Let’s talk about time management and why we never seem to have enough time.

When you often run out of time, with a never-ending to-do list, it may not be because you are bad at time management or because you need to get better at your job.

If running late, responding to patient and time demands and the stress that goes with this pressure are a concern for you, I can tell you that learning how to be more organised, structure your day better or upskilling with more professional development isn’t likely to make too much of difference.

This is because the problem isn’t the clock or your lack of skills.  The issue is the pattern of beliefs and emotional and physical responding that automatically is activated when caring for someone else.  Let me share an example with you. 

A familiar patient arrives, who, you know from experience, is too complex for their appointment time.  You feel tension between the clock and meeting the patient’s needs.  Doing a good job trumps, because you care and there just aren’t any other services available to do it.  You spend a little extra time with the patient, rationalising with yourself that shortening your break will help you catch up. But of course, this takes a toll on your time and energy resources.

At some level, you know that getting more skills isn’t the answer.  However, when there is a niggling sense that you should be doing more and you need to step up because there are no other options, it is useful to consider whether your habit of running over time is driven by underlying patterns of self-sacrifice. 

Logically, I’m sure you know that you can’t fill the gap of insufficient mental health services, and maybe, you even remind yourself of this.  But what I know is that you can’t always CBT your self out of the pattern of being overly responsible.  This is because being successful in your role, respected by peers, liked by patients, has been driven by long term emotional and bodily imperatives (as well as cognitive rules) of how we need to be when caring for someone else.

When you have the self-sacrifice schema you tend to put other people’s needs before your own most of the time.  Doesn’t sound like a bad thing for a GP to do, but the self-sacrificing schema causes us to ignore and suppress our own feelings and needs.  And if you do this habitually, it leads to a build-up of unexpressed stress and resentment – two key risk factors for burnout.

Healing from the self-sacrifice schema is a necessary, important component for sustainable practices at work.  It involves shifting your source of worth coming from what you do for your others to recognising and valuing your own needs and intrinsic value and prioritising this.  I know that the very thought of this can make some doctors feel uncomfortable! 

And, of course that makes sense – health systems often run on health professionals who feel overly responsible and give of themselves to fill the gap. The thing is, liberating yourself from self-sacrificing patterns doesn’t make you selfish, nor does it mean that the health service falls apart. What is does mean is that your practice becomes more sustainable, because your value and nourish your needs. And everyone ultimately benefits from that!