This is a continuation of my thoughts on “Manage Your Energy, Not Your Time,” by Tony Schwartz and Catherine McCarthy, as published in the Harvard Business Review. The first series in the post dealt with physical energy, the second, on emotional energy.

Mental Energy

• Reduce interruptions by performing high-concentration tasks away from phones and emails.
• Respond to voice mails and emails at designated times during the day.
• Every night, identify the most important challenge for the next day. Then make it your first priority when you arrive at work in the morning.

This is nearly impossible on the wards since so many people want to page you. I did, at one point, try using a Bluetooth headset on my cell phone so that I could answer phone calls more efficiently. I noticed that the more efficient residents would enter in orders, write notes, and present cases (i.e. multitask) during rounds. The point that the authors try to make is to emphasize how important it is to reduce clutter, and it relates to a condition one psychiatrist, Dr. Edward Hallowell, has labeled attention deficit trait.

This is a continuation of my thoughts on “Manage Your Energy, Not Your Time,” by Tony Schwartz and Catherine McCarthy, as published in the Harvard Business Review. The first series in the post dealt with physical energy.

• Defuse negative emotions — irritability, impatience, anxiety, insecurity — through deep abdominal breathing.
• Fuel positive emotions in yourself and others by regularly expressing appreciation to others in detailed, specific terms through notes, emails, calls, or conversations.
• Look at upsetting situations through new lenses. Adopt a “reverse lens” to ask, “What would the other person in this conflict say, and how might he be right?” Use a “long lens” to ask, “How will I likely view this situation in six months? ” Employ a “wide lens” to ask, “How can I grow and learn from this situation?”

Renewing emotional energy is harder to accomplish when on a high-stress high-stakes service like internal medicine or surgery. read more→

The Harvard Business Review magazine often features articles detailing techniques for personal improvement based on more rigorous scientific research and analyses of successful organizations and leaders. One of the articles featured in its recently-published compilation On Managing Yourself, “Manage Your Energy, Not Your Time,” focuses on improving yourself by managing energy instead of prioritizing and stressing about time management. The four dimensions of personal energy include physical, emotional, mental, and spiritual, which I’ll tie in this post and subsequent posts. I’ll cover the article’s highlights, and tie it in to make it more relevant to healthcare professionals:

Physical Energy

Authors Tony Schwartz and Catherine McCarthy summarize their techniques along these points:

• Enhance your sleep by setting an earlier bedtime and reducing alcohol use.
• Reduce stress by engaging in cardiovascular activity at least three times a week and strength training at least once.
• Eat small meals and light snacks every three hours.
• Learn to notice signs of imminent energy flagging, including restlessness, yawning, hunger, and difficulty concentrating.
• Take brief but regular breaks away from your desk, at 90- to 120- minute intervals throughout the day.

There are so many possibilities for new medicine-related ventures that it’s hard to define and pin down all the options. Enrolling at my school’s MBA program (at the University of California, Irvine) was my first step towards nailing those options down. UC Irvine has allowed me to hear from executives such as Rick Afable, MD, the CEO of Hoag Hospital and how he’s transitioning the organization towards a more vertically-oriented system. I’ve taken courses from non-clinical physicians like Sherri Treasurywala, MD PhD MBA, who worked for a high-profile consulting firm. UCI’s Brand Management class gave me the chance to meet restauranteurs like Wing Lam, CEO of Wahoo’s Fish Tacos. And I’m not done exploring — I’ve got 2 more quarters left in 2012 to explore the politics of healthcare, entrepreneurship, and (if time allows) consumer behavior.

To my surprise, online websites have allowed physicians with new ventures to post their thoughts. One such website, FreelanceMD, puts on annual conference, the Medical Fusion Conference, linking physicians (and healthcare providers (and medical students!)) together. Gregory Bledsoe, MD, formerly an emergency medicine attending physician at Johns Hopkins, graciously allowed me to attend the Medical Fusion Conference in Las Vegas. Interestingly, but not surprising, at least 25% of the attendees wanted to leave medicine entirely.

No B.S. Time Management for Entrepreneurs provides some insight into high-powered entrepreneurs like Dan Kennedy, who ran businesses so they worked for him in his favor, instead of the other way around. I routinely try to find ways to complete projects as effectively and efficiently as possible, so this book gave me some very interesting thoughts. And these are great for physicians: I often find doctors running around like headless chickens trying to perform surgery on one patient while answering pages about other patients in the PACU or SICU and juggling teaching medical students and research and side projects of running clinics in Africa and having a marriage.

(gasp) Let me exhale for a moment.

