Time Management:

A Realistic Approach
Valerie P. Jackson, MD

Realistic time management and organization plans can improve productivity and the quality of life. However,
these skills can be difficult to develop and maintain. The key elements of time management are goals,
organization, delegation, and relaxation. The author addresses each of these components and provides sugges-
tions for successful time management.
Key Words: Time management, radiology administration, organization
J Am Coll Radiol 2009;6:434-436. Copyright © 2009 American College of Radiology

Long hours are not a substitute for efficiency. Tasks not worth doing at all example, most authors stress the need for filing. This is
are not worth doing well. great if you 1) have a simple filing scheme and 2) have
—Alexander R. Margulis [1]
someone to do the filing for you. Otherwise, filing is a
INTRODUCTION time-consuming task that is difficult to maintain over
time. From Morgenstern, I learned that my method of
We have all been there: busy with our jobs and taking care of “organized piles” is perfectly acceptable as long as I can
our families, we have to-do lists a mile long. If we are lucky, find items easily. Instead of feeling like a filing failure, I
when we stumble into bed at night, we might have crossed feel successful in my maintenance of orderly heaps.
off a handful of tasks. We have trouble sleeping as we think
about all of the things we failed to do. For some reason, in
THE BASICS OF TIME MANAGEMENT
the middle of the night, the size of these tasks is exaggerated.
When we get up the next day, we are sleep deprived and The key steps for successful time management are as follows:
racked with guilt, ready to begin yet another day of being 1) set realistic goals, 2) get organized, 3) delegate, 4) relax
behind. This vicious cycle goes on day after day, month after and recharge, and 5) stop feeling guilty. There are two major
month, year after year. In this age of 24/7 connectivity, if we time management stumbling blocks: procrastination and
take a “vacation,” we continue to do work, and if we don’t, perfectionism. When we put off tasks (usually distasteful
we feel guilty. The fatigue, disorganization, and sense of loss tasks), we often increase our anxiety level, further delaying
of control usually leads to reduced productivity and quality our work on the task. If we insist on being perfect in every
of our efforts, both professional and personal. The stress and task, we minimize the chance that we will actually complete
anxiety take up valuable time and energy. Anxiety eats the task. In fact, perfect is the enemy of good. If 80% of the
brainpower. How do we break this cycle? Learning to man- effort produces 95% of the product, does it really make
age our time, instead of allowing time to manage us, is the sense to reach for that final 5%? Will anyone notice? Will it
key. affect the outcome?
There are many time management and organization
books and other resources. Unfortunately, many make Goals
the reader feel guilty, because it is difficult to complete all The development of goals is critical for personal success.
of the suggested tasks. Morgenstern [2] stressed that you Covey [3] described this as a process to “organize and
must take small steps and do things that feel comfortable execute around priorities.” Everyone has both immediate
to you. If you feel guilty and try to adhere to someone and long-term goals. In many cases, the very short-term
else’s style, you are likely to become frustrated. If you find goals or tasks supersede long-term goals to the point that
something that works for you, you will feel good about individuals may never achieve their lifetime goals. To
whatever you are able to accomplish and forge ahead. For determine if you have fallen into this trap, write down
your top 3 to 5 lifetime goals (Table 1). Next, list 10
things you plan to accomplish in the next week (your
Indiana University School of Medicine, Indianapolis, Indiana.
Corresponding author and reprints: Valerie P. Jackson, MD, Indiana Uni-
to-do list; Table 2). Compare these lists (Table 3): is there
versity School of Medicine, 550 North University Blvd, Room 0663, India- anything on your to-do list that relates to your lifetime
napolis, IN 46202; e-mail: vjackso@iupui.edu. goals? In the example here, many of the small tasks might

434 © 2009 American College of Radiology

0091-2182/09/$36.00 ● DOI 10.1016/j.jacr.2008.11.018
 Jackson/Time Management 435

