Christina Shenvi: That's great that your family does not pay
you to hang out with them.
I would worry if they did.
Sam: But what a cool job that would be.
Christina Shenvi: But what a cool job.
Hey, if someone would pay me to hang out with my family, that'd be awesome.
Sam: Hi everyone, and welcome back to another episode of Amplify.
I am your host , Sam Ashoo, and I wanna thank you for being a
listener and encourage you to rate us in whatever podcast app you're
listening in so that we can get the word out there to more listeners.
And I also wanna share with you that there are only a few days left in EB
Medicine's special $1 for a seven day subscription to any or even all three
of the journals on eb medicine.net.
That's a great deal.
If you're not already a subscriber, go there and take advantage of
this special and check us out.
You will not believe how many courses and how many issues and how many
hours of CME you will have access to.
It's an absolutely wonderful time saving and critical to
your practice subscription.
Do yourself a favor and take advantage of that special today.
And now let's jump into this month's episode.
Christina Shenvi: Nice to see you again, Sam.
My name's Christina Shenvi and I'm an associate professor of Emergency
Medicine at UNC Chapel Hill.
Sam: Fantastic.
Thanks for being on the show, Christina.
Today we're talking about focus, but before we dive into that, this
is your first time on the show and I wanna let listeners know what a
fantastically interesting person you are.
So, in addition to being in clinical emergency medicine, you
have a lot of other interests.
One of the biggest ones is geriatric emergency medicine.
Tell me more about that.
Christina Shenvi: That's right and having a lot of different projects in the air
or balls that I'm juggling at one time is what got me really interested in
time management and then focus and how we focus our attention and what we do.
One of the hats I wear is in Geriatric EM where I work with the geriatric ED
collaborative to help improve geriatric EM care around the country and now doing
a lot more internationally as well.
Some of the other hats are in education and educational leadership
as well as faculty development.
And then I have a lot of other side gigs or side hustles that keep life interesting
and one of those is in time management, and I got interested in that because
time management isn't something we do on the side, it's how we do everything.
And so in order to be productive to do more of what we care about, I
got really interested in some of the science behind how we spend our time.
The psychology of things like procrastination and focus.
And I created an online course all about time management.
Sam: Wow.
And somehow you're using all of that information for your
multiple interests as well.
And it must be working because you're quite successful.
You have your own podcast as well, correct?
Christina Shenvi: Yep, I run a podcast.
You know, I can say that it's the best Geriatric EM podcast in the
world because it is in fact the only Geriatric EM podcast in the world.
But also I have the privilege of interviewing a lot of experts in
the field and love to share that information with the listeners.
Sam: Fantastic.
Well, in addition to being an accomplished physician, speaker,
and educator, tell me what got you interested in time management and focus.
Christina Shenvi: Well, for about five years I was directing an
office at UNC that supported our 800 medical students academically
So I was working with a lot of students on how to study, how to work well,
and a lot of it came down to these challenges of focus and time management.
They would get distracted or they would put things off, or they
didn't know how to prioritize.
What to work on.
And so I did hours and hours of coaching, hundreds of students, one-on-one, and
then I started putting it together and how can I make this into a workshop
or a course that I can teach them?
And then I started talking about it at national conferences, and it
seemed to really resonate with people.
And I got asked by a physician up in Canada to create a four
week course for her faculty.
And so that grew into then something that I've run at many different
institutions as well as run on my own.
And then I built it out into an online course.
So got interested in it through that pathway, but really just love working
with people and trying to help them get more fulfillment in what they do.
It's not about like, here's a calendar, here's a scheduling spreadsheet,
here's how to track your time.
I mean, those can be useful tools, but it's really the punchline
is it's about managing your mind first, and then managing your time
and your attention and your focus.
Sam: And is this always specific to people in medicine or
people in all walks of life?
Christina Shenvi: I've worked with mostly physicians, but also
other high performing individuals.
So the focus is on people who are professionals, high performing, want
to do more of what matters, but also want to have time to travel or spend
with their kids or do other things.
Sam: And when you're talking about trying to find time to do the things
that you want to do, this can be career or non-career oriented.
Christina Shenvi: Correct.
The skillset is the same.
Sam: Awesome.
Awesome.
And when we talk about it to an audience of, say, emergency medicine physicians who
are listening today or perhaps residents, people in training, we've also got some
people who are other ki nds of clinicians.
There are PAs and nurse practitioners all kind of trying to juggle a busy clinical
practice maybe in training and then perhaps married, perhaps have children,
perhaps have other outside interests.
How is it that someone goes about trying to prioritize or categorize all of that
in their life when they're talking about things like focusing on what to do next?
Christina Shenvi: Yes.
Well, here is a framework that I like to use when I'm thinking about focus.
Now we can't cover everything in time management here in
one hour or one podcast.
But this topic of focus, just getting this down, can really be a good entry
point into making a lot of other changes.
So here's my framework for thinking about focus.
It is prioritize, strategize, and focus.
So we can walk through that and kind of unpack it a little bit.
Sam: yeah.
Christina Shenvi: Prioritizing means first, are you doing the right things?
Are you doing the things that matter to you, or are you spending
a lot of time on low value things?
The Pareto concept, the 80 20 concept of, you know, spend 80% of the time on that
20% that really matters the most instead of kind of spending most of our time on
the 20% that doesn't matter . So, first prioritizing, and this can take the form
of stepping back and saying, all right, what are all those things that I'm doing?
First, just list them all out.
I'm doing clinical shifts.
I'm running this you know, I'll list some of them for me.
I run a program called Flagship.
That's a nine month faculty development program.
I co-direct the ACEP teaching fellowship.
I'm speaking at these coming, you know, 10 things in the next three months.
I have four kids and I have various things that they're doing that I want
to be involved in or that I need to drop them off, you know, and, and do.
So these are first, just list all the things that you're doing.
And one framework I like to use when it comes to prioritization is the framework
called Ikigai, which has become more popular these days, but it's the idea,
if you can imagine a Venn diagram of what you love, what you're good at,
what the world needs, and what you're being paid for or can be paid for.
So think about that Venn diagram with overlap.
And what I like to do is then map onto it all those things
that I listed that I'm doing.
So some of them fit right in the middle.
I love it.
The world needs it.
Meaning like it's making an impact or it's important, it's making a difference.
So I love it.
The world needs it.
I'm good at it.
I'm, you know, working in my strengths.
I find that flow state when I'm working on it and I'm being paid for it.
That is the perfect center where everything aligns.
I wanna do more things that align with all those circles.
Now there are many things that we may do and love.
Maybe it's, you know, coaching your kids little league or
soccer practice or something.
Does the world need it?
Okay.
Yeah.
Broadly speaking, you're making a difference in kids' lives.
Are you good at it?
Well, you don't have to be the best soccer player in the world
to coach your kids' soccer team.
Do you love it?
Yes.
Will you be paid for it?
No.
But it could be a really high value thing for you because
it meets those other criteria.
S o for me, just listing those things out then helps me understand what
are those really high value things that I care about versus what are
things that are low value to me.
Maybe it's a committee that I'm on that I really need to gracefully exit from, or
maybe it's certain personal administration work, like home administration work that
I really don't like, or maybe it's work admin tasks that I want to then say either
outsource or some things maybe I can't outsource I wanna do them as quickly
and efficiently as humanly possible.
Or maybe if I can, I wanna take them off my plate altogether.
So first is just sitting down, understanding yourself, understanding
what you're doing, and understanding what you want to be doing, and that's how
you can start to big picture prioritize.
Which then can feed you into kind of prioritizing your day.
So I'm curious for you, Sam, what would that look like for you?
What are those things that like map right in the middle of the circle for you?
Sam: Yeah.
Yeah, that's a great question.
I mean, things I'm involved with, obviously this podcast in
EB Medicine, which is something I thoroughly enjoy doing.
And then , there are a ton of other things.
You know, I enjoy the martial arts.
That's a hobby.
I get to do that with my children.
It's definitely something I'm not getting paid to do.
But I'd say that's a pretty high priority for me.
Spending time with my family is, I think, at the top of the list.
Again, not something I'm getting paid to do, but something
I find of great high value.
The administrative stuff yeah, there's a lot of that kinda administrative,
nonclinical medical stuff that I do that I don't really have a passion for.
But it pays the bills and so, it can be challenging sometimes
trying to build a priority list.
So I've got a lot of things that I enjoy doing.
I've even got some things I enjoy doing, I just don't have time to do.
Playing music is one of them.
You know, I would say I value it, but not above anything else
that I've already mentioned.
And so it often falls off the list, but if I could, I would spend more time doing it.
Yeah, so then if I've got all of these things that I value and some I want
to be doing, some I maybe would choose to do less of, but they pay the bills.
Then, what would be the next step in that focus?
Is it better to kind of check off the ones that are maybe not of high value and
get 'em done as quickly as possible, or to put those off until the end and spend
more time doing the things that I enjoy.
Christina Shenvi: Mm-hmm.
Yeah.
So you've got your priorities.
Check.
And that's great that your family does not pay you to hang out with them.
I would worry if they did.
Sam: But what a cool job that would be.
Christina Shenvi: But what a cool job.
Hey, if someone would pay me to hang out with my family, that'd be awesome.
So you've got your priorities and this is now where focus
can help you unlock more time.
Because let's say you sit down for your day and you've got
all these things you could do.
Well, now you need to strategize, well, what am I going to choose
to do of all these things.
You could plan your next podcast.
You could go hang out with your kids and skip off work.
You could do your charts and your admin tasks.
Well, now you need to strategize.
What are you going to do?
And this is where focus can really help.
First of all, focusing just to do that executive functioning
of planning your day.
But then second of all, let's look at, for example, a high value task.
Like maybe for you that's planning out your podcast or something, you
know, content that you're creating for EB Medicine that you love.
If you can focus really well and do that work in two hours, focusing, using all
your attention, you can maybe get that done in two hours as opposed to not really
focusing, kind of also checking your emails, also bouncing around to different
things, and then it takes four hours.
One of my favorite books about focus is Cal Newport's book Deep Work, and
in that book he gives this equation.
The high value work that you produce equals time spent
times intensity of focus.
So I could spend four hours with low focus and get the work done, or two hours
in high focus and get that work done.
So that's just the first broad idea for how you can apply it
to your deep, high value work.
But then all these shallow tasks like, you know, for me, submitting
reimbursement receipts, planning my travel, you know logistics and
hotels, all those types of things.
Similarly, if I can take those low value tasks, let's say I have four
hours of low value tasks to get done.
If I can do each hour's worth of work in 45 minutes, in four
hours, I've saved an entire hour.
So those small changes in efficiency, because most things
that you do in an hour, an hour long meeting, an hour of emails.
If I can really focus and work quickly and get it done in 45 minutes, that doesn't
seem like a big shift, but in eight hours, that's two whole hours of your day.
So that's pretty incredible to me.
So, all right, Sam, we've got your priorities.
Now you're gonna sit down and strategize for the day.
Okay.
So one approach is to write down all the things that you could do that day, and
then look at them and say, all right, which things require a deep focus.
Which things really are gonna require like more than 45 minutes or so.
Maybe it's, you know, planning a presentation or creating some
content, writing an article, writing a grant, something like that.
Those you're gonna call deep work.
And then other tasks that maybe don't require all your focus, maybe lower impact
tasks, we're gonna call shallow work.
So now you can think about architecting your day so that
you can apply your focus best.
So for me, for example, what I'll do is write down the things that I could
do that day, like things that maybe are coming up that are due or things
that you know, somebody's emailed me and I need to respond to and do.
And I'll categorize them by deep or shallow work.
And then I'll prioritize them.
So with that deep work, what are the top three or four things in order
that are most important to get done.
And you could think about that with, you know, a two by two matrix of
what's urgent and what's important.
Or you'll just have a sense of, okay, this is due soon.
I need to get this done.
This is high priority.
You're gonna prioritize them.
And then I know for myself, I work best kind of first thing early to
midmorning, like from when I start work, if that's 9:00 AM 9:00 AM to noon.
I can get a good solid three hours of work done there, so I'll prioritize
my deep work during that time.
I know I've worked with some people who say they work really well at
5:00 AM before their family gets up.
So they will get up at 5:00 AM from five to seven they'll get some
deep work done, more power to them.
That is not me.
I know that from nine to 12.
That's my like sweet spot.
So I try to protect that time, not scheduling meetings for that
time if possible, and I will then prioritize that deep work.
And then you still need to have time to do the shallow work.
So that might mean, you know, for me, one approach is when I'm eating
lunch around noon or 1230, then I'll shoot off some of those emails
or do some of that shallow work.
But by looking at your work through that lens of what requires a deep focus
and what is high priority, then you can start to time block in your day.
So from nine to 10:00 AM I'll work on this.
10 to 11, I'll work on that.
Or maybe it's a bigger project, it'll take two or three hours and
you can start to time block out, this is what I'm going to aim to do.
So that's one approach.
How do you think that would work for you, looking at what you have on your plate?
Sam: So I like it.
But I'm wondering now, how much time are you spending in
the categorization process?
Like every morning you sit down and do this, or are you
just projecting out a week?
Or how do you go about doing that?
Christina Shenvi: It varies kind of depending on how
much time I have in a day.
And here, for this purpose, we're not talking about clinical work.
We're talking about like those other things.
If you have a whole day or a half day where you're like, okay, I'm going
to get all these other things done.
I will, if I have a whole day ahead of me, sit down at the start of the day and
write out, you know, deep work, here's the four or five deep work tasks that
I could do, and now let me prioritize them, and shallow work, here's the
three or four shallow work tasks.
And the nice thing about that is then if something pops into my head, like,
oh shoot, I've gotta email Sam about the podcast we're recording, then I
can add that to my shallow work tasks.
And when I come to the shallow work, I can knock it out so that when I'm deep in
the deep work, if something pops into my head as a reminder, I don't have to then
do it right away or keep it in my head.
I can write it down and do it later.
