Getting past that gotta-get-this-done-but-too-busy-right-now feeling

In the state of Pennsylvania you need a special permit to practice medicine outside of the supervision of an attending physician, called the unrestricted license.  For most residents, this is not a requirement – your training license allows you to train, and your unrestricted license allows you to practice, well, without restriction (really, it’s not that complicated).  Usually this means moonlighting.

Moonlighting is actually a glorious thing for a resident.  You get hands-on experience for problem solving, and the extra income goes a long way to supplement rent, food, and student loans for an in-training doctor.

I began my application in June, along with some background checks so the State can be sure they are not granting a license to a scrubs-clad terrorist.  Usually there are a few hiccups, but I was lucky: there was only one piece of paperwork missing.

I just needed to make sure that the state had the correct documentation for my internship year, and then a speedy procession would ensue, leading to my moonlighting and extra kachings.  One simple piece of paper.

The ensuing months followed a pattern like this: I would wake up in the morning, the back of my brain vaguely remembering some paperwork I still need to file.  You know the feeling I mean.  The one that periodically pops into your conscious mind at inopportune times during the day – in the shower, when walking down the hall, while eating a hotdog.  The one that your mind answers with “oh yeah, I’ll have to get to it later” but never quite find the time to.

For me, I had to get to work, so those thoughts were quickly pushed aside, buried by the most pressing issue: finding the shortest temporal and orthogonal distance from bed to work.  And putting myself in a presentable outlook.  (The bars aren’t high, but one should at least eliminate bad body odor.)  The pace of the daily task quickly picked up, and the less acute problems were temporarily forgotten.

Returning home after a full work day, I decided that whatever that could wait till tomorrow would do exactly that.  The cycle repeats the next morning.

Three months later, as of today I am still one piece of paper away from approval.

It was not about laziness – over the past three month I took on and moved forward in several projects.  It was not about effort – the cumulative amount of dedicated time actually needed resubmit my internship paperwork is less than one hour.  Probably on the scale of 10 minutes.

And then there it was.  Uncertainty.  Uncertainty is the culprit why things get stuck.

I never figured out the next actionable step.

The entire time the task was conceptualized as “complete my licensing paperwork,” but that is an abstract idea.  It had the grammatical structure of an action – there’s a verb, an object, even the implied first-person “I” subject.  The problem rests in the vagueness of the word “complete.”  What constitutes Complete?  Is it to email someone?  Make a phone call?  Eat a hotdog?  It can be a million different things.

The true todo items should have been “Call State Board of Medicine about what went wrong in the first submission” followed by “Call internship institution to resubmit paperwork.”

Ironically, putting my mind to determine the actual actionable steps necessary to move this task forward took 10 seconds.

I could have moved my “complete my licensing paperwork” project forward by spending 10 seconds over the past three months to decide what needed to be done next.

This turns out to be glorified common sense.  Of course everyone knows you can only get stuff done when you know what the “stuff needing done” entails.  I may be alone in the camp of “but I don’t always spend those 10 second,” but the odds are that I might not.

So what’s the next actionable step for that nagging gotta-find-time-for-this sensation in the back of your mind?  Take a few seconds and pay it some attention.

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Howard Chen
Vice Chair for Artificial Intelligence at Cleveland Clinic Diagnostics Institute
Howard is passionate about making diagnostic tests more accurate, expedient, and affordable through disciplined implementation of advanced technology. He previously served as Chief Informatics Officer for Imaging, where he led teams deploying and unifying radiology applications and AI in a multi-state, multi-hospital environment. Blog opinions are his own and in no way reflect those of the employer.

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