Table 1. Lifetime goals Table 3. Lifetime goals related to weekly to-do

1. Become the chair of my department or head list
of my radiology practice 1. Become the chair of my department or head
2. Get an MBA of my radiology practice (weekly items 1, 2, 3,
3. Shoot under 85 in golf 7, 8, 9)
4. Learn to play the saxophone
5. Retire to Fiji at age 60

that can be managed in the future. If it is too compli-

cated, you won’t keep at it.
ultimately lead to becoming the head of a radiology prac- We are all swamped with mail, most of it electronic. It
tice. However, this individual is unlikely to ever get an is critically important to learn to manage your mail and
MBA, learn to play the saxophone, or get to Fiji. For e-mail. Strive to handle both once. The 4 D’s for all types
many of us, the lack of correlation of the lists goes on for of mail are do now, dump, delegate, and delay. Most
weeks, months, even years. It is important to work to- e-mail can be read and handled immediately by a brief
ward your lifetime goals in addition to accomplishing response, forwarding to an appropriate individual, or
your immediate tasks. This means you must elevate your deletion. Only a minority of items should be delayed.
lifetime goals to higher priorities. Obviously, you cannot
Make a file for mail or messages that you can’t decide
ignore many of your weekly activities, but if you don’t
how to handle. Review this file periodically. You will find
perceive that you are not working toward your lifetime
that the majority of this mail never needed action at all.
goals, you will never accomplish them.
Most of it was unimportant and was taken care of by
Organization someone else. If you mistakenly put an important e-mail
There are 2 basic components to organization: organiz- in your delay file, it will be sent again. Ideally, you were
ing stuff and organizing time. Both are necessary for able to recognize the truly important mail when you
success in accomplishing your goals. Disorganization and originally opened it and took care of it immediately.
clutter add to stress. We waste time looking for impor- A problem with doing e-mail on a device such as a
tant information, often failing to find it. We spend too Blackberry is that one may find it difficult to deal with
much time repeating tasks, such as reading e-mail. We long messages and attachments. Thus, the item is
feel overwhelmed by the number of tasks to complete, opened, closed, and forgotten. The same problem may
and ultimately, we spend too much time worrying about occur with the use of a laptop. If you have this problem,
uncompleted tasks. It becomes difficult to distinguish try to identify messages with attachments or ones that
between important and insignificant tasks. will require concentration, and wait to open them on
How do you organize stuff? Throw out items— your laptop or desktop computer.
papers, e-mails, files, and so on—that you don’t need. One of the key components of organization is the
Organize and file (have someone else do the filing management of your calendar. Many of us let our sched-
whenever possible) so that you can find important ules manage us. This is necessary to some degree. For
items in the future. Unfortunately, organization and example, if your calendar says you are assigned to the
filing is an ongoing process, not just a onetime event. reading room, you must be there. However, if you can
That is why it is so important to find an easy system learn to manage your schedule to some degree, you will
ultimately accomplish more with less anxiety. The first step
is to develop a to-do list. It does not matter whether the list
Table 2. To do this week is paper or electronic; chose what works best for you. The
1. Abdominal reading room M, W, Th, F most important thing is to list everything you need to do
2. Department and hospital meetings on Tu and prioritize each item. Be realistic about what you can
3. Finish manuscript for AJR accomplish within the next day, week, or month. If you
4. Drive kids’ carpool to school overschedule yourself, you will be disappointed when you
5. Coach kids’ soccer W night cannot accomplish every task. Review your to-do list regu-
6. Prepare for MQSA inspection larly, daily if possible, and revise as necessary.
7. Revise pt safety protocols When you make your list, make time for planning and
8. Prepare presentation for seminar for referring prioritizing. Schedule time the first thing each morning
doctors
or the last thing in the evening to plan for the next day or
9. Revise referring physician phone list
week. It is important to do this daily or weekly because
10. Grocery store
your priorities will change over time.
436 Journal of the American College of Radiology/ Vol. 6 No. 6 June 2009

