First, I had to create an outline of my presentation and complete some background research. Then, I would design my slides and organize and rehearse the presentation. Because I had not even formulated the overall message of the presentation, I was getting really anxious about it.

I had little uninterrupted time at the office to prepare because I had double-booked my usual meetings in anticipation of attending the retreat. At home, I was similarly unable to extract myself from the usual interruptions of phone calls, texts and other urgent problems.

Enabling Deep Work

I decided to use one of my time-tested tactics to help me focus and create some dedicated thinking time for this problem. On the following Saturday, my wife was planning to run a short errand. I informed her that when she left, I was going to go on a brisk walk, so not to worry if I wasn't home when she returned.

I followed the plan and walked for about 45 minutes around our neighborhood. During that time, I was able to focus and mentally review the pros and cons that I wanted to present. I fashioned a short list of steps for the proposed project and a timeline in my mind. When I thought about a couple of background items that I needed to follow-up on, I dictated a reminder into my cell phone voice recording app.

By the time my walk was completed, I had a pretty good idea of the outline for the presentation. The approach I would take to present it and the final recommendation I would be making were much clearer. After dinner that day, I began creating the PowerPoint presentation based on the ideas I fleshed out during that walk.

Cal Newport Sheds Light on Deep Work

Since reading Cal Newport's book, Deep Work: Rules For Focused Success In A Distracted World, I have struggled with the best way to present my review of the book to my readers.

I could do a simple book review, but my conclusions could be easily summed up in a single sentence. It's an important book about a very important topic that every physician leader should read.

I could spend several thousand words summarizing the book. But I doubt I could do a better job than the analysis presented by The Productive Physician: Do You Want An Extraordinary Life? Choose Deep Work.

I've come to the conclusion that the best approach is to highlight some of the important concepts, and some examples of deep and shallow work as physicians, leaders and executives.

Intense concentration!

Definition of Deep Work

Let me start by defining what deep work is. According to Newport, it is: “Professional activities performed in the state of distraction-free concentration that push your cognitive capabilities to their limits. These efforts create new value, improve your skill, and are hard to replicate.”

It's counterpart, shallow work, he defines as: “Non-cognitively demanding logistical-style tasks, often performed while distracted. These efforts tend to not create much new value in the world and are easy to replicate.”

Some examples of deep work that involve intense concentration could be:

• research for a book or article,
• writing a comic strip, a book, a journal article, a serious blog post or even a script for a movie or a play,
• creating a new course to teach,
• preparing for an important planning meeting,
• spending time analyzing quality improvement data, or
• preparing a 30 minute board report.

Examples of shallow work include:

• running a meeting,
• processing work emails,
• scanning the literature,
• meeting with direct reports, and
• other day-to-day routine tasks that could potentially be delegated to others.

Value of Deep Work vs. Shallow Work

Although there are great benefits to the outputs derived from deep work, it doesn't mean that shallow work is unimportant. Or that all deep work is valuable. Spending hours focused on a new video game will result in output of little value, as intense and focused as it may be.

Without shallow work, much of the deep work cannot be pursued. The operation of families, businesses and communities require shallow work.

CEO Example

For example, much of the work of the CEO of a hospital or other business is shallow work. The CEO is often a political animal (no insult intended) who spends a great deal of time interacting with his/her employees and community. Coordinating and running executive meetings, interacting with the board, and attending fundraisers are not deep work (according to my understanding of Newport's definition). But these activities are integral to leading a large organization.

There might be time devoted to intense concentration, such as digesting new research or envisioning strategic options. But even these activities can be done in a group setting in which the CEO is facilitating a review and discussion rather than personally engaging in deep work.

Sometimes, the CEO’s primary responsibility is in support of deep work by others. It's critical that there is sufficient time for deep work by those who lead the divisions and departments of the organization.

I'm not clear on whether certain other activities that require intense concentration constitute deep work. Surgical procedures might be a form of deep work. Pharmacists reviewing and processing medication orders might fit the definition. Does a nurse cross-checking an order and retrieving medications at a dispensing cabinet qualify, since it requires intense focus, at least for a few minutes?

