If you ask any doctor how their day is going, they'll almost certainly reply "busy."It's an almost universal state of being in medicine, and we declare it like a kind of tic.But what if being perpetually busy isn't just a symptom of being under pressure but one of its principal causes?Bob Klaber-a paediatrician at Imperial College Healthcare NHS Trust and its director of strategy, research, and innovation-argues that our collective busy-ness is a barrier to all the changes we say we want.When every minute is ridiculously full there's no space for reflection, human connection, or the careful conversations from which better care emerges-and no time for teaching the next generation.Klaber invites us to adopt a different attitude to our work, one that de-emphasises frantic activity and multitasking and gives priority to being available for people and listening.As a clinician, he seems to practise what he preaches.For example, although his time for each clinical encounter on the ward is limited like any other consultant's, he makes a studied effort to give the impression of a man who has all the time in the world.In all written communication with his patients, Klaber gives them his email address.Paradoxically, this seems to lessen his workload because he can deal with potential problems immediately.Most patients and families never email him-but they hopefully find some benefit in knowing that they can.He reckons that around 0.5% send a note to say thank you, and 0.3% send helpful pointers to remind him of pending tasks in a way that makes his work quicker.A mere 0.2% of those emails are complaints: informal ones that let him know about something missed, forgotten, or not explained as clearly as it should have been.Klaber welcomes these too.He believes that dealing with them pre-empts the risk of people escalating them through formal systems that often make life more miserable for the clinician and for patients and families.Klaber's ideas chime with those of Nish Manek, a GP.Writing for young GP leaders recently, Manek points out how being busy can seem like proof of value, so we equate packed clinics and overflowing inboxes with importance. 1 But being busy, she argues, isn't always better.It's not a measure of impact, and it's not sustainable.Manek describes how some of the most thoughtful leaders she met weren't the busiest ones but rather the most intentional.They protected time to think and rest, giving others permission to do the same.Being unreflectively busy can be a compulsion.If you're tempted to dismiss this idea as madly unrealistic, you might consider what you've rushed through this week in a way that possibly created more work (or even harm) than if you'd done it more slowly.The way to leading healthier working lives may not mean doing more, or doing it quickly, but inquiring whether we're in a vicious circle-and finding ways to escape from it.
John Launer (Wed,) studied this question.