I had a mini epiphany recently. I realized there are three basic categories of time:

• Productive: many work tasks (but not all), completing a task at home, achieving a specific personal or professional goal.
• Non-productive and enriching: sleep, physical activity, being fully present with friends and family, learning something new.
• Non-productive, non-enriching, and pleasurable: Netflix bingeing, drinking another glass of wine, zoning out, going down a social media rabbit hole, funny cat videos.

And before you feel guilty about indulging in Category 3 activities, know this: I believe all three are necessary. Sure, if we spend virtually all our time in any one of these, our lives will fly out of whack. But some of each is a good thing.

With the pandemic, I experienced a gravitational pull toward Category 3. With the changes going on in the nation, in the world, and in my life, I wanted to escape. Spy novels, movies with predictable plotlines, crossword puzzles. Anything to stop worrying for a time.

Honestly, I think it was a fine way to cope during a dark period. Now I am being more intentional about shifting to enriching activities. I am seeking out friends from high school, taking an acting class, and trying to learn Spanish.

The physician trap

There is a common trend related to time that I have seen among many of the physicians I work with. They spend almost all their time in Category 1, with bits of Category 3 time around the edges, and scant little in Category 2. This pattern is due to the pandemic, but it is also the influence of the culture of the medical profession.

It can be a real challenge to change this pattern. There are many, many external pressures to be productive all the time, and physicians can feel guilty and uncomfortable when they are not.

When being productive is no longer an option due to physical fatigue, mental exhaustion, or frustration, physicians fill in with Category 3 activities. Of course.

These are easy to reach for, provide an immediate distraction, and feel good as you are engaging in them. The problem arises for physicians when these activities get in the way of Category 2 time.

Prioritizing sleep

When I ask physicians the question, “What are some of the preconditions that set you up to be at your best?” the response is almost universally, “Get enough sleep.”

Then I ask them to choose one small, specific action step to try as an experiment to get more sleep. Examples they have committed to include: “Set an alarm at 9 p.m. and shut down my devices” and “Charge my phone in the bathroom so I am not tempted to check it right before bed” and “Set a regular bedtime.”

They notice a big difference in how their day goes when they are better rested: They have more energy, more patience, and a more positive attitude. In fact, the physicians who take small steps to replace Category 3 time with Category 2 time are often amazed at how much sleep influences their experiences at home and at work.

Setting limits

The other change necessary for physicians to find a healthy mix is setting limits on productive time. Right now, the workload for physicians is unbelievably high and truly unsustainable. Finding ways to make this manageable is a real challenge.

For the physicians I work with, creating boundaries, advocating for more resources, prioritizing time, saying no, and being creative about efficiency generally bring some relief. And as they shift to a more balanced mix of time, they start to thrive again. They feel it, and the people around them notice.

If an off-kilter mix of time has you feeling helpless, frustrated, and exhausted, just know that change is possible. I see it every day.

Diane W. Shannon is an internal medicine physician and physician coach.