Important Shallow Work

Other extremely important functions, including bedside nursing care, the activities in the laboratory, physical therapy, and other ancillary services of the hospital, housekeeping, etc., often don't involve deep work. However, they're all necessary for the running of an effective health care organization.

When shallow work becomes too pervasive and distracting, however, it will interfere with deep work. Without an appropriate balance between the two, intellectual progress and creation of new value will suffer.

Effective Leaders Use Deep Work

After reading through the book twice, I've concluded that deep work is an important part of the physician leader’s life. I've also realized that the ability to engage in meaningful deep work depends on two primary factors:

• developing the ability to focus intensely on important work for extended periods, and
• consistently avoiding the distraction of shallow work.

Without accomplishing both of these aspects of deep work, it’s benefits will be elusive.

For example, you might be really good at achieving a state of intense concentration. But if you allow 100% of your time to be spent in shallow work, then that ability is of little use.

On the other hand, you might avoid all distractions (television, social media, email, etc.). But if you don't cultivate the ability to achieve a state of intense concentration, it does no good to set aside a specific time to do so.

Luckily, Newport’s book helps us to address both issues.

Routines for Developing a Deep Work Habit

Deep work usually requires quiet time alone so that our attention can be focused on a specific problem or task. And because such intense mental work can be exhausting, it is usual for it to last no more than a few hours at a time .

Because of this intensity, Newport has found that there are four distinct ways to approach deep work that he calls your “depth philosophy.” Integrating depth into your life serves two purposes. It enables you to improve your ability to concentrate, and it provides some assurance that you will have the time to do so.

Monastic Philosophy

The Monastic Philosophy may not work for most physicians. It involves drastically reducing shallow work by avoiding almost all distractions, including email and social media. This would be akin to locking yourself in your office and only engaging occasionally in conversations with your colleagues. Distractions are avoided at all costs.

Bimodal Philosophy

In the Bimodal Philosophy, you split your time between intense mental work and shallow endeavors. Each period may last a day or longer. During quiet time, it's as though you are practicing the monastic philosophy, but there are frequent extended periods when shallow work dominates. This approach probably does not fit the lifestyle of most leaders (except, perhaps, for those that work primarily as researchers or writers).

Rhythmic Philosophy

The Rhythmic Philosophy for deep work might be a better approach for physician leaders. Simply set aside time each day or two to do deep work. It might be possible in a corporate setting to block out two hours of uninterrupted time on Mondays, Wednesdays and Fridays to devote to tasks such as analyzing quality data, writing a white paper, or preparing a board presentation.

Journalistic Philosophy

Finally, you might consider the Journalist Philosophy as a viable approach to supporting your deep work. In this method, you switch into deep mode whenever there is down time or an open slot in your schedule. This approach can be effective. But it depends on the discipline of moving into deep work frequently, and the ability to shift from shallow activities to deep thinking quickly. This ability requires practice because most of us are easily drawn back into shallow work.

Develop a Routine to Use Deep Work

One common theme made evident by Newport and other authors concerns writing: it is important to develop a routine around writing (and other deep work). Do not leave it to chance or “feeling inspired” to do the work. It is necessary to schedule specific time and use deep work regularly.

Newport also recommends several practices to adopt as a way to develop the intense concentration and energy needed to focus. These methods include:

• walking in nature, thereby enabling “focused-attention mechanisms to replenish,”
• scheduling specific Internet time, and avoiding it at all other times,
• setting very short deadlines for deep work, forcing yourself to work with great intensity,
• practicing productive meditation, in which you focus attention on one well-defined problem while walking, jogging or driving, and
• memorizing a deck of cards (using a specific method that he describes).

Drastically Reduce Time Spent in Shallow Work

Newport also alludes to various methods to reduce the time in unnecessary shallow work, thereby increasing the opportunities to practice and engage in deep work.

Some are addressed in his description of the four depth philosophies. But he also provides advice on other ways to reduce distractions. Some of the methods that the physician leader might apply include:

• schedule every minute of each day,
• reduce interaction with email, similar to what I described in my September Monthly Leadership Favorites,
• limit engagement with social media to only those that add value,
• delegate as many tasks as possible,
• say “no” to requests for your time that are not highly valuable and pertinent to your goals,
• eliminate meetings without a specific goal, and end them early when possible, and
• reduce distractions by disabling notifications from emails, texts and social media accounts.

