Busyness into Promotion Part 5_ Protect Deep Work Like it is Clinic
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[00:00:00] If you're working nonstop, publishing, teaching, serving on committees, and still feel like your career isn't moving forward, you are not alone. I have been there a scattered tv constant exhaustion in the sense that all the effort wasn't translating into recognition or progress. The problem wasn't effort.
It was a lack of strategy and alignment. I'm Dr. Stacey Esman. I work with academic physicians to help them focus their work, build careers with intention and advance without sacrificing their lives outside of medicine. If you're ready to stop spinning your wheels and start moving forward with clarity, this is for you.
Hello and welcome back. Today we are doing our fifth and a series of five on turning busyness into promotion. And here we're gonna talk about protecting deep work like its clinic or procedures or your administrative time or whatever you actually protect and care about. And the key thing here is that your academic work.
Is your most important work. It needs to be scheduled and defended and [00:01:00] non-negotiable, which I think many of us know it has not been thus far. And the reason for that is this is what we did. We spent literally decades learning, educating ourselves, preparing for medical school, becoming doctors, learning how to do our craft, working through residency, maybe doing fellowship, all to become the academic physicians that we are right now.
And the part of that we loved was probably not just patient care, and I don't mean just patient care, but if you wanted to be at a fantastic clinician, you don't need to go into academic medicine. You could get paid more somewhere else and not have to write a paper and not worry about, leaving your family to go to a meeting and.
Maybe not worry about educating the next generation, although obviously lots of those things happen in private practice. But for those of us in academic medicine, those are all the bread and butter, and it is for many of us, at least one of those things that pulled us into academic medicine and made us want to do this.
This is the dream that we all live for, so how do we make it work? So [00:02:00] your most academic work has to be scheduled, and this series is about one outcome turning busyness into promotion. So we've addressed your career story, your calendar. Your service load your niche. And now this week's about execution.
It's about deep work and it's your most cognitively demanding work that you need to have protected space around or else it's almost impossible to find time to do it or to get into the flow that you need in order to make it happen. So what does deep work mean in academic medicine now? It's the work that advances your trajectory.
It's writing manuscripts, it's finishing the grant. It's analyzing the data. If you're not quite ready to write the grant, it's building a curriculum that ties to measurable outcomes or thinking strategically about your next two years or four years, or. Decades and it's cognitively demanding and it's easily interrupted, and it's hard to get back into that state when we get interrupted.
So there's a book by Cal Newport, it's called [00:03:00] Deep Work Appropriately, and it describes deep work as focused distraction-free concentration that pushes your cognitive capabilities to their limit. And this is exactly what academic scholarship requires. So when you think about context switching, when you have to switch from one thing to the other, there's a lot of data that shows that attentional residue gets stuck.
When we try and move rapidly between thing to another. I've, everybody's walked from one room to the other and you can't even remember what you went for and you went back to the first place and you had to think about it and you remembered then, oh yeah, that's why I went to the other room to get the thing.
And then you get the thing and you have to come back and be like, oh, what was I working on before? All of that is wasted time, wasted energy, wasted brain space, and so that complex intellectual work that we need to do in order to do that list I just mentioned gets fragmented. So academic medicine is structurally fragmented.
Think about what we do. We go to clinic, we go to, or we do procedures. We teach, we have an inbox, we have meetings, we have pagers. Maybe some of us do. I still do, and there's a lot of [00:04:00] administrative requests that are mixed in there. And there's the results box and all the other things that we have to take care of.
So if your deep work is placed at the end of the day, or you try and squeeze it in between meetings or clinics or procedures, it becomes shallow work because we don't have the time or the attention to put it together. And unfortunately promotion is built on depth. That's really the work that helps move us.
Now, when I was early in my career, I've told many people I did not consistently protect that deep work. I was productive, but I was so reactive. I was answering my email immediately. I was trying to get to my results box. I was looking at the data, I was answering the student who walked into clinic. I had research meetings in the middle of the operating room in between cases or while I was doing a case.
And it was crazy to be honest because I almost never got into that deep flow state. It did affect my long-term trajectory. At the beginning, I thought I was like killing it for the first three years, and then I met with all of the important people in my division, in my department, and they said, what are you even doing?
[00:05:00] And it was all over the place because I didn't understand how to buckle down and really get that deep work done. So by year three, when I spoke with my chair, I was not as well positioned as I could be. I'd worked hard, I'd been busy. But I did not have a sustained narrative, and that was when I got great advice to really work on many of the things we talked about before, including creating a niche and getting my calendar to be aligned and understanding my story.
But also I took the time for this deep sustained work. Now, I would love to say that I was smart enough to have read the book and figured it out, but I wasn't. What it was the mother of young children who realized if I left for work too late, I woke them up and then ruined everybody else's day, including my husband who was taking care of them at the time.
And I think we had a conversation one day when he's could you leave a little bit earlier? It would make everybody's life better. And so I went to work earlier and it was amazing. I spent like an hour and a half slogging through trying to write a paragraph at night, and in the morning I could write that thing in 20 to 30 minutes and [00:06:00] it was better.
And I figured out that this like cohesive, deep work when there was nobody else in the office, nobody knocked on the door. I didn't check my email, I didn't look at my EMR box. I got my academic work done and I really worked on the stuff I cared about. I was excited about it and I, it's a great way to start the day, by the way, if that's your smart time.
