Beyond productivity: What efficiency in medicine should really mean

My alarm clock rings a little earlier than it needs to most mornings. In the spring and summer months, I appreciate the opportunity to take advantage of early morning sunlight to get outside and exercise before the rush of the day begins. Before it’s time to get the kids ready for school and out the door—before I scramble to pack a somewhat healthy lunch and get out the door myself.I lace up my shoes and leave the house while the sun is just beginning to peek over the trees. Everyone is still fast asleep in bed, and I know that when I come back, the peaceful facade of my morning will have evaporated. The air is crisp, but I head toward the ocean.The edge of the wind sharpens as the ocean comes into view. The sunlight slants just right through the grey clouds, beckoning me toward the shore. When I arrive, I run along the beach until time reminds me that I must turn around, back toward the world of responsibility. As I turn for home, a gentle rain starts to fall—cool and clean on my skin. Home is always uphill, but my lungs ache in a satisfying, spent kind of way. I feel alive. Grateful. Grounded. All from my short morning run.I remember a time, not long ago, when it was rare to have time for something like this—not just time in the technical sense, but the mental bandwidth, the energy, the breath it takes to prioritize myself before anything else.Before adjusting my practice, I drove past the water every morning, wishing I had time to run, or even to stop at the beach and sit there for a few minutes to catch my thoughts. But long days charting and evenings preparing for clinic meant I went to bed too late. Nighttime ruminations on difficult patients and worries about medical errors clogged my mind. Even if I had carved out time, I’m not sure it would have had the same grounding effect. I doubt I would have lifted my head from the pavement in front of me to notice the sky, let alone run toward it.As physicians, we work exceptionally hard to provide the best care for our patients. We seek out methods of becoming more efficient so that we can, purportedly, become better at our jobs. We build templates into our EMRs and implement the use of AI scribes to make accurate documentation easier. We optimize workflows in our clinics to save money and improve patient experience. Maybe, we can see more patients in a day or reduce the non-patient care burden that we carry on behind the scenes. On paper, we’ve become impressively productive as a profession.Read: Dr. Ginevra Mills: The run that remembered meSomewhere along the way, however, it seems that we’ve stopped asking a deeper question about our motivations for making these changes: What do we really gain by becoming more efficient in our medical practices?We work in a system where we are the limited resource up against an unlimited demand for medical expertise. It’s no surprise that we equate efficiency with volume—more patients seen, more problems addressed, more boxes checked in less time. But that version of efficiency doesn’t create space. It consumes it. It turns physicians into machines that never quite power down. In this way, efficiency in our medical practices can leave little room for the human aspects of our job—or of ourselves.From early in our medical education, we are conditioned to accept this narrative of physicianhood. For years, I rarely questioned the exhaustion that came from long, stressful hours. Or the fragmentation of my life into little blocks that fit around my career. Never mind the fact that, in the dark recesses of winter, I could often go whole weeks barely seeing daylight. I believed that was the cost of being good at my job. Until one day, it wasn’t sustainable anymore. While I never intentionally set out to change everything about my approach to practicing medicine, sometimes life redraws the map for us.As I’ve been building a new practice over the last year, I naturally sought out ways to make this practice as efficient as possible. I was surprised to discover, though, that my understanding of efficiency in medicine began to evolve—not as a reaction to a crisis in my life, but as a question of personal and professional alignment. I began to ask myself some different kinds of questions about efficiency in my life: What kind of life do I want to build for myself with the tools I’ve been handed? And what kind of person do I want to become in the process?In any profession, it is easy to confuse efficiency with acceleration. In medicine, if we can move faster, see more patients, do more procedures, document quicker, we can fill more space. But real efficiency—wise efficiency—should create space, not take it away. It should help us spend our time where it matters most: on helping us live happy, wholesome and rewarding lives. The truth is, this type of efficiency doesn’t just benefit us—it benefits our patients, as well.When systems in medicine are built to support presence instead of pressure, we can offer our patients more than quick appointments with rushed decisions and split attention. It can support the quiet moments that allow us to listen to a patient without glancing at the clock, or to sit with the unexpected turns of our days without mentally triaging the next 10 tasks waiting to be finished. It allows us to embrace the values we have in our lives so that we can show up more fully for our patients and return home with enough of ourselves left to live lives of meaning and connection.Efficiency in medicine shouldn’t only be about enhancing our professional lives without attention to our personhood. It should be the means through which we honour both. None of us went into medicine because we wanted to become more efficient. We entered the field to connect, to serve and to be present for people in moments that matter. But presence takes time—and increasingly, time feels like the one thing we’re never allowed to have as physicians.There will always be ways that I can improve my productivity and efficiency in my new practice. As it continues to grow, I know that inefficiencies will continue to rear their heads and threaten to upend the work-life integration I’ve come to value most. These days, I try to notice when that balance is present—like in the mornings, when I can run to the ocean before work. It’s not a big accomplishment, but it marks something important: I had the time, the space and the energy to begin my day with intention. And, I still got to be a mom who got her kids out the door, made it to work on time, and was ready to be fully present to care for my patients.Overwork and burnout do not have to be an inevitable part of medicine, as if it’s simply the cost of doing good work. We should continue to seek efficiency in our medical practices to improve patient care and alleviate the negative pressures of our professional lives. However, we should seek out efficiency to answer an ever important question: How can we do this work well and still have something left for ourselves?The answer isn’t working harder. It’s working wiser.It’s redefining efficiency not as a way to push ourselves further, but as a way to keep ourselves whole.Dr. Ginevra Mills is a reproductive endocrinologist and infertility specialist based in Victoria.

Beyond productivity: What efficiency in medicine should really mean

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