I’m no efficiency expert. Not by a long shot. Yet I have somehow convinced many of you that I am super-efficient, am incredibly productive, and have a large amount of bandwidth. Believe it or not, I have been asked multiple times to share my secrets. I’m not sure I have any, but I’ll share what I know and do and hopefully the comments section will be where the real action is. You all know I love lists, so let’s make a list. We’ll call it the…

Top 10 WCI Efficiency Secrets

Now, before we get into this too far, I want to point something out. We’re talking about economic efficiency here. Obviously there is more to life than economics and a ruthlessly economical life may not be worth living. My life is far from being perfectly efficient and there are other purposes to living and even your career than simply maximizing the economic benefit from it. With that out of the way, let’s get started.

# 1 Kill Your TV

Okay, maybe that is a little extreme. But television is a gigantic time suck for the vast majority of our population. I can count the number of hours of TV I watched last Fall on two hands. I think there were 8 episodes of The Walking Dead and I watched parts of a few college football games. There is a good chance if you simply unplug the TV that your productiveness will go up dramatically. This also includes using the internet or a gaming console like TV. This is where I’m guilty. It is amazing how much time you can kill surfing back and forth between your ten favorite websites seeing if there is something new. In fact, you should probably just close your computer right now and go do something else instead of reading the rest of this post.

Multi-tasking at its best. Who says you can’t blog and spend time with your kids at the same time?

# 2 Some Time Is More Productive Than Other Time

This is a very important concept to understand. Benjamin Franklin said “Early to bed, early to rise, makes a man healthy, wealthy, and wise.” The Army says “We do more before 9 am than most people do all day.” What these quotes are hinting at is the fact that some of your hours are much more productive than others. In my case, I’m twice as productive in the morning as in the afternoon, and my productivity drops to perhaps 10% in the evening. And after midnight? Forget it. Somebody better be deathly ill or terribly injured if I’m going to be doing anything worthwhile. While there are some true night owls, I suspect most of us have noticed this trend in our lives. So what to do about it? Move the more fun stuff that you don’t need much motivation or life energy to do into the afternoons and put the really fun (or wasteful) stuff in the evenings. Then cut the evening short and go to bed so your morning is longer and your evening is shorter. Yup, you’re adulting now. My kids think staying up all night must be awesome. As an emergency physician, I’ve stayed up all night I don’t know how many times in my life. Certainly, it is in the hundreds. More than an entire year’s worth of all-nighters. Not only is it a cardiac risk factor, but I don’t get much done at night nor the entire next day. Working nights is incredibly non-productive.

# 3 Eliminate Financial Chores

I do very few financial chores. I don’t do any research on individual stocks or mutual funds. We only look at our spending once a month and at our investments even more rarely. We don’t go meet with a financial advisor. All our bills are on auto-payment. I even pay my taxes online with a credit card now. All this time savings can be used to do something more productive.

# 4 Marry the Right Person (and be the right person)

My wife is amazing. People tell me that all the time. Nobody ever tells my wife that I’m amazing, of course. At any rate, she’s a very productive person and she has very high expectations for me. We push each other to be healthy, productive, contributing members of the family and our community. Get this one thing right in life and you can screw up a lot of other stuff and still end up being productive and happy.

# 5 Focus on Family Efficiency, Not Personal Efficiency

[Update: 6/16/17: I managed to unintentionally offend a lot of people due to my own insensitivity with the next two paragraphs as they were originally written. So I rewrote them as I wish I had originally written them. To those who were offended, please accept my sincerest apologies, know that I will work harder to be sensitive to people in different situations from my own, and know that I ALWAYS welcome guest posts from regular readers about their successes and struggles with their financial lives. ]

Remember that we’re discussing economic efficiency here and that life isn’t all about maximizing economic efficiency. But if you’re looking for ways to maximize the economic efficiency (time and money) of your household, I think there is an important point that has to be made. There are a lot of things that need to be done to run a household, I’m sure your list looks a lot like mine:

  • Earn money
  • Buy food
  • Care for young children
  • Run older children to activities
  • Supervise homework
  • Repair the house
  • Prepare the meals
  • Laundry
  • Run errands
  • Clean
  • Yardwork
  • Financial chores

The list goes on and on and on. However, if you (or your partner) is a high-earner, chances are that maximum economic efficiency is not found by having your partner also be a high-earner. High-earning professional jobs tend to take up a lot of time and life energy that cannot be dedicated to the other tasks on the list. That’s not to say that those pursuits are not worthwhile, for personal development and societal enrichment. But strictly from a household economic perspective, it’s not an efficient set-up. My wife and I realized this relatively early in our career. It didn’t make much sense for both of us to have a career in a traditional sense. So I focused on medical school and residency and attending duties and she filled a support role with a major focus on raising kids and running a household. Actually, I probably ought to reverse that statement. She filled the primary role of raising kids and running a household and I filled a support role in making sure we had the money to keep food on the table. But either way you look at it, it is amazing how much you can accomplish when someone else is taking care of huge sectors of what you want and need done in your life. The converse is also true. As my practice has become less demanding on me over the years she has been able to branch out into her other interests. The fact that I, like most other physicians and other high-income professionals, earn gobs of money basically eliminates financial concerns from her life.

Imagine what you could do with your life if someone just handed you thousands or even tens of thousands of dollars each month without you ever having to manage a traditional career or “go to work?” All of a sudden you can run a church organization, direct a soccer league, coach two teams, teach a refereeing class, take up a new sport, raise four kids, organize a family reunion, plan vacations, serve on community boards, go help out an aunt, work in the side business, and volunteer in the schools like my wife does.

Obviously, the converse is also true. Having two stay-at-home parents is also not particularly efficient. While you might have the cleanest house on the block, it’s eventually going to get foreclosed on. I don’t know exactly what the maximally efficient combination is for a couple. Perhaps it is one partner working 3/4 time and one working 1/4 time. It is probably different for everyone. But the chances of it being two people working full-time, paying huge amounts of taxes (including two sets of Social Security and Medicare taxes for little additional benefit), and having to hire out child care, house cleaning, yard maintenance, food preparation, financial advisory services etc seems low to me.

Every couple needs to work out a fair division of labor and that combination will be different for everyone, but it’s worth at least considering efficiency when making those decisions.

# 6 Let It Go

Life is short. You cannot do everything. Figure out what your priorities are and throw the rest out. Learn to say no and don’t feel guilty about it. When WCI ramped up, I dropped a couple of hobbies and a volunteer job. I can always go back to them, but I had to decide where to use my limited bandwidth. Sometimes our house is really messy. I mean REALLY messy. We just decide sometimes that keeping it clean isn’t our priority. It’s not the end of the world. It turns out you can clean toilets every other week (or every other month) and nothing really bad happens. Our driveway faces South. If we don’t shovel it, it will melt off a few days after the storm anyway. There is really no point in shoveling after March 1st. If you just came home from a trip and you’re going on a similar one in two weeks, that stuff can sit in a pile in the garage (or even stay in the car) until then rather than being put away and then pulled back out. You can’t do it all. Stop trying.

It’s a lot like a shift in a busy emergency department. You don’t have time to do everything for everybody, so you have to prioritize. The guy in room 1 needs intubated, better do that. The lady in room four needs a central line for her pressors but is on her way to the intensivist. They still know how to put in central lines, so leave that to them. The woman in room 17 wants her fibromyalgia worked up- that can be done in a primary care clinic. Discharge. You can do a billable review of systems very quickly or very slowly, so you learn to ask questions like “Any seizures, blindness, sore throat, chest pain, shortness of breath, vomiting, vaginal discharge, new rashes, fevers, or hallucinations?” and move on. You catch up on charts instead of chit-chatting with everyone cruising through the department so you can leave at the end of the shift. As you approach the end of the shift, you’re all over radiology and the lab to make sure everything you need done before you go is actually cooking. As you constantly look for ways to be more efficient, you learn a few tricks. All those lessons can be applied to the rest of your life.

# 7 Sharpen the Saw

Stephen Covey’s (RIP) 7 Habits of Highly Successful People has a 7th habit called Sharpen the Saw. What he means by that is sometimes you will finish a woodcutting job faster by taking 5 minutes out to go sharpen the saw, rather than fighting through the log with a dull saw for an hour. We need to take the time to do those things that will help us to be more efficient. While it seems like we’re wasting time we don’t have, it actually makes the rest of our time more productive. The classic example is exercise. If you exercise, you will be more fit, have more energy, be more alert, and can work longer. You will also develop a discipline that will carry over into the rest of your life.

# 8 Work Less to Work Smarter

One of my great secrets, and the one that allowed me to really do the WCI thing, is that I don’t work all that much. When I was full-time (I went to 3/4 time in 2016), I was working fifteen 8-hour shifts. Granted, you would sometimes get out an hour late and there were some administrative duties, but if you do all the multiplication, the actual average number of hours at the hospital was close to 30 per week. To make things even better, 80% of those hours occurred at what are traditionally less productive hours- evenings, nights, weekends, and holidays. That left me all kinds of “productive time” (weekday mornings) to do something else. We’re all workaholics in medicine, whether we want to admit it or not. Limiting your work hours is likely to make you more productive at work AND at home.

# 9 Regular, Uninterrupted Sleep Is Better

Here’s another lesson learned from being an emergency doctor. Actually, that’s not entirely true. I really learned it from NOT being an emergency doctor, i.e. dropping my overnight shifts. Now I never miss out on my entire anchor sleep. Anchor sleep is a concept well known to shift workers. Basically, sleep that occurs between 10 pm and 8 am is more valuable than sleep that occurs at other times of the day. It’s probably a hormonal thing. That’s why a shift that ends at 3 am is nowhere near as painful as one that ends at 7 am. You only lost some of your anchor sleep. But since I cut back to 12 shifts and dropped my overnight shifts, I am amazed at how much less time I spend in bed. My sleep is MUCH more regular. Except for 3-4 days a month when I work the late shift, I go to bed within an hour of the same time every night. Where maybe I used to sleep 9 hours and still not wake up refreshed, now I wake up after 6 1/2 or 7 hours ready to go. When working late shifts, it is hard to switch back to a day type schedule, so you don’t. You just stay on this schedule all month where you sleep until 10 or 11 in the morning, and you lose out on a lot of those really productive pre-noon hours. For many specialties, interrupted sleep is a big deal. Limiting your call (and educating those who call you so they won’t have to call you next time) can pay huge dividends in productivity and happiness. Small children and extensive call are a bad combination for productive sleep.

# 10 Do Multiple Things At Once

Some people say there is no such thing as multi-tasking. That’s not entirely true. Let me give you a few examples. I keep a list of articles I want to share in my newsletter each month. Where do I keep them? I keep a lot of them on my Twitter feed. In many ways, I can “recycle” the same material for the blog, the book, Twitter, Facebook, the forum, a live presentation, the newsletter, the podcast etc. Very few of you guys do WCI in more than 1 or 2 of those ways. Nobody is reading or listening to EVERYTHING I do, so it’s fine to have some overlap. Besides, repetition is a useful learning strategy anyway. If I write for another publication, I’ll use it for a blog post or mention it in the newsletter. Blog posts can be packaged up into a book. Lots of efficiencies to be gained there.

In summary, efficiency and productivity enable you to accomplish more of what you would like to accomplish in your life. Following these tips may help you to make incremental changes that over time will dramatically boost your productivity.

What do you think? Are you a productive person? How did you become that way? What tips do you have for people who want to accomplish more? Comment below!