Posted on Jan 7, 2013 in Weblog | 0 comments

Ramit Sethi, a New York Times-bestselling author and productivity/finance/entrepreneur expert, talks about the 5 productivity mistakes that people make in his latest blog post. Here are my thoughts on how this applies to physicians, along with notes from the video itself since it doesn’t come with a transcript.

Productivity mistake #1: Trying to do it all ourselves

Which to-do items will change your life (e.g. learn how to invest), and which just needs to get done (e.g. empty the dishwasher)? If you rank them all at the same level, you set them up for failure because you can’t do them all. Top performers in the same 24 hours are very clear about where their time deserves to be spent. As you earn more and more, you can trade money for time. e.g. hire someone else to do laundry.

What is one thing you can you outsource today? Each week, pick one thing you can do to save one hour a week.

For me, I can get all my groceries delivered at Or as a physician, delegating tasks properly to other members of the team. I remember one family physician at UC Irvine saying she was overwhelmed with trying to raise her family, be a wife, take care of her patients, and also clean the house — she’s always been the one to clean her house — when she finally yielded & hired a housekeeper.

Productivity mistake #2: “Neglecting the importance of limited energy, cognition, and willpower.”

We don’t take into account how we are cognitive misers and have limited energy. We often hit the day at 4pm putting things off until tomorrow. Ramit makes fun of people who spend tons of energy/time on saving money on a $4 latte, but it diminishes their cognition, and impairs their ability to “go for the Big Wins”. We should focus our cognition on “Big Wins,” such as investing early, negotiating our salary, finding a dream job, traveling abroad, and calling family.

Each additional thing we add to our list, makes it less likely we do anything at all. That’s also a paradox of choice.

Pick one less thing to focus on this week, e.g. things you haven’t gotten around to forever, that’s been on the to-do list or calendar forever, like unpacking a box, reading a book. Just give it away. If it’s a box that you wanted to unpack, throw it away or unpack it now. Stop feeling guilty about it!

As a physician, I won’t be able to assign equal importance to all tasks that come in, so I will have to learn how to pick my battles. One lesson another attending physician at UC Irvine taught me in her outpatient clinic was that patients will come in with a list of 15 things going wrong with their body that day. And we can’t solve it all in a short 15- or 20-minute visit, because we still have to take care of other patients! So setting boundaries is important. Ask them, “What one thing can we address today?” and delay the other problems for a future visit. If possible, choose the one thing that will kill them first (chest pain and “the worst headache of my life” are pretty good ones).

Productivity mistake #3: Feeling like you have to be productive all the time.

A lot of Type A people have it difficult to “let loose,” not being able to turn things off, having their phone with them wherever they go. But Ramit’s very particular about his rest time, at times sitting in bed, watching movies, and just recuperating. He often takes a 2- or 3-week vacation to recuperate, and that’s part of the mental side of productivity.

Read Jim Loeher et al The Power of Full Engagement. This talks about sprints and the need to pace yourself. If you’re a Type A person that finds it difficult to sit or relax, try scheduling relaxation into your calendar. They need it. They need a block that says “guilt-free do nothing time.” Look at your calendar, schedule it if you have to, so that you can mentally recover. Absolutely critical to top performers to have time and to also have mental energy to be

As a physician, this likely contributes to the phenomenon known as physician burnout. The most successful physicians I know keep things “high-yield” so that they have high-yield work — work that produces the most output in the shortest amount of time — and high-yield play. I myself have a ways to go to work at this.

Productivity mistake #4: Productivity tactics that make us feel good

We try to find the latest app, trick, hack tool (I’m thinking of, but this prevents us from seeing our priorities, the fundamentals. Hacks, apps, tricks, and tools are easy to focus on. The challenge: eliminate all your productivity tools this week. Go back to fundamentals, like a simple notepad, like a pen and paper, for just one week and see how that goes. Instead of using all these fancy tools, just for one week, say “I’m going to try to keep everything on the simplest tools available.”

Most physicians I know don’t revel in “productivity porn.” I myself am guilty of reading numerous articles on Lifehacker and — as this blog probably shows — reading lots of business & self-help books! I gotta admit, I’m not quite sure I’m ready to give this up quite yet.

Productivity mistake #5: Not doing honest assessments of our performance.

Deluding ourselves that we think we’re productive, but we’re just busy. Often times we just send emails, find a lot of hours pass by, and not much gets accomplished. Mistake in today’s information overload economy. Be honest: “What did I say I was going to get done? And what did I actually get done?”

On Monday, ask yourself: What are the 3 things I want to get done this week? Just 3. Set a goal of what you want to accomplish this week.

On Friday, ask yourself: What did I accomplish? What did I NOT get done? And be honest with yourself: why did it not occur? So each week, you’ll get better at estimating these things. You have to learn how to better estimate how long things take.

Physicians may have a harder time at this as weeks blur together, so perhaps trying this exercise during a typical work day would work better. Or, during 2-weeks or 4-week chunks, however your rotation (if you’re a medical student or resident) is scheduled.