What I Do to Get to Deep Work

In order to reduce the amount of shallow work, I use all of the approaches listed above. But I must admit that I'm still trying to learn how to say “no” and protect my discretionary time.

When I was working as Chief Medical Officer, I routinely had my assistant block out time for an hour or two several times a week. This allowed me to work uninterrupted on important projects that required intense thought and creativity (Rhythmic Philosophy).

At home, I squeeze in uninterrupted blocks of time to read, write blog posts, work on an eBook, or prepare for my new podcast (applying the Journalist Philosophy). This works for me because I developed an ability to shift quickly into intense concentration as a child.

When I grew up, I was the oldest of ten children. My family of twelve lived in a three bedroom bungalow. I generally studied in the middle of the dining room, surrounded by my siblings and their friends while they ran around playing tag and other games. This taught me to focus intently, ignoring the chaos that surrounded me. I continued this practice regularly through high school and college.

And I still do deep mental work while on 30- to 60-minute walks. These are mostly devoted to creative thinking, like developing new ideas and outlines for articles.

I haven't tried to enhance my attention skills by learning to memorize a deck of cards, but I'm thinking of giving it a try later this year.

In Closing

In conclusion, as a physician leader, and especially a healthcare executive, I believe it's important to devote a sufficient amount of time to deep work. It will enhance our effectiveness and productivity, allowing us to create more and lead better.

Please list more examples of shallow and deep work for the physician executive. Or answer the following question:

Which of these activities do you think use deep work, and which demonstrate shallow work? Please list your answers in the Comments.

1. Performing 3-vessel coronary artery bypass grafting (CABG): deep or shallow?
2. Bathing a bed bound patient: deep or shallow?
3. Preparing an employment contract for a newly recruited general surgeon: deep or shallow?
4. Writing an annual report summarizing the quarterly quality and satisfaction measures for a multispecialty medical group: deep or shallow?
5. Running a quarterly medical staff meeting at a large medical center: deep or shallow?

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Next Steps

If you think a friend or colleague might enjoy reading this post, please SHARE it using the links below.

Thanks for joining me.

Until next time.

The post Effective Leaders Use Deep Work Wisely appeared first on NonClinical Physicians.

Some years ago, a young African-American came to the realization that the key to escaping the poverty and hopelessness into which he had been born was to escape from illiteracy. Hence, he devoted much of his youth to educating himself. He not only learned to read, but to speak and write passionately and eloquently.

After moving from his birthplace in Maryland as a young man, he began to write about his experiences and found a following for his writings. Eventually, he published a book describing his life as a young black man in the U.S. Those writings and his speeches inspired thousands of persons who read them to join the movement that he had committed himself to.

His book, written and published at the age of 27, described in detail his life under, and escape from, slavery. It was published 16 years before the start of the U.S. Civil War, and made a meaningful contribution to the abolitionist movement that eventually ended slavery. That author was Frederick Douglass.

Great writing can have profound effects. It is an essential skill of any leader. Verbal communication is important. But writing serves as the basis for most important forms of lasting communication, even if the message is delivered in a speech. Whether writing a scientific presentation, book, white paper, or newsletter to our colleagues, it is a fundamental skill that must be learned.

When I think about improving my writing skills, I tend to think about writing from two standpoints:

• How to improve the process of writing, i.e., how can I make my writing more effortless and productive?, and
• How to improve the quality of writing, i.e., how do I create a message that is more engaging and persuasive?

I have found that blogging has enhanced both aspects of my writing. I am no expert, nor am I the next Twain or Hemingway. But I have spent hours studying the process of writing. And through blogging, I've experienced a crash course in creating content.

I have written in excess of 100,000 words in the past nine months. During that time, I have learned some things about writing more productively and efficiently that I think that other physician executives might find useful.

For this post, I am going to focus on the first aspect of writing skills: the methods I use to write in the most efficient way possible. Attmepts I've made to improve the quality and persuasiveness will be presented in a future blog post.

How I Used To Write

When I was preparing a presentation for the board, a lecture for the medical residents, or writing a paper to present to my medical staff colleagues, I usually wrote using the following approach:

1. Select the topic,
2. Decide on the three or four most important points I wanted to make,
3. Begin with a short introduction,
4. Write the body of the text, being careful to correct my grammar and spelling as I went along,
5. Write the conclusion, emphasizing the major points,
6. Create the title of the paper, based on what I had written, and
7. Go back over everything once or twice to clean it up.

This approach works, but it can be very inefficient. As a hospital executive, it might work out if you are only preparing one or two major presentations a month, and only occasionally writing articles in excess of 1500 words.

Unless your writing produces one complete coherent message (which I have never been able to do) it is unlikely that creating these documents would take less than three to four hours each, especially if they need to be converted to a slide deck for presentation to a medical staff or executive team.

Creating something like this twice a week will chew up a good day or two, especially if substantial research and inclusion of references are needed.

My New Keys To Writing Quickly

These are the methods I have learned and adopted over the past year. I found them useful in focusing my efforts to create content that is of equal quality to prior efforts, but in less time.

1. Create Writing Rituals

I was taught the concept of “state learning” when I was in college. This is a phenomenon in which memory retrieval is best when the learner is in the same state of consciousness as when the memory was formed. A similar process occurs when creating. Without getting into a long discussion about deep work or achieving a state of flow, suffice it to say that we each write best under certain conditions.

For me, it is early in the morning when I'm able to concentrate and unlikely to be distracted. I've already consumed at least a half cup of fresh coffee. And I have disconnected from phone calls, social media and email. Other rituals are described in this piece by Kathleen O'Shaughnessy. This may be the most important of my keys to writing quickly and clearly.

2. Start With a Descriptive and Compelling Title

As noted above, I used to believe that it was easier to brainstorm my content, write out the majority of the material, and then use what I created to help develop a title that was pertinent and descriptive. Over time, however, I have come to believe that by spending my time on the title first, based on the purpose of the article, it will drive the rest of the writing process. It forces me to be sure that my content truly delivers on the promise of the title.

Besides describing the point of the article or presentation, I try to create a title that will pull the reader in. It should be compelling and inviting. For this site, I think some of my titles might sound a little clichéd, but it is usually clear what I'm writing about.

3. Use the “Brain Dump” (or “Vomit”) Method

I've come to use a method recommended by other authors in which I write very quickly, without any censorship, dumping as much content on the page about the subject as possible. The idea is not to worry about syntax or spelling, poor construction or even vulgarities in this first iteration.  Just get the ideas down.

I have learned to ignore the spell checker. Some writers turn it off for this part of the process. I try to capture every related thought or idea about the topic, regardless of how peripheral it may seem initially.

And I don't want to be side tracked by any editing as I go. Editing comes later.

4. Use Google Docs for the First Draft

I use Google Docs because it has the best spell checker, hands down. I have noticed that some spell checkers are good, some are terrible, and Google Docs is awesome.

For example, although I would never write an article using email, I've noticed that the spell checker in AOL is awful. Because my typing is so crappy when I'm in a hurry, I often spell “the” as “teh” and “would” as woudl.” The spell checker in AOL never catches those mistakes.

Microsoft Word is pretty good, but its list of proper spelling suggestions often places my intended spelling in the middle of its list. The same can be said for the spell checking in my WordPress text editor. So, I must take the time to select the correctly spelled word most of the time, before moving to the next one.

However, Google Docs catches every misspelled word, and it somehow places the correctly spelled word at the top of its list every time. So, I just accept every suggestion and can correct an entire 1500 word document with dozens of mistakes in less than 10 to 15 seconds. I then copy and paste that draft into WordPress for the final editing if I'm writing a blog post.

One more advantage of Google Docs is that it automatically stores every document in the “cloud.” So, I don't have to send it to DropBox or Evernote to keep it accessible. This is great for me because I use three different computers to write (depending on if I'm at home, at work or traveling), one of which is a MacBook! I can access Google Docs on any of them flawlessly.

5. Use a Template

I learned this from Michael Hyatt. He uses different templates for all kinds of documents. For blogging, I have created a template that reminds me of the overall structure of the article. It can be changed, if necessary, but it eliminates the need to recreate the structure each time. If you write regular updates or board reports, using a template will maintain consistency and speed up the process.

