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As a clinician, researcher, or academic, you are no stranger to the demands of a busy schedule: juggling patient care, research, teaching, and administrative duties. The holy grail for any busy person is to be more productive and impactful with less effort – but how do you actually achieve this?

As an ICU doctor and researcher, I am interested in maximizing productivity and impact. As clinical demands ever increase, achieving impact in other domains like research, education, and administration becomes more difficult.

About a year ago I read Jason Calacanis’ blog post on the A.D.D. approach to maximizing productivity for startups in an AI-enabled era. After successfully (at least partially) integrating this approach into my own practice, I have seen firsthand the time savings of this approach.

Let’s explore the A.D.D. approach so you can integrate it in your own workflows to scale your impact.

The A.D.D. Approach: Automate, Deprecate, and Delegate

To start, it is important to recognize that for a busy clinician (or academic), time is likely the rate limiting factor for productivity, impact, and overall life-balance (happiness even?). The A.D.D. approach prioritizes the value of your time, directing it towards your most impactful activities. So what does it stand for?

Automate – remove repetition

Deprecate – stop doing things

Delegate – get other people to do things

Let's look at some specific examples.

Automate: Remove Repetition and Noise

Automation reduces the time spent on repetitive tasks, allowing you to focus on high impact activities. With the impressive growth of AI technologies, the opportunities for automation will undoubtedly continue to increase. Even without Skynet (AI) having fully taken over, here are some free (or cheap) automations you can integrate into your workflow:

1. Scheduling Meetings: Are you still scheduling meetings using multiple rounds of emails where each person is sending their availability? If so, you can easily save time by linking your calendar to an app like TidyCal (free) or Calendly (free) and have people book in to your schedule. If you are coordinating a group of people, When2Meet is a free and simple scheduling tool (Doodle Alternative).

2. Automatic Inbox Cleaning: A huge time-sink is managing a cluttered email inbox. Fortunately, there are lots of easy-to-use tools that save hours per week. I use Clean Email to automatically sort, filter, and unsubscribe to unwanted emails (it takes 5 minutes to set up!). Through implementing stringent rules and sorting, I have reduced the ‘noise’ in my inbox by 90%. My favorite feature is that I can review all my subscriptions at once and quickly unsubscribe to any that aren’t relevant anymore.

3. Reference Formatting: This is an obvious one, but if you aren’t using a reference manager to manage in-text citations for your manuscripts then stop reading this post and download Zotero or Mendeley! (both free)

4. Generative AI Tools: Whether we like it or not, generative AI has (and will continue to) change the way we interact with our world. Already we are seeing its ability to disrupt and automate processes in our every day lives. Just by leveraging free large language models (Gemini, ChatGPT, Claude) here are some easy ways you can save time:

1. Draft Lay Summaries

2. Draft Cover Letters

3. Draft Administrative Emails

4. Create outlines for administrative reports

5. Graphically represent data from excel sheets

With major software companies integrating these tools into email, document processing, Powerpoint, Excel and beyond we can expect major advances in productivity in the next 1-2 years.   

5. Manuscript Formatting: If you are submitting manuscripts to journals, you know the formatting process is tedious and repetitive. Thankfully this can be automated. Resub automatically formats your manuscript for submission in any journal saving hours per submission.  

Deprecate: Do Less (of the stuff that doesn’t create an impact)

The 80:20 rule (Pareto Principle) suggests that for most projects, 80% of the impact is achieved by 20% of the work. If you can identify work that is not achieving the 80% impact and just stop doing it, your time savings will exceed any small loss of impact. This is the part of the A.D.D. approach that theoretically takes the least amount of time to do, but is often the hardest.   

1.Meetings: Synchronous meetings can be a huge time-sink that disrupt productivity. Even if a meeting is only 30 minutes, it disrupts productive work on both sides. Some meetings are necessary, productive, and valuable, but in medicine, many meetings can be replaced by a thoughtful email, screen recording, or voice memo. Be particularly mindful of weekly recurring meetings, as in my experience, these can often be deprecated.

One alternative to a weekly meeting (e.g. for a research team), is to have members provide a written weekly summary. Then, meetings can focus on group ideation or overcoming specific challenges, rather than simply summarizing progress.