So that's one approach.
Or if I know oh, I have Tuesday afternoon free, I have Thursday morning free, then
I can, you know, block out ahead of time, maybe the week ahead, what I'm doing.
It really doesn't take that much time.
Sam: And when you're deep in the deep work, this is like time where
you've silenced your phone, put that away, no one can get to you unless
it's an emergency kind of thing.
No distractions.
Christina Shenvi: Perfect.
So we've prioritized, we've strategized.
Now, how do you actually focus?
So if you've set aside, all right, Tuesday morning, you're gonna work on
that podcast or you're gonna work on that grant, how do you actually focus?
And part of it is definitely reducing distractions . There's a
lot of literature on distraction and procrastination and psychology.
Even I've read some literature from kind of the IT world about this.
It's really fascinating.
And in thinking about it, why do we distract ourselves?
Why do we get so distracted?
We check our phones on average, this is from twenty twenty four, three
hundred and forty four times a day.
Sam: Wow.
Christina Shenvi: When we are in the office on email, we check
our email every two minutes.
What is going on?
I think there's several things.
One is that often we wanna avoid the negative emotions that
may come up with other work.
So for example, let's say we're working on that grant and we're like, Ugh,
this is really overwhelming, or this is frustrating, or this is boring.
Or maybe we're writing a paper and we're like, Ugh, why am I doing this?
It's never gonna get accepted.
We have a lot of self-doubt.
We want to avoid those negative emotions.
So what do we do?
Sometimes we go to TikTok or Instagram or Facebook or whatever.
Other times we go to, let me just knock out a few emails.
Sam: Hmm.
Christina Shenvi: So most often when I've worked with now hundreds of physicians
and other professionals, when I talk with them about what do they do when they are
seeking distraction, often it's shallow work, so they'll go to their emails
because there's a sense of satisfaction from knocking out a few easy emails.
That feels a lot easier than the hard work of writing that paper,
writing that grant, writing that book chapter, creating that PowerPoint.
So sometimes we avoid things because we want to avoid the negative emotions.
Sam: Hmm.
Christina Shenvi: Other times though, we feel like, you know, it's productive.
I get a sense of being productive if I can check off a few items on the to-do list or
emails, and that's not bad, but it becomes maladaptive if we are then not ever
getting to the deep work that we wanna do.
Sam: Hmm.
Christina Shenvi: There's also a commodity, there's a
price tag on our attention.
There's a saying that if you are not paying for something,
then you are the product.
Your attention is what is being bought and sold.
And that is very true about social media, which I'm gonna harp on because
that is one of the big distractors.
When you look at, for example, so I'm gonna pick on our phones for a minute.
Sam: Hmm.
Christina Shenvi: When you look at how much time we spend on our phones per day,
on average , what would you guess the average time spent on a mobile device?
And I'm not go nna make you pull up your phone and show us your weekly average use.
Sam: yes,
Christina Shenvi: That's between you and God.
What do you think is the average in the US?
Sam: I'm gonna guess like,
sam_1_07-18-2025_120148: uh,
Sam: five hours.
Christina Shenvi: You're pretty spot on.
Yep.
The average is five hours and 16 minutes.
And if you look at baby boomers, currently the average is like
four hours and 20 minutes.
It increases if you're a Gen X, four hours, 48 minutes, gen Y or
millennial five and a half hours and Gen Z, six and a half hours per day.
Now I hear you say, okay but I am using a lot of that time for productivity.
Well, maybe, but the data would argue that actually the sliver of time
that we spend being productive on our phones is actually relatively small.
So from some really interesting data on how we spend our time on our
phones only, what percentage would you guess we spend on productivity?
Sam: Oof.
20%.
Christina Shenvi: 5%.
Sam: Gosh, you're killing me 5%.
Ugh.
Christina Shenvi: Now there's lots of other great things we do.
17% is on streaming audio or music, so I love that.
I listen to tons of audio books or music while I'm at the gym or driving.
So , I'm okay with that use of my phone.
Productivity also can be helpful sometimes, although
there's some caveats there.
But we spend a whopping 37% of that five and a half hours or
five, and a quarter hours on social media and 25% on entertainment.
So we need to take an honest look at our phone use and our distractions.
And it's interesting, Sam, so I went on like a nice deep rabbit hole about this.
Why are we accessing social media?
The number one reason is boredom.
Sam: Hmm.
Christina Shenvi: when we are doing tasks that are maybe boring.
What do we do?
Well, five minutes into the task, what do we feel?
We feel like this tingle in our brains and our brains are like, this is boring.
I don't like boring.
I like interesting.
You know what's interesting?
My phone.
And so I encourage you to try this, like try just moving your phone somewhere
where you can't reach it and sit there and work on something and just
start a timer and notice how long is it before you reach for your phone.
