Interruptions: Bad at Work, Good at Home for Physicians

At work, I am examining the flow of our clinic. You can have the best templates, efficient nursing staff, on-time patients, and perfectly organized exam rooms but still fall behind, all because of interruptions. Interruptions are hard to predict except to know that they will be there in some form every day. Sometimes they’re small like an e-mail message or phone message from a patient. Sometimes they are larger - a patient walking in with chest pain or a patient about to deliver a baby. It’s exceedingly challenging to plan for something that is about to happen but which occurs unpredictably and takes up an unknown amount of time.

Some of it is embedded in the nature of our work. When I’m running 45 minutes behind and walk in the exam room to find a stressed-out father holding an infant and trying to amuse a toddler with a full diaper, he immediately softens when I explain that I had to admit a patient to the hospital. He understands what I still struggle with - doctors address emergencies, urgencies, and unexpected occurrences as a routine course of business. However, our days still tend to remain organized in such a way that these events can throw our schedules into a tailspin. How? Why? We know they happen; they cannot be prevented, predicted, or avoided.

I think that I, like many people, like to have as much control as possible. When I look at my clinic schedule for the day or open my calendar, I want to believe that it is the roadmap for my day. So, the threatened loss of control that comes with the unexpected is annoying and aggravating and feels uncomfortable. I wonder if I looked at my schedule differently - kind of like a map for a road trip. A map tells you the general direction you are going, but any good roadtripper knows that the best trips involve unanticipated detours. Likewise, you know you’re going to stop for gas and meals and to sleep but you may not know exactly where or when.

At home, interruptions can be the best part of the day. I personally love Wisconsin winters for one reason: cold days. These are days when it is simply too cold to go outside so everything gets cancelled. No snow to shovel. No guilt about not going outside to do errands or chores; just a wide open day full of possibility. Interruptions also come in the form of my four-year-old son who frequently pulls me back to bed in the morning for snuggle time. While it sometimes means I have to skip some part of my morning routine, I know that particular interruption will fade fast as he becomes busy with his own morning routine.

So in the balance of work and life, responsibility and obligations, schedules and appointment, it’s important to know that interruptions are going to happen and they can be anticipated with dread or with expectation.