What If the Problem Isn’t That You Haven’t Tried Enough?

“I’ve tried everything.” 

You finish seeing your last patient at 5 pm, but at 7:30 pm, you are still in your office.

You have tried getting to the office earlier.

You have tried staying more focused.

You have tried using templates, shortcuts, batching, lists, and productivity systems.

And yet, you are still taking work home.

You may be thinking, “I’ve tried everything. Nothing works for me.”

What if the problem is not that you have not tried enough?

What if you have been trying to solve the wrong problem?

You do not necessarily need another productivity hack. You may need to understand what is actually keeping you at work.

You may be solving the wrong problem. Not all extra work is caused by the same thing. Perhaps you are spending too much time documenting - but perhaps documentation is not the biggest issue. Maybe it is constant interruptions, switching between tasks, an overflowing inbox, over-documentation, difficulty saying no, overthinking decisions, taking on work that could be delegated, an inefficient workflow, or a heavy mental load that makes it difficult to focus. If you treat the wrong problem, even an excellent strategy will not solve it. Before asking, “What productivity strategy should I try next?” Ask, “Where am I actually losing time?”

You may be trying to change too much at once. When physicians are desperate to get their evenings back, it is tempting to overhaul everything - all at once. 

New workflow. New schedule. New documentation system. New inbox strategy. New morning routine. Changing five things at once can create more cognitive load and not less. Instead, choose one area to improve. For example, this week, you choose to focus on completing each patient note before moving on to the next patient. Small changes are easier to implement, evaluate and sustain. You do not need to transform your entire workday overnight. 

You may be relying too much on willpower. A strategy that works only when you are having a perfect day is probably not a good strategy. Clinic days are unpredictable. Patients run late for various reasons. Someone needs an urgent call. The computer freezes. A colleague asks a question. A difficult conversation takes longer than expected. If your system depends on you being perfectly focused and disciplined all day, it will eventually break down. Instead, create systems that make the desired behavior easier, even on difficult days. This is an opportunity to emphasize that efficiency is not about simply trying harder.

You may not know your biggest time leaks. Before you fix your workflow, ask:

Where am I spending more time than I expected?

What repeatedly interrupts me?

What tasks am I doing multiple times?
Where am I switching between tasks?

Where am I doing that someone else could do?

Which tasks consistently follow me home?

You might discover that the thing you thought was taking the most time is not actually the biggest problem. You cannot effectively change what you have not identified.

You may be underusing the resources you already have. Sometimes the solution is not another app, another template, or another productivity system. It may be using what you already have differently. Consider you staff, your EMR”s existing capabilities, templates and text expanders, delegation, team workflows, scheduling, and existing knowledge and experience. You may not need more resources. You may need to leverage your current resources differently. Sometimes an outside perspective can help you see possibilities that are difficult to see when you are immersed in the problem.

Stop searching for the perfect solution. Start experimenting. There may not be one magical change that suddenly gives you your evenings back. That is okay. Instead of asking, “What is the one thing that will finally fix this?” Ask, “What is one thing I can test this week?”

Choose one change. Try it. Notice what happens. Keep what works. Modify what does not. Then experiment again. This shifts you from frustration and helplessness to curiosity and possibility.

You do not need to keep doing this alone. Maybe you have already tried the productivity tips. Maybe you have already downloaded the apps. Maybe you have already changed your schedule. Maybe you have already promised yourself that tomorrow you will be more efficient. And you are still working at 8 pm. That does not mean you are incapable of changing. It may mean you have not yet identified the specific combination of mindset, workflow, boundaries, systems, and strategies that works for you. That is where individualized coaching can be valuable. Rather than handing you another checklist of things to try, coaching can help you step back, understand what is actually happening in your workday, identify what is getting in your way, and experiment with changes that fit you, your practice and your goals. 

There is more to discover. The fact that you have tried many things and are still struggling does not mean nothing will work. It means there is more to discover. You do not need to become a different physician. You do not need to work harder. You do not need another dozen productivity hacks. You need to understand what is actually keeping you at work after your last patient, and find an approach that works for you. Your goal is not simply to finish your charts faster. It is to leave work with your workday actually over, so your evenings belong to you again. 

If you are a physician who is tired of working late and ready to figure out what is really keeping you at work, my 1:1 Physician Coaching Program may be the next step. You do not need another productivity hack. You may simply need a different way of looking at the problem.