The Tiny Inefficiencies Making Your Physician Workday Longer Than It Needs to Be
There are things I’ve done hundreds of times in medicine before it occurred to me that I was still doing them manually for no particularly good reason.
The same patient instructions. The same explanation before a procedure. Medication guidance I’d given countless times. A paragraph in a note I could practically type from memory. Each one took very little time. Thirty seconds here, maybe two minutes there. Which is probably why I didn’t think much about them.
Physicians are remarkably good at tolerating tiny inefficiencies. We notice the obvious things that make our workdays difficult: an overloaded clinic, the inbox, call, meetings, administrative work. The smaller irritations tend to survive because individually, none seems worth stopping long enough to fix.
But twenty or more patients a day, five clinic days a week, forty-eight working weeks a year changes the calculation.Those minutes accumulate, quickly.
When physicians talk about wanting better physician work-life balance, we naturally gravitate toward the larger pieces of the job. Sometimes those are exactly what need attention. But I’ve become increasingly interested in the smaller pieces too, because a workday is partly the accumulation of hundreds of tiny decisions about where our time and attention go.
I Started Paying More Attention to My Attention
For a long time, I thought about efficiency mostly in terms of time. Now I think about attention.
Every time I stop to reconstruct something I’ve already explained dozens of times, I have to shift gears. Remember what I usually say. Type it again. Check it. Then move back to whatever I was doing before.
There are plenty of places in medicine where that effort belongs. Patients deserve individualized care, and clinical judgment should never become a template. But there are also things I simply don’t need to reinvent every time. If I routinely give the same preparation instructions, I can create the dot phrase and then modify what needs to be modified for that particular patient. The same can be done with common medication guidance, routine follow-up plans and recommendations I find myself giving over and over.
Standardizing the predictable parts gives me more attention for the parts that actually require me to think. That has become a much more useful definition of efficiency for me.
The Twenty Minutes at the End of the Day Matter
We tend to think about physician work-life balance in fairly large units. An afternoon off. A reduction in FTE. Fewer call weekends. A different clinical schedule. Those changes can matter enormously. But there is also the ordinary Tuesday when none of those things is changing and you would simply like to get home on time. Ten minutes saved during a clinic might mean finishing a note before the next patient arrives instead of adding it to the pile to complete tonight while you are watching Law and Order.
A better template might remove a few minutes from several encounters. A process you finally stop recreating every afternoon might mean there are three fewer things waiting when the last patient leaves. Twenty minutes doesn’t sound particularly impressive until it’s 5:40 pm and those are the twenty minutes standing between you and going home to your family and your non-work life. I think we underestimate how much those small margins affect the experience of practicing medicine.
Physicians Become Very Good at Making Inefficient Systems Work
This is one of the reasons I pay attention to small inefficiencies when I think about Career Architecture. Physicians are trained to solve problems in real time. When something doesn’t work particularly well, we often find a way around it. We're so used to making do that we find a new hack or we absorb the chaos to accomplish the task that we set out to do.
If the day is too full, we move faster. If documentation piles up, we finish it later. If a process is cumbersome, we develop our own workaround. We answer a portal message between patients, finish a note over lunch, and squeeze another task into the five minutes before the next meeting. I am guilty of making all these adaptations. Eventually, the workaround can become so familiar that we stop noticing there was a problem in the first place.
The first step in changing my behavior was to watch my own workday for these moments. When I noticed that I’ve done this exact thing a hundred times. I asked: Does the task genuinely require fresh physician judgment every time? If so, the time belongs there. If it doesn’t, I want to know whether it can be templated, standardized, delegated appropriately, bundled with something else, moved to a better point in the day or simply eliminated.
Ultimately, you need to understand if this repeatable task requires your full cognitive attention. Over time, I’ve become less interested in figuring out how to do repetitive work faster and more interested in understanding why I’m still doing it that way.
Career Redesign Can Be Surprisingly Ordinary
When we talk about redesigning a physician career, it’s easy to picture the major decisions: changing jobs, reducing clinical time, leaving a leadership position, renegotiating an FTE or considering whether to leave medicine. Career Architecture includes those decisions. It also includes what happens at 4:30 pm on a regular work day.
How often are you interrupted? What are you repeatedly recreating? Which tasks actually require your expertise? What have you continued doing because you’ve always done it? Does the work fit inside the workday, or has your life gradually become the place where the overflow goes? These details can seem insignificant when we examine them individually. But we undoubtedly experience their accumulation.
So before assuming that improving your career requires a major change, spend a week noticing the small pieces of your workday that you’ve stopped questioning. You may find a few minutes here. Ten minutes somewhere else. A task that can disappear entirely. Sometimes getting a little more of your life back starts there.
If your career feels heavier than you remember choosing, my free Five-Minute Physician Career Misalignment Audit can help you look at where that weight may be coming from. It’s a practical place to start before deciding what, if anything, needs to change.
