Don’t Commit to Overcommit

Triage What’s Important

Most of the hospitalists interviewed for this article advised other hospitalists to learn to effectively weigh the risks and rewards of taking on new commitments. Here are some techniques suggested for stemming overcommitment and avoiding potential burnout:

• Dr. Hovan has taken on roles that, in isolation, could be accomplished effectively, but which, when combined with his other responsibilities, became diluted. “There comes a point,” he says, “where you really have to triage what is most vital and most important and say no [to some offers].” He points to the Mayo Clinic’s triple shields logo—“Patient Care, Education and Research”—as a test for his decisions about whether to accept invitations to lecture, to do research projects, or to provide education to residents from another program. “Patient care comes first,” he avers. “Any other commitment must be consistent with the advancement of patient care. That simplifies decisions.”
• Dr. Dallas emphasizes synchronization of appointment books. Her pocket PC device is connected with her Outlook calendar so that entries update in real time. To prevent double booking, she advises blocking in social and family commitments, and she advises turning down committee meetings while on shift.
• “A hospitalist shift trumps everything, and it’s useless to show up knowing you’ll get paged out of the meeting in two minutes. This frazzles and disrupts you—why do that to yourself?” She also inserts small blocks of travel time between appointments, especially if she is going to another building on the hospital campus, to avoid being late to important meetings.

  Dr. Baudendistel believes it is important to have well thought-out reasons when declining project invitations. A young hospitalist can leave the door open while saying no, he advises, by having a Plan B ready. In that way, a hospitalist can explain that the current offer may not be in his or her bailiwick—but that the idea is appealing—and can offer an alternative scenario. It’s crucial, especially early in one’s career, he maintains, that “you project a willingness to participate without foreclosing all options.”

• Dr. McKean urges hospitalists to set goals within a three-year framework. “It’s very easy to just say ‘yes’ to everything and then become overwhelmed, working extremely hard, just to stay afloat. But if you instead have a three-year plan, then when you’re asked to do something, you can consciously say to yourself, ‘Is this in accordance with my plan? Is this going to make it easier for me to get to that three-year goal?’ ”—GH