The template I use for a blog post generally follows this structure:

• Title
• Personal experience or story
• Introductory paragraph
• Photo
• Body
• Photo/Quote/Table or Graph
• Summary/Conclusion
• Call to Action

This helps keep me on track. Also, if I get stuck on one part, I will work on another for a while, then jump back and finish the previous section later. I use a different template for different types of articles (e.g., a journal submission versus a blog post).

6. Do Research After the First Draft

This just sounds wrong! And it's true that for a scientific paper, I better have my facts organized and referenced, because the purpose is to present those findings to support a thesis.

But for white papers, guest posts, and non-peer-reviewed journals, the number of footnotes or annotated references is small. And the research is often used to support only a handful of statements. I don't know I'm going to include most of those statements until after the brain dump is completed.

If I do extensive research before I write, then I spend time chasing down some arcane fact that I end up not using in the article anyway. I can waste hours running down these rabbit holes.

For me, it's better to get a first draft on paper, then track down the references for the one or two statements that need support and include footnotes or links as needed. Often times, I may already have the reference stored in Evernote, since I use that to collect information proactively to help stimulate ideas for my writing.

For example, when I started this post, I had no inkling I was going to mention deep work and flow under: 1. Create Writing Rituals. But there they are, so I looked up the links to those terms after the completion of the first draft.

7. Set It Aside, Then Edit

Once I'm satisfied with the first draft, I really like to step away from the copy for several hours, or a full day if possible. I think I make better decisions about paragraph placement, eliminating clichés, and assessing section headings if I am looking at the content with fresh eyes. What seems like a logical statement sometimes reads awkwardly after taking a significant break. And remaining misspellings and missing words jump out much easier.

And I edit ruthlessly. I cut, shave, shorten and reorder until it sounds the way I want it to. I sometimes eliminate 30% or more of the original material in this step.

8. Read the Article Out Loud

It would be nice to have the material reviewed by an editor. But because I'm focusing on productivity and speed, this is not an option in most cases. Reading the content out loud is one more way to pick up poor sentence structure or phrases and paragraphs that sound awkward or confusing.

9. Write More

The final key that I've come to realize is that writing more helps me write better and faster. Nothing works like practice!

Wrapping Up

There may be additional little tricks that I've forgotten. But if you adopt some of these nine suggestions, you will certainly improve the speed and quality of your writing. And you could start writing a blog to practice these techniques and enjoy the other benefits of blogging that I described in a previous post.

Next Steps

Please tell me about any writing hacks that you have discovered and applied. My readers and I can always use more hints to help us improve our writing.

In a future post, I will provide some ideas about writing that is more compelling and inspiring.

Don't forget to Subscribe here.

Email me: john.jurica.md@gmail.com

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The post Blogging Has Taught Me 9 Keys To Writing Quickly And Clearly appeared first on NonClinical Physicians.

Your directors will create their goals as well, as we discussed in SWOT Analysis and Goal Setting. You will then review their goals and help adjust them as needed.

Using the SMART acronym will help you to identify appropriate goals. And they will ensure that you continue to remain indispensable to your CEO and board.

SMART Goals

Various words have been used for each letter in the SMART Goals acronym. I prefer to use the following.

Specific

Each SMART goal should be written in a way that is not ambiguous or inexact. You must avoid any lack of clarity, for the reasons discussed in my post on Clarity. An example of a nonspecific goal might be: “Our unit will improve our patient safety scores this year.” A much more specific goal would be: “Our unit will achieve a central line-associated blood stream infection (CLABSI) rate below the national average rate for the coming calendar year.”

Rather than use an outcome measure, you could also define completion of a project, such as “Our unit will put in place a multidisciplinary team to reduce CLABSIs, which will achieve 100% compliance with completing the AHRQ central line maintenance checklist and audit form on each patient, and will achieve 100% compliance with placing the central line under ultrasound guidance.”

Measurable

It is easier to track goals that lend themselves to measurement. It is clear when they have been succcessfully completed. The preceding example demonstrates this principle well.

Attainable

This is usually not a major problem. Most of the time, our direct reports are going to think carefully about attempting to achieve a goal that is not within reach. This is especially true if there is some type of salary increase or bonus attached to achievement of the goal.