Sam: Hmm.
Christina Shenvi: So , there are lots of things out there, lots of reasons
why our attention is under siege.
A lot of people are making a lot of money off of our attention.
The other thing about social media without going too deep into this,
is it has a variable reward system.
Sam: Hmm.
Christina Shenvi: So you know, back to those experiments with mice or rats or
whatever, where they would press a lever.
And if you press a lever and you always get a reward, it's not that addictive.
If you press a lever and you never get a reward, well you're
gonna stop that pretty quickly.
But if you press a lever and sometimes you get a reward, like a slot machine,
that is the most addictive and that is exactly how social media is, and
it's designed that way on purpose.
So we sometimes seek distraction because of avoiding those negative emotions.
It's easy to look at.
It's entertaining.
It gives us some dopamine.
Sometimes it's productive, right?
Sometimes we find that good deal or that new idea or that good book recommendation,
and it also avoids the burden of choice.
It avoids decision fatigue.
So hear me out with this one.
When we are working, we have to decide what am I gonna do next?
You know, we talked about that already.
Prioritizing our day.
What am I gonna do?
What am I gonna write next?
What am I gonna say in this email?
It's just constant decisions, whereas why are reels that just
continuously scroll so much easier?
We don't have to choose what to look at.
It's just fed to us, which is so easy on our brains.
So that becomes a habit, that becomes an addiction and here's
what scares me straight each time from Cal Newport's book.
He says, if you spend enough time in frenetic shallowness, you can permanently
reduce your capacity to perform deep work.
Sam: Wow.
Christina Shenvi: Isn't that frightening?
Sam: That is scary.
Good grief.
Christina Shenvi: And I'm like, frenetic shallowness.
Oh my goodness.
That describes my day sometimes.
Sam: Wow.
So let's say I'm already super distracted by my phone and checking it a million
times 'cause it sits on my desk right next to me while I'm trying to do my deep work.
And it is consistently going off or consistently trying to draw my
attention away from what I'm doing.
Or if I'm doing something boring.
I'd imagine this takes some training and practice to develop as a skill then
just like anything else I'm going to do.
Christina Shenvi: Absolutely, 100%.
Sam: I mean, I can already feel the anxiety of putting down my phone somewhere
away from where I can't see it and not know that something else is going on.
Christina Shenvi: There's an aphonaphobia.
We're worried if we don't have our phones with us.
Yes.
So here's where it starts with our minds.
So in order to focus, yes, there's lots of strategies.
I'll give you strategies, but first we need to clear our mental environments.
So I think about, making the desired behavior easier.
Like let's say you're on a diet, you're really trying to cut out carbs
or whatever it is, you're cutting out fat, I don't care, whatever it is.
Let's say you're trying to eat healthier.
You wouldn't leave a buffet of donuts, cookies, and, you know,
whatever is you're poison of choice, on your kitchen counter, right?
Sam: Right.
Christina Shenvi: Because every single time you go by your kitchen
counter, you're gonna be tempted.
No, my kids know if there are candies out, I will forget and I will just eat
them without even like, consciously think- it's like a reflux, you, you know,
walk by and I'm just gonna grab one.
So they know any sweets need to go in the oven, like the bottom oven that we don't
use except on Thanksgiving, you know, so everything has to go in the bottom
oven and that way it's out of sight.
I'm not gonna eat it.
We need to make the desired behavior easier for ourselves.
And here's three approaches, clear the mental environment, the physical
environment, and our digital environments.
So I told you it starts with understanding and managing our minds.
We can't sit down and focus and do deep work if we have a lot
of mental trash churning up.
And that could be benign things like, oh, I need to email Sam.
Oh, I need to do my reimbursement spreadsheet.
Oh, I need to buy milk when I'm at the store.
So all those thoughts, those are like balls bouncing around in our heads.
We need to have a place to put those so we can talk strategies for that.
We need to have a system to capture all those to-dos.
But then a lot of times there are other thoughts that are getting in the way,
like oh, this is never gonna get accepted.
No one's gonna like this podcast.
Why should I spend time planning it?
Nobody's gonna listen.
If they listen, they won't like it.
They'll think I'm stupid, or whatever it is.
Whatever things we have churning in our heads.
So we need to start with a clear mind.
One approach that I like, you know, some people meditate.
That's great.
I'm not very good at meditating.
What I am good at is writing things down.
So my approach is if I feel like there's all these things turning
around there to take five minutes and just write down all my thoughts.
Without any judgment or censure.
So write down everything and just notice what's there.
Oh, interesting.
That's why I am avoiding this 'cause it's really boring, or, oh, I feel
resentful that I have to do this because my department is now making
me do this or that, whatever it is.
So I am avoiding it because I feel resentful or I feel a
sense of institutional betrayal.
