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Time Management: How to get things done without really trying

The fundamental principles of entrepreneurship that all successful business leaders know are rarely taught in medical school.

It's time to become fully aware of these basic principles, which are essential to boost your efficiency and awaken the proactive mindset that sleeps in you.


Let's return time to the place it deserves. Miles Davis said: "Time isn't the main thing. It's the only thing." Time is incompressible, infinite, priceless and cannot be saved – and each of us uses it for very different purposes, depending on our culture, aspirations and, above all, our awareness of its value.

Two powerful laws of success are thus to be combined to combat any tendency to procrastinate – the force that prevents you from following through on what you set out to do:

Parkinson's law

"Work expands so as to fill the time available for its completion" or the "deadline principle."

The more time you have to write an article, for instance, the more time you take to write it. Thus, the human tendency is to exploit the totality of a given amount of time. When there's no time limit, a project may never see the light of day.

The time you give yourself to do a task is a mental limit, often linked to an external constraint. But this mental limit can be easily rescheduled: halve the time you gave yourself to do a job. Divide it into elementary sub-tasks and eliminate the non-essential tasks. You will see that it works; you'll have taken half the time to do it.

Once you understand the principle, divide this time by three; you'll be amazed to discover that it still works.

The 80/20 law of the Italian economist Vilfredo Pareto

He found that 80 percent of the country's wealth was in the hands of 20 percent of his countrymen. This law became progressively more popular when it was realized that it applied to many other areas.

In other words, 20 percent of the work is responsible for 80 percent of the final result. We agree that 80 percent isn't 100 percent, but as Sir Winston Churchill said, the word perfection is spelled "P-A-R-A-L-Y-S-I-S." Don't aim for perfection. Aim for efficiency. Aim for 80 percent – it only takes 20 percent of your time. It's more important to do the right thing than it is to do it right.

Combine and apply these two laws as often as possible and you'll see your productivity take off.

Habits and proactivity

Our relationship to time and our behaviors depend on our habits. To change, we must change our habits. This separates us from our freedom to consider and react differently to the obstacles we encounter.

It's easier to say than to do – and changing a habit requires determination and unwavering conviction. Becoming aware of the stimuli triggering our counter-productive habits is the first step to fighting them. Look at yourself and identify your distracting stimuli.

Our behaviors are the result of our decisions and not our condition. Everything we do is the result of our choices, intended or not. If you really want to be the architect of your own life, your choices must no longer be the result of the external circumstances. Think specifically about your own situations. For example, do you continually find yourself in internships where there aren't enough people? Is what you're doing right now going to help you get to what you really want in life?

Finally, you have to be extraordinarily proactive: This is the most important habit to adopt. Make an attempt to stop being reactive and to become proactive as often as possible. It's a matter of being clear about your long-term goals and thus acting according to your internal values, the ones you hold most dear.

Proactive people act according to their system of values and principles in life and decide according to the circumstances – or even provoke those circumstances.

Your responses to external stimuli depend on your own values; therefore, what matters is how you react when external forces test your convictions.

Don't sit on the sidelines and wait to see what happens. When you're proactive and take the initiative into the unknown you may fail, but more often you will win.

The words used by each individual make it fairly easy to distinguish which category they're in. The vocabulary of reactive people will typically be: "I can't…", "I must...", "If only...," while the proactive expressions are "I choose..." and "I can approach the problem differently."

Don't consume energy dealing with that which you can't control (i.e., politics, news or social media trends). Rather, focus upon what you can improve in your world today. What are you dedicating your 24 hours to? Your circle of concern should be in harmony with your circle of influence (where you can make an impact today).

The reagent's circle of concern focuses on things for which they are powerless, which don't depend on them (in other words, bistro discussions). Reagents will readily criticize others' shortcomings, thus releasing negative energy that significantly reduces their circle of influence.

The proactive are a part of the solution, not part of the problem.

The direction

This is the fundamental element. After climbing the ladder, it's one thing to realize that our life is not exactly what we dreamed of 20 years ago, but it's quite another to live the life we dreamed of and not live it at all.

That's what can happen if you let yourself be carried along by the will of others. What makes you vibrate? On which wall are you going to put your ladder? The walls of the public hospital or those of the private clinic? academic research or leisure and family life? Living abroad or staying at home?

If you don't know (don't worry, you're not the only one), take an afternoon out of your life and think: "I'll have a successful life in 20 years and I will look like..." Imagine yourself in every situation. If you can't imagine that, look for new experiences to give you a clearer picture of the situation.

This answer is personal; there's no point in lying to yourself. What do you really want? Write it down. Ignore the mental constraints that stand in front of your most ambitious desires. Free yourself of any guilt about those.

Congratulations – you have set your direction.


Now you've put your ladder on the right wall, all you have to do is climb it.

Some principles of sociology can be very useful to optimize your climbing time:

  • A principle generalized by General Dwight D. Eisenhower is to work as much time as possible on "non-urgent/important" tasks. Sort out today each of your tasks to be performed – individualizing urgent/important tasks, non-urgent/important tasks, non-important urgent tasks and nonurgent/non-important tasks.
  • Adapt to the hours of productivity: Productivity is highest in the morning and lowest in the evening, generally after 8 p.m. Save the most important things for the morning.
  • Dare to delegate: Time is also money! How much does an hour of your working time cost? To find out, divide your monthly income by the number of hours and days you work, which will give you something to compare – to see if what you do with your professional time is wisely used, or if you'd be better off entrusting certain tasks to someone else.
  • Take regular breaks to boost your efficiency. During a presentation, the listener's attention quickly fades dramatically after 45 minutes. Even a tiny break will ease your body and reboot your brain.
  • Always give yourself a deadline for every job you start.
  • Reward yourself every time you complete the project on time.
  • Start immediately! Don't plan to think and then take action. Typically, to combat "white sheet syndrome," write anything on your screen. Never wait until you're ready, because that moment will never come. If you fight this moment of initial paralysis, in one hour you'll have solved a problem that could've lasted for months.
  • Use speed reading – and avoid reading what's unnecessary. You have to select your readings (use the Tables of Contents; does my query justify reading an entire book chapter, an article or just a summary?). Prioritize your readings (sort "to be read in the month;" "to be read;" and "to be read before 6 p.m. tomorrow"). Impose time limits (give yourself one hour to understand the main principles of this surgical technique, for instance).
  • Manage interruptions: It's better to go to people's homes than to let your office become invaded by others.
  • Know how to say no: If someone offers you something you won't have time to do, dare to say: "No, I don't have time." You'll avoid being considered unreliable.
  • Teamwork: Spread your time by amplifying the actions that will allow you to broaden your collaborations and synergies. You'll increase your impact by associating with new people on projects.

I would like to thank Marc Revol, MD, for sharing his inspiring teaching, and Ian Hovenkamp for his proofreading.

Dr. Lupon is PGY-4 in the Department of Plastic, Reconstructive and Aesthetic Surgery at Hôpital Européen Georges Pompidou, Paris, and a Research Fellow at the Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston.