Everyone seems to experience flow differently, but I have experienced it in teaching clinics. It is incredible how fast a morning can pass when you enjoy being around enthusiastic learners committed to improving the health of individuals and society. Occasionally when I write columns, I also find myself in the flow and am shocked that the entire afternoon has passed by.
Dr. Csíkszentmihályi’s flow model has important implications for well-being for rheumatologists. According to Dr. Csíkszentmihályi, flow only occurs when three preconditions exist: 1) clear goals and progress; 2) clear and immediate feedback, and 3) confidence in the ability to complete the task.3 When we are at our best, we should feel that we are entering this trance, but we can only do so when those three critical conditions are met.
The electronic health record (EHR) has been an impediment to achieving this flow state because it has made sure we have no sense of clear goals or progress. After all, most EHR systems have been made for administrators, with billing in mind, rather than for clinicians, who seek cognitive and empathic engagement with their patients.
Interprofessional teamwork is another aspect of making sure time passes pleasantly through the flow experience. When we are around people who make us feel valued, we can achieve flow as an entire unit.4 Rheumatology is rarely a solo activity; ensuring we have teams that can get into this flow is important for quality care.
Time Management
A week after Greg’s appointment as these ideas churned in my head, I started to comprehend a deeper meaning to “time management.” Admittedly, as a student and trainee, I wasn’t the best at time management. Procrastination has been a companion of mine since high school—one I have been unable to shake off. But looking at this discordance between chronos and kairos, I’m starting to see that my procrastination is less a failing of mine than a desire to manage the passage of time. By procrastinating, I’m looking at extending the time that I’m enjoying and putting myself into a forced flow state for a challenging time-driven situation with clear goals and immediate feedback.
I wish I had known Greg earlier because it would have saved me so much self-loathing and would have provided me a positive direction for my work. There is no shortage of gurus out there who peddle solutions for fitting more tasks into one day. I’m guilty of reading their books and blogs and listening to podcasts only to realize that none of their methods is sustainable. The time management that I seek is mastering the sensation of time passing.