But there needs to be balance. I have had pharmacy directors who thought they could make remarkable improvements in inpatient drug utilization. Then they experienced the intense resistance to restrictions on the formulary that physicians demonstrated.

Relevant

Management goals should be REALLY relevant. You and your staff are going to spend significant amounts of time and energy trying to accomplish these goals. They therefore need to be the top priorities for your division or department for the coming year.

Try to weed out the peripheral, “nice to have” goals and focus on the “must have” goals. These are teh goals that will advance the mission and vision of the organization.

For example, consider a facility that is addressing the patient safety issue of CLABSIs as mentioned above. Accuracy of documentation and codingis very important, since there are very specific inclusion and exclusion criteria being applied. Your CLABSI measures may be calculated and published inaccurately if coding mistakes are made.

Therefore, a relevant goal for the Nurse Documentation Specialists might be: “Put in place a process to review all charts of patients with a discharge diagnosis that meets CLABSI ICD-10 codes prior to final coding.” A less relevant goal might be something like: “Achieve 100% pre-discharge chart review by Nursing Documentation Specialists for patients with catheter associated urinary tract infections.” The latter might be an important goal, but it is just not relevant to the more pressing issue of CLABSIs in this case.

Time-Limited

Every goal must have a deadline. After all, a goal without a deadline is just a dream. (Sorry, I have no original attribution for this quote. It has been quoted in various forms by many authors and speakers, including Robert Herjavec on an episode of the TV show Shark Tank!)

One Bonus Requirement

It is also very helpful to add milestones to each goal. These are the steps that must be completed or reached along the path to achieving the goal. Starting with the goal in mind, the milestones can be developed by working backward to the present state. It is helpful if the milestones generally follow the same SMART format, but it is not always necessary.

My Turn

Now, I am going to use these guidelines for smart goals to set some goals for this blog. That will allow me to use another tool to achieve accountability: publishing my goals to the world (or at least my blog readers!). Here are a few to begin the year…

1. Add a new blog feature – interviews with successful physician leaders – by the end of January, 2017.

The interviews will start out in written format. I will include answers to a series of questions about the path a leader or executive took in the journey from clinician to formal physician leader. The final question will address advice for the fledgling physician leader. These interviews will be posted once each week.

Milestones: create the interview template; identify the first five interviewees; contact those colleagues to enlist them to participate; send out the survey(s); collect responses; prepare them for publication; begin publishing the completed interviews.

2. Write an e-book about hospital patient safety, and make it available for free to my audience by the end of March 2017.

This is intended to be a practical guide for any hospital executive involved in understanding, supporting or improving patient safety. It will focus on the recognized components of patient safety that are currently being measured and reported. The e-book will include advice on how to improve patient safety in the hospital setting. I will also provide guidance on improving safety rankings published by HealthGrades and Truven (Top 100 Hospital).

Milestones: complete the background research for the book, create the outline, design the layout, write each chapter, compile the complete e-book, post the e-book, publicize the e-book on Facebook, LinkedIn, my email list and through guest post on other blogs.

3. Write a second e-book by the end of June 2017, topic to be determined.

Milestones: select topic, complete research, etc., etc.

4. Compile a list of physician-authored blogs and post on LinkedIn by the end of January, 2017.

I am personally fascinated by the blogs being written by my colleagues in medicine. I enjoy reading the breadth of blogs being produced. But I am surprised that some topics, such as physician leadership, are not well represented in the blogosphere. I believe other physicians might find this list of interest, so I have slowly been compiling the list in order to share it. I will do so on various social media sites and my own blog in the near future.

Milestones: search other physician-authored blogs for blogrolls; complete additional searches; compile and organize list; publish list.

Start Using SMART Goals

Go ahead and give it a try. Write down your goals for 2017 now. Use these guidelines to rewrite old goals.

Let me know what you think of my new goals for the beginning of 2017.

Don't forget to subscribe here.

As always, write me directly at john.jurica.md@gmail.com

The post How I’m Using SMART Goals for 2017 and You Can Too appeared first on NonClinical Physicians.

My commute is rather long (over an hour each way). On 2 or 3 occasions I have been severely delayed due to major accidents on the tollways that I take to work (Quel embouteillage!*). So I make it a point to leave extra time for my commute.

