Ok, sure. ‘Measure thyself’ is a bit of a lazy pun on Luke 4:23, but the fundamentals of any improvement process are to define the problem and measure the effects of various changes.
Want to lose weight? Weigh yourself (define the problem), then weigh yourself again after modifying your diet and increasing your exercise (measure the effects).
Want to learn a new skill? Decide how you are going to approach learning it (define), and then commit to a regular practice that you can log each time you complete (measure).
One of the foremost leaders in the field of management, Peter Drucker, is famous for the phrase:
What gets measured gets managed
Thankfully, it’s never been easier to measure some aspects of personal productivity than in this era of smartphones, fitness trackers and spreadsheets.
When a physician is asked ‘what are the important measures of your performance?’, there could be any number of responses:
- Medical errors
- Length of hospital stay
- Clinic throughput
- Publication in peer-reviewed journals
- Research projects supervised
- Grant funding received
- Hours in teaching
By definition, personal productivity requires each of us to define for ourselves what we value and measure. And this comes to down to priority. Defining your priorities is fundamental to deciding what to do next, where to focus your energy and time, and how to measure your output.
Deciding your priorities can be a challenge, however, as you will spend a lot of your time as a physician on what other people have decided is important. It is critical that you meet the professional and personal obligations of your role, but equally critical that you define what you want to achieve in the time you do have control over.
Many productivity experts suggest the development of a mission statement which can be used to align your priorities (see also Covey for an example). The definition of your mission and values will allow you to consider all decisions about priority through a new lens.
What are the components of your work that are most important to you? How could you measure your performance in those areas? What does your position description say? How do you align your personal priorities with those of your department head? If there was any one project or task that would make your work more effective today, what would it be?
After deciding what you wish to prioritise, it is necessary to define the outcomes by which you will measure your success. These might be obvious, such as in the case of frequency of peer-reviewed publication, although they are often more nebulous and require careful consideration. Teaching efficacy is one such outcome that might be quite hard to define. It is very unlikely that your impact as a clinician educator is the one thing that makes a learner pass or fail!
You can develop metrics for many types of goal, but it is important that you carefully consider the metric and then define how you will track it. If it is a habit or behaviour that you would like to develop, you could log instances of that habit or behaviour as part of a daily journaling exercise. If it is a mood or perspective shift you are trying to achieve, can you set reminders on your phone or watch to remind you to appraise your performance regularly throughout the day?
Measuring progress toward a goal makes the achievement of that goal more likely. Success comes from defining the outcome you wish to achieve and the metric by which you will measure success. Most importantly, tracking your performance against that metric over time is crucial. The act of tracking your progress keeps the goal and its metric in your mind, therefore leading to a higher likelihood you will focus your time and energy on that goal.
Finally, create some form of visual reminder of the goals you are trying to achieve and their associated metric(s). This could be a spreadsheet that you keep on your computer or phone. You could track performance using an online service, although it could be as simple as a sheet of paper stuck at your desk or a series of checkmarks placed on a calendar. The key to using these aids is that they must be seen often enough to remind you of your goals and encourage you toward their achievement.
I will be writing a lot more about measurement because it is a key principle of execution that can be leveraged to enable greater success.