But if it's not, your smart time and your best times at night are. I, somebody I was talking to the other day, and their best time is from two to four in the afternoon, not mine. That's a great time for a nap. But that's when it was good for them. And so today, I protect my deep work in the same way that people think about how much you cannot interrupt the time that's for clinic or the time that's for procedures.
I protect that time. And if a patient is scheduled, I do not casually give that slot away. Academic time should be treated the same way I treat clinic, and that is what I do now. So my writing blocks are at least two hours less than that, and I rarely allow this full immersion that allows me to flow.
Sometimes I can get into it in 20 or 30 minutes, but oftentimes once I [00:07:00] get into it, I wanna stay there and I don't want it to just last these short periods. And I don't wanna give my academic time back to clinic or meetings or whatever it is I'm being asked to do. Administrative time is not for overflow of your clinic.
You can do that in other spaces or we can work on making you more efficient at that. But regardless of how you get it done, I don't want you giving away your academic time. 'cause what you're doing is giving away the career that you spent all those years working for this academic time is to do the things that made you want to be an academic physician.
Whether that's writing a curriculum or writing a paper or doing the research. And if interruptions are likely, you can use structured intervals like the Pomodora technique. And the classic is to use a 25 minute interval and a five minute break so you can let people know, I will reach out to you in 25 minutes when I'm done.
Or there's a sign on your door that says, don't interrupt, or you just don't check your email and you don't answer your phone. But in general, that immersion is more powerful for complex work. And so the principle is simple, deep work time is not [00:08:00] negotiable. Obviously, huge emergency, you're gonna run outta there, but on a regular basis, don't allow that time to be given away.
And the other thing I'm gonna tell you is people tell me that their administrative times only been given away for emergency cases, but it's booked out three weeks or four weeks or six weeks. I don't know a lot of emergency cases that I can book out three, four, or six weeks. So it's not really an emergency.
Or really even an urgency. And you cannot fix system issues by giving away your administrative time. So please don't do it. And just as late, you would not cancel a clinic for a minor inconvenience. Do not cancel scholarship time and deep work for a minor inconvenience. Now time blocking research is been well known in knowledge workers and in academic medicine specifically, and it shows that pre-commitment to focused work increases your output and decreases your cognitive load.
The decision that you're going to do deep and focused work increases how much work you get done, and it decreases all of that decision [00:09:00] fatigue that we're feeling. So when work is scheduled in advance. Decision fatigue decreases and follow through. Improves. So I want you to think about that.
Just scheduling the time means you get more done and you feel better. So in academic medicine, the default environment pulls you towards that reactive medicine, that reactive work protection has to be intentional. This, if you've done anything with the Eisenhower matrix, is the important non-urgent stuff that needs to get on your schedule so that your life is aligned with the things that you care about.
You picked academic medicine for a reason, let's help you do it. So if your administrative time is repeatedly converted into clinical overflow, your promotion timeline moves out. It's not as quick 'cause you're not getting the work done. Or if you're scheduling meetings on that time, your writing blocks disappear.
If deep work always happens after everything else, it's probably not happening consistently. So if this is you, I'm gonna challenge you. Schedule some deep work and you can start with 25 minutes. It doesn't have to be two [00:10:00] hours. I'm gonna guess you could find somewhere to fit 25 minutes in your schedule.
'cause that's how you build promotion with this sustained visible output. Now if you wanna build a deep work system, I do recommend trying to find a two hour writing block. If you can place it early in the day when possible, or if you're like, I am a genius at 11 o'clock at night, do it at 11 o'clock at night and book it before meetings.
Fill your calendar. Do not give your academic time back to clinic or to meetings except for true emergencies. And the ones you cannot schedule a week or two out and define one specific output goal for each block. So that you're really focused on the thing that's most important. And if your big thing is to get your grant done or to write that curriculum or just get the paper done, what I'm gonna tell you is try and do something every single day that gets you there, but then have at least one time a week with the big block to really get things done.
Now, I also want you to track completion, not just the time you spent on it, so this is about the outcomes. Not just the effort, and it's not about perfection, [00:11:00] it's about discipline. This is building a habit, building a muscle, getting used to doing this and saying no. The boundaries are sometimes the hardest part.
The goal is not to feel busy. It is to build that pipeline of educational opportunities or grants or papers or programmatic work, whatever it is that you wanna be known for, and to compound. And just remember that busyness, that's automatic, that's built in, that's structural. Deep work needs to be deliberate, and it should be the important non-urgent stuff that gets scheduled in that space.
So if you want your promotion to be predictable, the most important work needs to be treated like or clinic. You need to defend it. It needs to be non-negotiable, except in a true emergency. So if this resonates, please listen to the other Medical Mentor Coaching podcast and pass this along to a friend or colleague who might find it useful.
Where I want to discuss with everybody how to make sure that you have time for academic advancement. And if you're a chair or division chief, consider whether your department has a system that protects faculty's [00:12:00] deep work time or scale. Our ferry programmed provides department-wide strategy and coaching so that scholarship and promotion are not left to individual willpower alone.
Please join me as I talk about these topics every week. Subscribe on your favorite app or watch us on YouTube, and I look forward to talking to you next week.