When I walked into my dark, quiet clinic today, I was struck by the benefits of arriving early. Today, I had some left over paperwork from home that I needed to do, and a blog post to publish! I also wanted to clear my desk  and respond to some email messages. I was able to do most of that before the first employee arrived a little before 8:00 AM.

How Being Early Really Helps

1. Get the best seat.

I usually arrived early to take examinations, including board exams. Back when most of the exams were held in large conference rooms with hundreds of people, it was really useful to be able to select a comfortable seat, in a location near the door and/or restrooms. By arriving early, I get the best seats at the concert, the game, the lecture and on the Southwest flight.

2. Chat with the host.

Arriving at a party early allows my wife and me to have some one-on-one time with the host before he or she gets too busy. Arriving early to a hospital board meeting allowed me to interact with the board members informally before the meeting.

3. Make final preparations and fix technical issues.

There have been several times when presenting at a conference that technical difficulties and room adjustments needed to be addressed before starting. Had I not been early, I would have made my audience wait and embarrassed myself.

4. Enjoy the sense of calm.

My deadline looms. A sense of anxiety keeps popping up as I remember the reports I promised to deliver, and projects I committed to complete. But, I feel so much more relaxed if I get the project done early. Recently, I was asked to write a guest post for Doximity and it felt so good to submit it two days earlier than requested.

5. Enhance the quality.

When I get something done early, I have more time to reflect and go back and fix little mistakes. Whether it is  installing a reclaimed wood floor, or writing a blog post, it's nice to be able to make those final improvements that set my work apart from others'.

6. Early attempts are better.

For certain assignments, early completion is MUCH easier. I am the secretary for an investment club, so I get to record and publish the monthly minutes. They are WAY easier to complete (and more accurate) if done right after the meeting.

7. Looking good.

I think people around me believe that I am dedicated, hard-working, organized and accountable when I arrive early, deliver early, and finish early.

And you know what they call the one who gets to the finish line early? Answer: WINNER.

Next Steps

Now go out and develop the new habit of being early.

1. Commit to yourself to adopt the habit of arriving, delivering and finishing early.
2. Arrive 5 to 10 minutes early for routine meetings, 10 to 15 minutes early to major committee meetings, board meetings and conferences you are attending, and 20 to 30 minutes early if you are presenting a lecture or speech.
3. To help lock in the habit, arrive early for movies, concerts, birthday parties and other informal events.
4. Complete all minutes within 24 hours of the pertinent meeting.
5. Deliver updates, management reports, and white papers at least one day before the deadline.

Can you think of a time when being early really worked out for you? Tell us in the comments.

_________________

*French translation: What a traffic jam!

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Email me directly here: john,jurica.md@gmail.com

The post How Being Early Builds Success appeared first on NonClinical Physicians.

Office email had become a major aggravation for me. Along with the occasional helpful or important message, I was wading through dozens of useless and bothersome emails whenever I had a spare moment. I was deleting dozens of messages that added nothing to my effectiveness as chief medical officer.

Many of the incoming emails were rambling or outright confusing. Some left me wondering about their purpose: to inform me? ask for advice? or seek approval? And my direct reports and colleagues were using email in a way that didn't seem appropriate.

For example, is it appropriate to use email as a real-time communication tool, expecting immediate answers like an instant messaging system or chat room? I thought that email was designed as an asynchronous tool for communication.

Complex and subtle arguments were being misconstrued. Staff was feeling angry about seemingly critical or negative messages. So, I stepped back and reassessed my use of email. I developed a set of guidelines that I follow to prevent these and other email mistakes.

My Guidelines for Eliminating Email Mistakes at Work

1. I limit my emails to neutral or positive messages only.

I never send emails that might be considered negative. Without sufficient context, body language and tone of voice that comes with face to face meetings, it is easy for a neutral message to be taken as negative. If I need to deliver a negative message, bad news, or constructive criticism, I do NOT use email. Face to face is preferable; via telephone is alright in some cases. And when congratulating someone via email, I try to do it in person as well.

2. I try to be very careful to whom I reply.

If I'm not careful when responding to an individual following receipt of a group email, I may accidentally respond to the group. This can be embarrassing or offensive, depending on the content and who gets it.

