Countless times during the course of my day, some person, entity or task vies for my time and attention.
“If I could just have a minute of your time” begins a request to also see the spouse of a scheduled patient, a sales pitch from a pharmaceutical “rep” or home oxygen vendor, a phone call from a visiting nurse, a message from a far away relative of an elderly patient in tomorrow’s schedule or a plea to complete the form Mr. Henderson forgot to bring with him for yesterday’s appointment. Unspoken, the same request lies behind every email, fax, memo, journal and invitation that finds its way to my office. A minute of my time doesn’t seem like too much to ask.
In years past I would consider such requests with a constant awareness of how much my time was worth to my employer. “Seven dollars a minute”, I would say, only half joking, when non-patients asked for a minute of my time. That is the “opportunity cost” for a minute of a family practitioner’s time in today’s American health care industry.
Lately, and probably not a minute too soon, I have started to very seriously ponder what each minute of my time is really worth. And I now understand better that time isn’t measured in dollars. Sometimes it isn’t even measured in minutes.
To the patients that entrust me with their care, a minute of my time could make the difference between a good visit and a less than satisfying one. It could make the difference between making the right diagnosis in the first visit or much later. To the far away relative, a minute could mean the difference between needless worry, calm reassurance, or planning a last trip to see their loved one before it is too late.
The emails, memos and invitations obviously pale in comparison to the things I originally went into medicine for, but I have tended to become distracted by the interruptions. And the dollars-per-minute way of thinking is really a very large distraction, too: Again and again I have found that when I don’t watch the clock I am more effective as a physician and more powerful as a healer. I diminish the value of my professional skill, experience and wisdom by thinking of my work in flat rate terms. A minute at a bus stop isn’t the same as a minute at the Symphony, is it?
And, thinking of my employer’s “opportunity cost” – what about my own? My organization will probably be there long after my time is up, so how much is a minute worth to me, since I have fewer of them? I know what the real answer is, I have just had trouble claiming it for myself: My time is invaluable, priceless.
When our horse started to colic today and I left the office early, four patients with routine appointments had to be rescheduled. I made sure they were safe before I drove home to help my wife handle the situation. In years past I would have struggled with guilt, but today I didn’t.
I have come to realize that your days are numbered in the pressure cooker that medicine today can be if you aren’t well rounded in your life. You can’t help others if you aren’t taking reasonable care of yourself. This doesn’t mean that one should be selfish, but it also means one shouldn’t be forever self-sacrificing.
Every time I watched the “safety on board” presentation before takeoff, I have startled at the idea of putting your own oxygen mask on before helping others with theirs. But it is good advice.
My goal is to live long and work until the end in my profession. I want to be the kindest, wisest physician I can be. I also want to be the kindest, wisest human being I can be.
It was about time I let go of my dollars-per-minute yardstick for the value of my time at work. It is also high time for me to think of all of my remaining minutes, 13 million if I live as long as my parents, as absolutely priceless.
The horse is doing fine. The goats are chewing their cud. The barn is warm and cozy under the starlit late winter sky. It is well below freezing and the crusted snow crunches under the cleats of my winter boots as I walk back across the yard to our little red farmhouse.
My stay-at-home vacation has started. I intend to spend it wisely.
“A Country Doctor” is a family physician who blogs at A Country Doctor Writes:.
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