2. Checking your email: Automating your inbox is a great first A.D.D. step. To take it further, limit the number of times you check your email to 2 or 3 times per day. Most (all?) emails are not urgent and checking emails more frequently is not useful.

3. Low-impact Committee Work: Some committees form innovative collaborations that yield impactful changes. Most committees do not. Reflect on any committees you are on and whether your involvement is 1) impactful 2) necessary. Can you forgo some meetings or the committee altogether?

4. Casual Networking Events: Casual networking events are fun, but their impact varies. Certainly, networking is important, but be deliberate in ensuring that the events you are attending are worth the time-cost to both your personal and professional life.  

5.  In-person Conferences: In person conferences are fantastic. You meet incredible people, share ideas and research, and connect with your broader professional community. It is important to recognize, however, there is an opportunity cost of time, effort, and money from attending conferences. When I return from conferences I am often exhausted, taking days to recover and get back into my groove. This varies by individual, but being deliberate in which conferences you attend is important.

Delegate: Hand Off (as much as you can)

As a physician, researcher, or healthcare provider, you have unique domain expertise. With that said, there are many things that other people can (and want to) do better than you.

What skills do you possess that no one else on your team can do? Identify those and try to delegate everything else.

With support, instruction, and time you can delegate these other tasks to team members who will be able to do them as well (or better!) than you can. This scales your impact and allows you to focus on the areas of innovation that are unique to your expertise. Here are a few ideas:

1. Email Inbox Management: If you have an administrative assistant who can triage, respond to, and schedule things via email on your behalf this can be a significant value add. It takes some trust and coaching to make work but can pay off. There are new AI tools in this space so I imagine this delegation will be available more broadly in the near future.

2. Data Collection: Delegate chart reviews, data collection, and other research tasks to research assistants or medical trainees (with supervision). Remember that delegation takes work – invest time upfront in training and supporting your delegee.

3. Ethics Approvals: Ethics approvals can be a huge time sink – invest in training a team member who can diligently navigate this process. As a bonus, longitudinal relationships with the ethics board often expedites submissions.

4. Meeting Scheduling: Even if you use a scheduling service like When2Meet, coordinating group meetings is tough. Delegate this if possible.

5. Research Accounting / Budgeting: If you are a researcher, accounting and budgeting is crucial. If you find someone with these skills hold onto them! Accounting is not directly impactful, but is absolutely necessary and a great task to delegate.  

6. Grant Drafting and Management: When a grant is being prepared for submission, your unique domain expertise is necessary in creating the research questions, hypotheses, knowledge gaps, and discussions. Other parts of the grant, however, do not require in depth domain expertise and can be drafted or coordinated by other research personal. A grant manager can help direct your focus to the areas of the grant where your domain expertise has the most impact.

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How to get started using the A.D.D. framework

Congrats! You’ve made it this far in the post and want to start applying the A.D.D. framework today – here’s how to do it.

Step 1) Start with a task audit of what you do on a week-by-week basis. This includes research, education, administration, social media etc. Rate each task as high, medium, and low in the domains of time, impact, and expertise (aka how much of your unique expertise it requires).

Step 2) Identify which A.D.D. strategy you could potentially try for each task.

Step 3) Each month, pick the task with the highest time commitment and lowest impact and apply an A.D.D. strategy to it.  

My recommendation is to start with email inbox automation and meeting scheduling automation – these are two low hanging fruit that easy to optimize today.

Final tips to maximize productivity and impact

Here are some final thoughts on how to maximize your productivity and impact:

1) Small upfront time investments compound over time resulting in significant long-term time savings.

2) Be ruthless in deprecation. Some people have gone as far as to automatically wipe their entire non-clinical calendar. Then people can rebook back onto the calendar if there is a need. Interestingly, from talking to those who have done this, only 20% of people rebook and most meetings are addressed with a simple email or screen recording.

3) Create a team of people who are better than you at their strengths. This includes paid staff but also trainees, students, and anyone else you can bring onto your 'team'. Everyone has their unique skillsets and strengths. Be curious enough to discover them and then invest time to develop them further.

It is never easy achieving an impact. With these tips, however, you can start doing more with less. If you are interested in more ways to scale your impact, sign-up for our newsletter for the best tips and tricks.

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