Doing One Thing At A Time

Doing One Thing At A Time


Leonard Zwelling

One of the things I have been working on is trying to know what I am doing when I am doing it. This sounds easy, but it isn’t and I guess I’m not the only one with this struggle if Oliver Burkeman is to be believed in his piece in The New York Times Sunday Opinion section on July 30.

Burkeman makes the case for not multitasking. Apparently, he has stopped listening to the radio or podcasts while doing something else (like driving) so that he can devote his full attention to the single task at hand. This strikes me as a terrific philosophy to be employed by clinicians.

Of course, you might say. Doctors must concentrate on the patient in front of them and give their full attention to the signs and symptoms before them as well as listen attentively to the patient. It seems obvious. But, is it?

It really wasn’t the case when I was caring for patients over thirty years ago and I suspect it’s even less so now. Why? Because you have doctors in the middle of clinics trying to do clerical tasks like getting insurance clearance for needed tests while also having to fit in research, training modules, and perhaps even a meal once in a while. Concierge doctors do not have these problems. Mine takes his time with me and explains all the lab test and any other findings. He’s in no rush. It’s really a unique experience to be his patient.

What if the leadership of academic centers like MD Anderson made their number one imperative effecting changes that would allow clinicians to solely concentrate on their patients when they are providing clinical care? That would mean providing doctors with buffers from outside distractions when they are in clinic. No phone calls or emails or texts. Doctors would devote their full attention to their patients and nothing else.

And what about allowing all faculty members to focus on their roles in the mission of the institution? Again, get rid of the electronic medical record if it does not improve patient care. Stop the endless training modules on diversity, sexual harassment, and high performing nonsense and let faculty get back to patient care, research, and education.

As the power of A.I. seems to grow on a daily basis, and no one seems to know how the algorithms really work, we all seem to feel that we should be doing more. In fact, we would be doing more if we tried to do fewer things at once. And, as Burkeman says, if you think doing one thing at a time is so easy, “try it.” It is not easy at all and it is not easy to get comfortable limiting yourself in a world that seems to emphasize multitasking. It turns out that people who really get a lot done are those people who do one thing at a time, do it well, and then move to the next thing.

To accomplish this will require two major changes. First, we each will have to devote ourselves to stop multitasking despite the premium put on doing exactly that. If you want to know why Tiger Woods was such a great golfer, all you need to know is that the shot he was about to make was his whole world at that instant. There was nothing other than that shot. Can you imagine a world where there was nothing else but the one task before you? It’s hard. But we can each commit ourselves to trying.

Second, the leadership of the institutions in which we work can make such behavior easier to do and far more rewarding by ceasing to overload the faculty’s days with needless make work and be more responsive to the needs of the people who actually do what makes the institution uniquely great.

This is asking a great deal from ourselves and our leaders, but the payoff is tremendous, not only in the amount of useful work getting done, but the diminution in the distractions that lead to burnout and job dissatisfaction. Like Burkeman says, “try it.”

Dr. Zwelling’s new novel, Conflict of Interest: Money Drives Medicine and People Die is available at:,

on amazon if you search using the title and subtitle, 


directly from the publisher Dorrance at:

2 thoughts on “Doing One Thing At A Time”

  1. This reflection on multitasking and its dangers is timely. Just look at the number of pedestrian deaths caused by inattentive drivers texting on cellphones. The same dangers arise when doctors are multitasking, increasing the risk for complications in patient care.
    I once listened to music in the operating room, but eventually realized that the operation went more efficiently when I focused on the procedure and teaching the students, residents and OR staff, instead of discussing why I loved “Smooth Operator” by Sade

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