All sorts of big feelings maybe under the surface that we don't realize.
So just writing them down or, you know, maybe it's coaching.
I have gotten coaching over the years.
It's been invaluable to the point that I was like, this is amazing.
I'm gonna get training and become a coach because it's so life altering.
Or maybe it's therapy, whatever it is for you that helps you clear your mental
environment so that you can then focus only on the thing that you're doing.
So that's the first step.
Then the second one, this is probably the easiest, is clearing
the physical environment.
There's actually a lot of studies that having a clear physical
environment helps you focus better and make better decisions.
So just having a space, doesn't have to be a big space, just having a space that
is under your control and is cleared.
Now, the biggest one for us as kind of knowledge workers is
clearing our digital environment.
And there's, you mentioned Sam having, you know, a phone next to you on your desk.
There are studies that show that having a phone on the desk, not even, you know,
doing anything with it, just having a phone on the desk next to you makes
you perform worse at difficult tasks.
Sam: Hmm.
Christina Shenvi: So yes.
Can we multitask?
Sure.
I can drive and listen to a podcast.
I can walk and chew gum, you know, not to like toot my own
horn, but I can walk and chew gum.
But have you had this experience when you're like trying to read
road signs and you're navigating to a place you weren't familiar with?
I have to turn the music off.
Sam: Yes.
Christina Shenvi: I can't.
Sam: Yes.
Christina Shenvi: I'm at that age.
Tell me you're in your mid forties without telling me you're in your mid forties.
So I have to turn the music down because I need to focus.
So when we're trying to do difficult tasks, like imagine trying to sing along
to lyrics and do math in your head.
No, we can't do two cognitively challenging tasks at the same time.
So just stowing your phone somewhere where it is away from your arms
length reach is a good first step.
Clearing your digital environment means also turning
off any dings or notification.
Sam: Mm-hmm.
Christina Shenvi: You don't need that in your life.
I would not let a coworker like barge into my room and tap me on
the shoulder every five minutes.
And yet when we have a ding that's notifying us, oh, you have an email, you
have a message, that's what we're doing.
Why would you let them do that?
So clearing out any sort of things that are gonna notify you
or distract you, close down your email when you're trying to work on
something that requires deep work.
Sam: I like that.
I like that a lot.
In fact, I was just having this conversation with my daughter the other
day because we are in the same house.
She's a teenager and she prefers to text me whenever she needs anything.
And so I finally had to approach her and say, listen, if you need
something, come and find me.
Otherwise the texting is for when you're not here in the house or I'm not here.
'Cause I'm, I'm not gonna look at my phone.
'Cause I'll get a text from her and she'll be like, can I have this?
And then a few minutes later, Hey hello, are you gonna answer me?
I'm like, is this an emergency?
Like, what's going on?
Come find me.
But yes, I can totally empathize with the whole, my phone is going off every
three seconds 'cause someone is, you know, teams messaging me personal
messaging, me sending me an email, sending me a work email sending me some
other notification you know, DMing, me, sending me a social media post.
Whatever it is, there's always something coming at me.
And, although I have stopped the, you know, the dings and the vibrations
and those kinds of things, they still pop up on my screen as notifications.
And now what I've found I'm doing is the phone sits next to me on the desk
and , just the screen lights up and I start getting distracted and I go, oh,
Christina Shenvi: Yep.
Sam: What was that?
And I look over and read it and I'm like, I'm really doing myself
a big disservice in that scenario.
So, yes.
Okay.
Christina Shenvi: Yeah reclaim your time.
Reclaim your focus.
You know, I had a real realization.
I was speaking on the topic of focus about six or seven months ago, and I realized,
well, this is not the realization, but I realized I will never be a supermodel
or a professional athlete, right?
That's not a major realization, but the realization was, the only thing I
have going for me really is my mind.
And so I wanna protect Protect it and nurture it as much as I possibly can.
Just like an athlete would exercise their body and train their skills.
I wanna train my mental skills 'cause that's what I rely on.
That's, you know, what I do and what my livelihood relies on.
And so that's part of what keeps me motivated as well as the risk of
eroding your ability to do deep work.
All right, Sam, so I've got some practical strategies.
Sam: Okay, let's do it.
Christina Shenvi: If you're ready.
All right, so clearing your mental environment, one approach is to sit
down and write all your thoughts.
Clearing your digital and your physical environment, that's
relatively straightforward.
You also need to have a system to manage all those open loops.
So
Sam: Yeah.
Christina Shenvi: let's say you're sitting there doing your deep work, you've
planned, you've time blocked, right?
You can't just do deep work for five minutes.
That's very difficult.
So you've planned out this hour and a half, I'm gonna work on that big important
task, that wildly important task, and you've silenced your phone, you've done
all the things, and then you're sitting there and in pops the thought into
your head, oh, I need to buy milk, or I need to send that email to Christina.
Now that thought is draining your cognitive capacity.
'Cause cause we're not good at keeping things in our head while
also focusing on what we're doing.
So we need to have a system to capture those tasks.
And here's where sometimes people run into challenges.
They, especially in January, they like to buy the notebook
that will end all notebooks.
Or they download a new app and they're so excited, I'm gonna
put al the things in here.
Sam: I love me a new app.
Christina Shenvi: yeah.
And then what happens a month, two months later, you're like, oh, I've put all these
things in there, but I'm not really doing 'em, or I'm not going back to look at it.
And so I'm gonna delete that app.
That app didn't work for me.
It's gonna go in the graveyard of apps with all the other
apps that didn't work for me.
Well, there is no perfect app.
A system needs three components.
You need to be able to put things in, organize them, and take them out.
Right.
That's all it needs.
So that could be a paper notebook.
Sure.
That could be a bullet journal, that could be an app.
I've tried a lot of the apps.
My favorite ones are Microsoft to do.
That's the one I actually use the most.
Sam: Really.
Okay.
Christina Shenvi: Or Trello is also a good one.
ToDoist.
There's all pros and cons.
None of them are perfect.
None of them are exactly what I want them to be, There's no perfect app,
so stop waiting for the perfect one.
If you wanna use an app, great.
If you wanna use paper, great.
I've, you know, done both over different times.
But you need a system that can then take those things, organize them, and
then you can access them at the times when you need it, because you don't
need the concept of, I need to buy milk, when you're sitting at your desk.
You need that when you're at the grocery store.
Sam: Yeah.
Christina Shenvi: You don't need, like, I need to email this person,
when you're at the grocery store.
You need that when you're at your computer or your phone.
So creating a system that works for you and just continuously adapting
it, you know, whatever works the first time is not gonna be your final system.
So find a system that works for you.
Some other action ideas are to use some time pressure for that project
or thing that you're working on.
One approach that works for a lot of people is the Pomodoro method,
which is setting a timer for 20 or 30 or 50 minutes or maybe an hour and
a half, depending on how much time you want, using some time pressure.
So if you set a timer then now you're like, okay, I'm on the clock.
I've gotta keep moving.
That can help you stay focused or another approach is breaking up big projects
into interim goals with deadlines.
This also helps with what's called the planning fallacy.
I don't know if you've ever heard of that.
That was coined by Daniel Kahneman and Amos Tversky and , one of the best
examples of this is the Sydney Opera House, you know, that iconic building.
And that was historically opened 10 years later than planned, with a budget
of 102 million instead of 7 million.
Sam: Oh
Christina Shenvi: So I'm always thankful that I've never done
something 10 years later and millions and millions of dollars over budget
Sam: Yeah.
Christina Shenvi: But very often I'm like, oh yeah, I'll do this thing
in an hour, and then an hour goes by and I'm like 20% of the way through.
So if you break things down into substeps and sub categories, then you realize, oh
just this first step will take an hour.
And then the second step, how long will that take?
So that can help you better stay motivated and also better
estimate the amount of time.
Sam: So what I'm hearing is you need to design your own app so
that we can all benefit from that.
Christina Shenvi: I don't know, man.
You know, if anyone wants to design an app with me, I'm, I'm there for it.
Sam: Let's do it.
Let's do it.
Ladies and gentlemen.
You heard it here first on EMPlify.
It's coming to your app store immediately.
Okay, so, I need to find a system.
I'm curious now, you said you've tried all kinds of apps and all kinds of systems.
How long did it take before you found your ideal system or whatever it is you use?
Christina Shenvi: You know, I really loved just a paper system for a long time.
And that was working well for me, but decided I wanted to move to a digital
and I'd tried out things like Trello and I think Todoist, maybe Google tasks.
I can't remember.
I tried a bunch of them just so I could be familiar with them, landed on
Microsoft To Do for several reasons.
One is you can make different categories of lists.
So I have like personal things which I'll store, for example, books to read, books
that people have recommended or you know, things that I might wanna write about.
And then I'll have my work tasks, which has various lists, some
of which are shared with other people, if it's a joint project.
And you can assign tasks to different people.
There I'll keep track of, for example, upcoming talks that I'm giving that I
need to write, and when the due dates are for submission or just random tasks
that come into my head when I'm, you know, about to fall asleep or walking
or driving or something, and I'll add them to that to-do list for quick tasks.
And then when I'm doing my shallow work, I can knock some of those out.
It's again, not perfect.
I like that you can organize it well, and when you check off a task, it gives a
very satisfying little ding for me, which that is, you know, I think in medicine
we got very programmed during residency to have check boxes and check them off.
So I use that to my advantage.
I love having a checkbox and I love checking it off.
So I then try to use that to motivate myself to do the
things that are on my list.
So again, it's not perfect, but it works for me.
Sam: On a daily basis, when you sit down in the morning and then you're
plotting your schedule for the day and assigning deep and shallow tasks, are you
then referring back to this to-do list and looking at items that are pending?
Or are you building a new list of like, these are today's
items, or how's that working?
Christina Shenvi: Yep.
Typically, if I have a whole day that you know, for example, today I have
maybe seven hours of meetings, so I don't really have any deep work time
today, so it'll be mostly shallow tasks.
So then yes, I'll look at that list and say, okay, what are
the most important shallow tasks that I need to get done today?
Or sometimes they'll come at me through email.
Often shallow tasks come through email.
So what are the shallow tasks that I need to get done there?
And then if I have more time in my day that I'm going to be doing deeper shallow
work, then I'll maybe make a chunk of time for emails and shallow work.
There's a lot of data that, for example, if you check email continuously throughout
the day, you spend more time on email then if you chunk your email times and say,
okay, I'm gonna do shallow work and emails during these times of the day because
we still need to make time to do it,
Sam: Yeah.
Christina Shenvi: But we don't want to it grow and extend into
all of our day and then not do those other more important things
Sam: So like I'm imagining a future where, you know, some AI, the chat GPT or
Claude or Gemini or somebody I can just turn to and say, Hey, look, I need an
hour today of deep focus on this topic.
Put this into my schedule, and then remind me when I'm at Publix
that I need to buy some milk today
Christina Shenvi: Absolutely.
Sam: And just have it do it for me.
Christina Shenvi: There are programs out there that are saying they're using AI to
help you schedule and things like that.
I have not explored those yet.
I love AI.
ChatGPT and I are BFFs, but I haven't used it that much for actually
integrating with my schedule.
So that'll be the next iteration.
Sam: Okay so I need, first, better control of my own mind and my own mental space.
Second, I need some kind of system to organize my deep and shallow focus tasks.
And third, I need to make sure that I am in a distraction free
zone when I'm sitting down to do my deep tasks so that I can't get
distracted and taken off of track.
Does that sound like a good three steps there?
Christina Shenvi: Absolutely.
And you can train your brain to focus better.
Focus is like a muscle.
So the more that we focus and the more we train our brains, it can become our
superpower so that then you can make time for more of the things that matter to you.
And I know, in EM especially, we often joke, oh, I'm so ADHD , and I think
there is actually some evidence that more people who do have diagnoses of ADHD go
into emergency medicine because there's something there that attracts them.
Sam: The stimulation.
Christina Shenvi: Yeah, the constant stimulation, the constant urgency.
However, the challenge is then switching gears to doing deep work or
something that requires deep focus.
That can feel really challenging, especially for people who have
ADHD distraction can be even more detrimental when you're trying to focus.
You know, it varies.
There's a whole variety of how it manifests with people.
But for some people with ADHD they have an ability to really hyperfocus
on certain things, but distraction can be even more detrimental.
So I think about it like a train, you know, it takes a while to get up to speed.
If you're stopping every two miles, you're never gonna really get up to speed.
So creating a long track, working on our engines so that we can get up to
speed and really focus is something that can help transform our ability to
be productive and to then make time for other things that are important to us.
Sam: Awesome.
Well, honestly, this has been tremendously helpful.
I don't think I've ever sat down to devote this much attention to the
process of scheduling my day and my tasks and building the priority
of things that are important to me.
I really, really like this.
So let's say you're one of our listeners and this also resonates with you.
Where can they go to find you maybe engage you as a personal
coach or take the course?
Tell me more about that.
Christina Shenvi: Absolutely.
You know, Sam, this is the life changing magic of learning how to
focus and prioritize and strategize.
You can find me on my website, which is timeforyourlife.org, and that
has a link to my online course, which has about 16 hours or 12 hours
I can't remember, of CME content.
And also you can find how to contact me there.
I would love to hear from listeners.
Sam: Awesome, and we'll put that in the show notes.
Christina, thank you so much for spending the time and sharing your wisdom with us.
This has been very helpful for me.
I really appreciate you being on the podcast.
Christina Shenvi: It's a pleasure.
Thanks for having me, Sam.
Sam: And that's a wrap.
Thanks for joining us for this episode of EMPlify.
I hope you found it informative, and I want to remind you that ebmedicine.net
is your one stop shop for all of your CME needs, whether that be for emergency
medicine or urgent care medicine.
There are three journals, there's tons of CME, there's lots of
courses, there's so many clinical pathways, all this information at
your fingertips at ebmedicine.net.
Until next time, everyone, I'm your host, Sam Ashoo.
Be safe.