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Focus, Focus, Focus
By Marshall O. Zaslove, MD The following is excerpted from "The Successful Physician: A Productivity Handbook for Practitioners", from Aspen Publishers, Inc. A Cautionary Tale:A few years back, my wife fell very ill with what turned out to be a nasty
atypical pneumonia. She seemed to be sinking, and I thought she was close to respiratory failure when I rushed her to our local hospital E.R.. Luckily, the physician on duty was someone I personally knew
to be an excellent clinician, thorough and very focused. He got studies quickly, and by mid afternoon had called a pulmonologist to come and take over my wife's case. Then the shift changed. The E.R. doctor
coming on duty was nattily dressed, and he motored up in a sleek sports model. He sauntered around the room, bantered with the nurses, glanced at the charts, and then settled into a long conversation with a
technician about . . . baseball. This second physician, it was clear to me, just wasn't focused on his patients. What worried me more, he wasn't focused on my wife--who was gravely ill and, as far as
I knew, in mortal danger. The first physician must have picked up on my anxiety, because instead of leaving at the end of his shift, he stayed with my wife until the pulmonologist arrived. Everything
turned out OK and after a few days in the hospital my wife recovered. But see how crucial it is--from our patients' point of view--that we Pay Full Attention. We even use the phrase; "This person needs
medical attention." So our patients expect it, and so do our co-workers. Benefits of Focusing: Several major advantages accrue to us if we're fully focused at work:
- We can get more done in less time, and our work will be of better quality, with fewer errors.
- We'll have less mental stress, and we'll be more optimistic, because our outside life is forgotten whenever we focus fully on our patients. (We can't do anything about our personal problems at that
moment, anyway, except worry.) The poet-pediatrician William Carlos Williams wrote that he became so absorbed in his patients that " . . . nothing of myself affected me."
- We're automatically "in flow," a sort of peak experience which is closer to play than to work; by staying fully concentrated we literally turn our work into play.
- Some physicians claim an ability to focus intently on a clinical problem until they "see" the solution. There is no question that the best medical students, the best residents, and the best practitioners
have in common the habit of excellent concentration.
- When you're fully focused and concentrated, other people around you can work with more focused attention, also; it's infectious, as is being scattered.
- The highly focused physician is more powerful, commanding, and effective in all her interpersonal interactions; it's the difference between a flashlight and a laser. When you give orders and requests with
fully focused attention, people respond more carefully and accurately. So being fully focused cuts down on rework and misunderstandings.
- If you can focus fully on your patient--even during a brief visit--she will think the visit was longer!
Developing Focused Concentration: The "Master Skill" of Medicine
All of us had good concentration at one time. We learned how to force our attention to focus on a lecture after being up all night on the wards, and later we used the same skill to keep our attention
focused on our work during long surgical procedures or late-night medical watches. But as we advance in our profession our lives become more complex, and responsibilities, distractions, interruptions, exhaustion,
etc., take their toll on our concentration. Whatever we can do to strengthen our attention will help us be more accurate and effective in everything we do. To develop your concentration:
- Of course, AVOID MIXING WORK WITH ANYTHING WHICH DESTROYS OR WEAKENS YOUR CONCENTRATION. Not only are drugs, alcohol, and fatigue on this list, but also less obvious stuff like moods (anxiety,
depression, anger), illness, hunger, pain, etc. Pregnancy, recent research shows, can be associated with some mild decrement in attention (probably in the fathers too!). You obviously can't avoid
everything on this list, but at least you can be aware of them and adjust your work. It's my habit to ask a nurse or a pharmacist to double-check all my orders when I'm aware that my concentration may be
fuzzy.
- Psychologists recommend "compartmentalizing," keeping our private and professional lives separated by a mental firewall so they don't interfere with each other. This is particularly important if we're
raising children or just trying to have a satisfying family life.
- The best course, suggested by the teacher Kirpal Singh: AT WORK, BE FULLY AT WORK; AT HOME, BE FULLY AT HOME. Our patients and our families both deserve our full attention. Which is not to say that we
can't spend break time (or time waiting for an O.R.) relaxing with colleagues, or socializing with our staff. Such moments can actually be very enriching; they build our relationships, and relax and recharge us.
Since some manual procedures can be done on automatic, light chat during undemanding work is common.
But in general, most physicians feel that we're in this profession to help our patients, not for a social life, so we need to keep our eye focused on
the ball--not on baseball. The habit of focusing attention can be transferred from one task to another. I doubt I could have practiced my specialty--which involves daily contact with very disturbed individuals--without
meditating every morning for the past 26 years. To improve your concentration, consider taking up a pursuit which demands total concentration, such as yoga, chess, tai chi, a martial art, or-perhaps the best of all
meditation. Do it every day, and notice the effect on your concentration span after a few weeks. Finally, if we can succeed at keeping our attention focused steadily on a given goal, project, or clinical field for years, then
we will achieve something great. |
