The Time Audit Most Physicians Never Finish

For a long time, my deep work happened in the evening. After a full day, I would sit down to write or plan, tired, and those sessions produced far less than I wanted. By moving that deep work time to the morning, I was able to do more in less time. A look at my calendar helped me realize that my most important work was getting my most tired hours.

Deep work now happens in the early morning, when I am at my best. I start each day by scheduling the big things, the work that moves my biggest projects and ideas forward. My days now begin with a win.

In an ideal world, we make time for our most important work by scheduling deep work first, in the hours when we think best, and protecting it.

My last post was about deciding what deserves your time, and what to say no to. This one is about the other half: getting your important work done once you have made room for it.

Why does important work end up in leftover hours?

Clinical care, meetings, and messages all arrive with urgency, and someone is waiting. But the work that builds your career (your manuscript, your grant, your big idea) waits quietly. So this work moves to whatever time is left, often the end of a long day.

The result is predictable. You bring your lowest energy level to your most important work. The fix is a scheduling decision: give that work your best hours first.

How do you see where your deep work happens now?

Open last week's calendar and label every block with one of three types of work:

• Deep Work. Focused work on your strategic priority: research, writing, strategy, long-term projects. This is where careers are built, and it needs protected time blocks.
• Collaborative. Work with others: clinical care, teaching, mentoring, meetings, committees. It is necessary, it requires coordination, and it often interrupts deep work.
• Reactive. Email, messages, urgent requests, problem-solving. It arrives with no advance notice and pulls you from planned work.

Then look at two things. First, the rough percentage of your week that went to deep work. Second, when it happened. Evening and weekend deep work is a signal that your most important projects are running on leftover energy.

When should you schedule deep work?

I recommend that you schedule deep work in the hours when you think most clearly. For many of us, that is early morning, before clinic, email, and the day's requests arrive. For others it is mid-morning on an administrative day. If you're not sure when yours is, pay attention to where your energy is highest, and give it to the work that matters most.

This is especially important as deep work needs a runway: time to warm up and get moving. For most people that runway is at least 45 minutes, and is often longer. Short gaps between patients are useful for messages and quick tasks, but for most of us, big projects need a real block.

What belongs in that block?

I recommend that you schedule the top priorities that will move your most important work forward in that block. This includes the paper that moves your research program forward, the grant section, and the curriculum you want to build. It's the perfect time to develop the idea you keep coming back to. This is the place for the work that is important and rarely urgent, which is exactly why it needs a scheduled place.

Name one project for each block before you start. A block labeled with a single, specific task is much more likely to get used for that task.

How do you protect the block once it is on the calendar?

One of the best ways to protect these blocks is to make them recurring, occurring on the same day and time each week. You are also much more likely to be effective if you tell your scheduler that this time is protected and not available for clinical work. It is also useful to group your collaborative work so meetings sit together in order to leave other stretches of time open. I also recommend that you schedule reactive work for set windows, such as email at lunch and at the end of the day.

The next critical step is to check your progress. A realistic goal for a busy clinician is 10 to 20 percent of the week in deep work. When your most important work gets less than 10 percent, it is competing for leftovers. You may also benefit from asking yourself when your last true deep work block was. If you cannot remember one from the past two weeks, that is important data.

How can department leaders help faculty do their most important work?

Picture a division where every faculty member's best hours are protected for the work that builds their careers and the department's reputation. Leaders in that division see more papers, more grants, and faculty who stay.

The schedule shapes those hours, and leaders shape the schedule. Consider a simple first step: look at when your department holds its standing meetings. Moving one recurring meeting out of the early morning, or onto a single shared afternoon, can return prime thinking hours to every faculty member at once. Then invite faculty to share when their deep work currently happens. The answers will show you where the schedule can help.

Frequently asked questions

How do physicians make time for deep work?

Schedule it first, in the hours when you think best, as a recurring block of at least 45 minutes with a single named project. Tell your scheduler the block is protected.

What is the best time of day for deep work?

The hours when your energy and focus are highest. For many physicians that is early morning, before clinical work and messages begin.

How much deep work should a physician have each week?

A realistic goal for a busy clinician is 10 to 20 percent of the week. Below 10 percent, your most important work is competing for leftovers.

How can department chairs protect faculty deep work?

Keep standing meetings out of faculty members' best hours, group them where possible, and protect academic blocks on the official schedule.

Where to go deeper

In my new book, The Physician's Guide to Owning Your Time: Do Less. Accomplish More., Chapter 7 covers deep work: how to find the work that builds your career and protect a block for it. Find it on Amazon.

Book a 30-minute exploratory call and leave with your first deep work block on the calendar.

If you lead a department, forward this to your faculty. Then look at when your standing meetings fall.