Determine your most effective mental time and sched- boomers and older should examine whether our work
ule this time to work on important projects. For example, ethic (or “overwork ethic”) is actually better.
if you are a “morning person,” don’t waste this peak brain Obviously, it is necessary to balance work and relax-
time to do e-mail. Instead, use it to work on an important ation, but what is the cost of overemphasizing the work
project. Save the e-mail for times when your brain is not component of our lives? The balance between work and
maximally efficient. However, don’t do e-mail right be- personal time is delicate but should not be ignored.
fore bedtime; an unpleasant message can destroy your When we take the time to relax with family and friends,
sleep for the night. pursue outside interests, and truly “get away,” we re-
Break large, important projects into manageable seg- charge and find renewed strength to tackle all of the
ments. Some people find it helpful to get away from their important tasks.
desks or workstations where they may be distracted by
Ditch Guilt
e-mail, phone calls, or cases. However, staying at your
desk has the advantages of ready access to your reference Etta Pisano [5] published an excellent paper on time
materials, files, and so on. management in 2001. She stressed that one of the most
Covey [3] also stressed the determination of urgency and important (yet most difficult to accomplish) elements is
importance in attacking tasks on your to-do list. Decide getting rid of guilt. The guilt may involve things that you
what is important and what is not. It is also important to don’t get done at home or the office. Many of us are, for
decide if a task is urgent or not urgent. Urgent, important some reason, hardwired to feel guilty about all sorts of ridic-
tasks should be at the top of your priority list. Unfortu- ulous things. However, guilt just leads to stress and anxiety,
nately, we often consume a great deal of time with “easy” which lead to more stress and anxiety. Nothing good comes
activities, which are frequently of low importance. from an unreasonable sense of guilt. In fact, worrying just
Time management and organization are not the same makes a task take longer and also makes it less pleasant to
as multitasking. Multitasking is widely practiced but is accomplish. I have learned the hard way not to waste time
not necessarily a good thing. For example, think of the worrying about a daunting project: just do it!
last time you talked on your cell phone as you drove Stress and feeling of loss of control can lead to anxiety
home. How much of the trip do you remember? It is and depression. When you are anxious or depressed, it is
likely that you remember the phone call more than the even more difficult to manage your time, complete im-
driving. Although this may make your trip more enjoy- mediate tasks, and accomplish your lifetime goals. If you
able, it makes it less safe, because your attention is not or those around you find this affecting you, don’t hesitate
fully on the road. One definition of multitasking is “do- to get professional help.
ing two things at once by taking twice as long to do them
half as well” [4]. It is better to give your full attention to SUMMARY
tasks, particularly the important ones.
The implementation of realistic time management plans
Delegation can improve productivity and the quality of life. Accept
the fact that you are not Superman or Superwoman. Find
Before doing a task, ask yourself, “Why me?” Delegate time to relax, including time to do absolutely nothing.
whenever reasonable and possible. The downside of del- Stop feeling guilty. The result of having adequate “down-
egating is that you must still check to be sure the task is time” is a brain that works better during both profes-
done, and sometimes it takes longer to tell someone else sional and personal time.
how to do a task than to do it yourself. Get over the guilt
of delegating: think of it as a leadership-building oppor- Those are my principles, and if you don’t like them . . . well, I have others.
tunity for others in your practice. Many tasks can be —Groucho Marx
handled effectively (or even more effectively) by others.
Don’t use your time to do something that someone else REFERENCES
can do more easily or better. 1. Margulis AR. The road to success: a career manual: how to advance to the
top. London: Elsevier; 2007.
Relaxation 2. Morgenstern J. Organizing from the inside out: the foolproof system for
organizing your home, your office, and your life. 2nd ed. New York: Henry
In the current environment of overachievement, over- Holt; 2004.
scheduling, and overstimulation, we tend to underesti- 3. Covey SR. The 7 habits of highly effective people: powerful lessons in
mate the need for mental downtime, relaxation, vacation, personal change. New York: Free Press; 2004.
and time with friends and family. I often hear criticism 4. Powell SK. To multitask or not to multitask—that is the question. Lippin-
that “generation Xers” are too interested in personal cotts Case Manag 2005;10:221-2.
time, friends, and families. Those of us who are baby 5. Pisano ED. Time management 101. Acad Radiol 2001;8:768-70.