3. I never use “bcc” (blind copy).

I can't think of many situations in which I want to send a copy of an email to someone without the primary recipient knowing. That would be like secretly taping a phone call and sharing the tape with someone not on the call. The blind recipient may not remember it was blinded and an embarrassing interaction may follow. It also seems a little sneaky to me.

4. I rarely use abbreviations that the recipient(s) may not understand.

Abbreviations can be annoying if they're not obvious. I think the use of jargon and non-standard abbreviations is just lazy and hampers communication. If a message is important enough to be drafted and sent, it should follow the rules of clarity.

5. I use proper spelling, punctuation and grammar.

Shortcuts are appropriate for text messages. But most business emails are sent from a computer and can be properly formatted. Sloppy sentence structure only leads to confusion, and may be taken by the recipient as evidence of lack of professionalism. There is even a Chrome Gmail plugin (Just Not Sorry) that can help avoid certain words and phrases to help your messages sound stronger and more confident.

6. I keep each message to a single topic.

Many persons, including me, sometimes file emails for future reference. When an email message addresses multiple issues in a single email, it can cause 2 common problems. While the first issue is usually addressed, the subsequent ones may be ignored. And filing the message becomes problematic. Do you file three copies, each in a separate location?

7. I'm trying to use more descriptive subject lines.

If someone is scanning emails, make it easy for them to pick yours out. In fact, consider treating your subject lines like a newspaper or magazine headline – pithy and inviting. I've seen some of my colleagues present the entire message in the subject line, leaving the body of the message empty (e.g., “Confirmed – tomorrow's meeting in Room A at 2:00 PM“). Now that's efficient!

8. Other helpful practices to reduce email mistakes.

If I am unable to respond immediately to an important message, I respond with a brief note acknowledging its receipt. And I include an estimate of the timing of a full response. Being proactive prevents the sender from re-issuing the message and cluterring up your inbox further.

Sometimes my attachments cannot be opened due to compatibility issues. This can usually be resolved by converting and sending the attachment as a “PDF” file.

Maintaining Control of Email

Beyond what may be considered “etiquette” issues, email can paradoxically eat up time and impair productivity. In order to avoid being overwhelmed, there are some regular practices and dozens of software products that can improve email management.

1. I spend time un-subscribing on a regular basis.

I hear  complaints of “I have over a hundred new emails to go through every day.” Many of those are subscriptions no longer worth receiving. So, I try to take a few minutes each day and un-subscribe from those I no longer wish to receive. Some email services will ask if you wish to un-subscribe when you mark a message as “spam,” which can be very helpful. There are also tools that will supercharge your ability to unsubscribe like Unroll.Me, Unlistr and Unsubscriber.

2. I try to batch email reading to once or twice a day.

I learned this from The 4-Hour Workweek by Tim Ferris. It is much more efficient to run through 30 emails at one time than to stop every 15 minute to respond to one or two emails (this is one example where batching is good, in contrast to usual Lean Principles). If you find it difficult to ignore emails as they come in, turn off notifications, or use BatchedInbox to deliver messages at times you specify.  To support this practice, you can batch your outgoing emails to late in the day or first thing the next morning, to avoid the back and forth that can otherwise occur (these options are built into Outlook and Gmail).

3. I try to process email more efficiently.

There is an adage that one should only handle a document in your physical inbox once. The same is true of email messages. If an email can be dealt with immediately, do so and then file it or delete it. This includes taking action personally or delegating it immediately to someone else.

Items that cannot be dealt with in this way can be sent to a “Later” or “To do” file to be emptied during dedicated, scheduled time each day. If I need to keep an email message indefinitely, I send it directly to Evernote, as described in Productivity Tool for Physician Executives.

There are literally hundreds of more ways to reduce these email mistakes and make email more effective, but those are the major ideas that I follow. Some authors recommend the goal of emptying your Inbox completely each day. I rarely accomplish that. And like other's have advised… DON'T SEND EMAIL MESSAGES THAT ARE WRITTEN IN ALL CAPS!

Well, folks, what did I miss? Mention other suggestions in the comments below.

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As always, email me directly if you have any questions, or if you'd like me to write a guest post for your blog at: john.jurica.md@gmail.com

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