Physicians Should Use Limited Resources Wisely

April 8, 2014

Going that extra mile for patients can be tempting. But overworked physicians must think about the "return on their time," first.

This past weekend, my husband and I threw a birthday party for our 10-year-old daughter. We invited many more girls than we anticipated would be able to attend - given historic RSVP percentages - and were surprised to get all "yes" responses. We planned multiple activities and stations for the girls; however, they were completed in under an hour. The uninhibited play we allowed outside was the best part (plus the M&Ms). All of my little touches were appreciated by my daughter, but probably overdone, in the end. I congratulated myself for not going overboard, but then realized I did. In the end, as is often the case with kid birthday parties and probably with kids in general, they just needed a few activities to break the ice, plenty of time to play, and some sugar sprinkled in to be happy.

So often, I do this same type of thing in other aspects of my life. I over-plan or overdo in an attempt to help my husband, friend, or patient. One example from work illustrates my point perfectly. I was dismayed to find that a number of my patients who had recent annual physicals with me failed to schedule a mammogram. These were patients who wanted (or at least told me they wanted) mammograms, but for whatever reason never got around to scheduling them. I decided to write each woman a heartfelt plea to please get this important test done (this was before recent studies showing that it may not be as important as we once thought). I felt the personal tone would compel these women to prioritize this health exam. I was wrong. Maybe they appreciated the letter, maybe they didn't even read it. What did help was scheduling the mammogram for them at the time of their physicals. I think many of my patients were just busy and put "mammogram" on a gigantic to-do list.

Often, physicians who struggle to balance work and life create massive to-do lists that are largely self-generated. We place multiple important items on an ever-growing list, convinced that if we just get the list done, we will somehow be "in balance."  I often question some of those items on my own to-do list, and possibly those on yours as well.

One sure-fire way for me to test whether an item is valid is to test the resources I have to put in to something, to get a certain product out. In the case of the birthday party, my desired output was that all the girls, including my daughter, had an enjoyable and fun afternoon. I forgot to remember that these girls have fun together every day at school, simply playing at recess. In the case of my patients, I failed to realize that my desired output - scheduling the mammogram - was something they already were having a difficult time doing, despite recognizing its importance. The resources I devoted to achieving the desired result were wasted in carefully crafted letters, and just needed to be a different type of resource altogether (my nurse scheduling the appointment).

As I run another race this week on the balance-beam between my work and my personal life, I hope I can remember to use my limited resources - time, intellect, energy - in the wisest way possible to achieve the best result.