friend, prioritizes arriving early for meetings because he values his interactions with others. When it comes to activities that we deem important or valuable, such as a job interview or a concert, we are much more likely to be punctual. However, for more trivial appointments, we often forgive our tardiness.

After my embarrassment in clinic that day, I felt a bit of cognitive dissonance stirred by this episode of “No Stupid Questions.” I place a premium on my interactions with patients, but a consistent failure to sufficiently prepare indicated to me that this was untrue, at least subconsciously. I was uncomfortable shortchanging my patients, both emotionally and clinically. In an attempt to curtail this behavior, I resolved to arrive 10 minutes early every day to see what — if anything — changed.

Despite some initial skepticism, I found that during the next rotation, I had a better grasp on my patients’ medical history and previous workup, leaving more opportunity to engage them on a personal level. Though my hours for that rotation were longer, I left work more satisfied than I had in the weeks prior because I knew my patients well and provided them with better care. These changes to my professional life were quite welcome, but the greatest surprise was that my household chores, email inbox, and other tasks that used to be my “one more thing” were somehow still completed.

Life as a resident is stressful, with many demands on our time that are often immoveable or out of our control. It is natural to fiercely protect our time away from work and strive to be a time maximizer, eking every bit from the time that is truly ours. But if you’ve found yourself in a similar position, rushing off to see patients and crunched for time in the morning, consider showing up 10 minutes earlier each morning. This small amount of time just might have a significant impact on the care you provide for your patients each day.  

Image sourceRoom 3 by Jay Gorman licensed under CC BY 2.0.

Grayson Ashby, MD Grayson Ashby, MD (1 Posts)

Resident Physician Contributing Author

Mayo Clinic

Grayson is an ophthalmology resident at Mayo Clinic in Rochester, MN, with stops at Furman University and Mayo Clinic Alix School of Medicine for undergrad and medical school, respectively. When not at the hospital, he enjoys fly fishing, cooking, and spending time with his wife and their two cats.