In the book, Dan Kennedy provides nuggets called “No B.S. Time Truths”, with some of my thoughts: read more→

(Photo: Gene Hobbs)

Look at all those gears go.

Back in my day — a long, vast time of 2 years ago — our medical school had an ancient version of Harvey, a patient medical simulator machine that mimicked heart and breath sounds. It constantly broke down — as would be expected for a mechanical machine launched in 1968 — but it was very quaint, if not entertaining, to watch the contraption unfold, gears grinding and wheels spinning and all.

(future internist Larry Kim, surgeon Madhukar Patel, and internist Joy Ye)

Fast forward to today. On my last week of my ICU (intensive care unit) rotation, they treated us to an afternoon session at the UC Irvine School of Medicine’s all-new-with-new-car-smell Simulation Center. In it, nurses and staff dressed in scrubs guided us through operating rooms with working equipment and several amazingly life-like simulation mannequins that not only had carotid artery, radial artery, dorsalis pedis pulses, plus heart sounds, breath sounds, a throat to intubate — and blinking eyes! The staff even pushed a button in the control room to make the fake patient seize. It’s pretty crazy to watch a humanoid thrash about in seizure: this thing, this lifeless being, this humanoid robot is just one step away from an actual human with an actual seizure.

(I thought this was funny. As seen on Facebook, written by one of my past attending physicians (identities blurred out))

the call pager may appear like a simple box of plastic powered by a AAA battery but, in fact, it is akin to the one ring from the LoR trilogy or a deathly hallow from the HP series. when growing up as a med student, one dreams of the ultimate power of becoming a physician: to enter orders, to heal patients, and to return pages from this box plastic by answering “this is dr. _____ returning a page”. alas, with great power comes great responsibility… Wednesday at 8:26pm

soon this box of plastic powered by a AAA battery can see through you searing the depths of your soul (hence, the one ring analogy) and you get paged at the most inopportune times: in the bathroom, while sleeping, trying to hit on your senior resident while rotating on peds wards (if you’re single and available). at some point in residency training, every trainee has thought to themself: “man, i wonder what life would be like without having this box of plastic tethered to my hip” or “let’s blow this mother up”… Wednesday at 8:30pm

My co-chair-in-crime, Aislinn Bird, and I will host — in just a few short months — an exciting one-day conference for medical students interested in psychiatry right in the heart of downtown San Francisco. Every year, our PsychSIGN group (which stands for the “psychiatry student interest group network”) puts on both local (“regional”) conferences and national conferences. We do this to get medical students jazzed up about mental health — and, of course, try to dispel the B.S. stigma against mental illness that still pervades many medical schools. Besides, what else is cooler than studying how the mind works?

(Even cooler — the conference is accessible by Muni and BART!)

This time, Aislinn and I were fortunate that the American Psychiatric Association was holding a conference right in San Francisco as well: they generously donated a conference room complete with AV equipment and a continental breakfast. Some organizations, like the California Psychiatric Association and the American Association of Chairs of Departments of Psychiatry, generously donated to help support us. I feel extremely grateful that our existing physicians want to help the next generation of physicians.

I get a lot of questions from medical students and residents interested in purchasing a tablet. These tablet devices are essentially thin, large-screen computers that weigh about 1 pound with great Internet connectivity and batteries that last for more than 7 hours. These are amazingly useful for physicians for looking up medication dosages, showing patients illustrations of procedures, viewing anatomy while in the operating room, sorting through e-mail, and — best of all — reading and annotating PDF files of the latest medical journals without lugging around pounds and pounds of paper.

There are two operating system choices that you — as a physician or a medical student — can run on your next tablet:

• an iOS device: the Apple iPad is the only tablet that runs iOS
• an Android device: a large variety are available, manufactured by Asus, Acer, Motorola, Sony, and other computer and phone companies

There are two other tablet systems out there running Palm webOS and Blackberry OS, but there are hardly any medical software available for those two platforms. You shouldn’t bother considering these two operating systems. Windows 7 also runs on tablets as well, but while the system runs any Windows application you throw at it, the OS was not made strictly for mobile use and suffers from poor battery life and a cumbersome user interface.

Two weeks ago, I took the USMLE Step 2 CK, yet another “step” towards full medical licensure. Studying for this exam was challenging while I juggled final exams for business school (see above), med school graduation activities for my classmates, and preparation for my sub-internships in medical school, but I managed to do it! And now I eagerly await my exam results.

Here’s what I did to prepare for Step 2 CK, and the advice I would give to other med students who must suffer through this 9-hour ordeal: