What is work?

When I started my first research year of fellowship, it was disconcerting to suddenly have control of my schedule & work day (rather than responding all day/night to the immediate needs of patients/pagers). I eventually figured it out and was rather productive in my research but every now and then continue to be hit with uncertainty about the progress I am making. How much of my days are spent doing REAL work---advancing my goals and utilizing my skills---vs. "busy work" only peripherally related to my (and my employer's) mission.

I recently read that career/job satisfaction is highest when workers see progress being made. I definitely get that; my best days are those in which I have achieved something tangible. For me that equates to one of the following:

•  writing grants and papers
• diagnosing, treating, or reassuring patients
• creation of usable laboratory data--designing, performing, and analyzing experiments

Yet there are many many days where I do NONE of those things. I can have a busy 8 hour day doing nothing towards my major goals! How is this possible? What am I doing with my time? I'm not necessarily "wasting " it in the traditional sense of chatting, internet surfing, or spacing out. Its just the little (or big) extraneous tasks that I still have to do that take up so much damn time!

For clinical work, in addition to the actual revenue-generating office or hospital visits, I am:

• returning phone calls or emails, sometimes playing days of phone tag with patients
• typing in telephone encounters for above
• calling in/faxing prescriptions (we used to have nursing support for this but are in-between nurses)
• filling out prior authorization forms (same)
• printing and mailing (hand-addressing the envelope) lab or radiology prescriptions
• writing letters to referring physicians---initial office note and updates for all lab/xray results
• reading about complicated cases
• discussing cases with colleagues for advice
•  arranging appointments for patients because our schedulers will not overbook without explicit instructions from case to case
• scanning my schedule ahead of time because schedulers with been known to stray from the template or even put in a panel on days I have requested off months in advance

In terms of research, I also spend a LOT of my time not writing, planning experiments, or performing benchwork. I hired a tech that started in November, so I am doing way less crap than before but still:

• Ordering reagents/supplies. Tech actually places the orders now, but a lot of this is new to her so she wants me to provide catalog numbers and to help her research bigger equipment pieces
• Following up on said orders because our ordering people suck and have messed things up weekly
• Meeting with research mentors---my primary mentor who I meet with approx 3 times/month, another mentor in a junior faculty mentorship program, my division chief. This includes time spent trying to set up these meetings and then time wasted waiting for these busy, invariably late, people to show up to meetings
• Doing rote lab work when my tech is out (she was out 3 days for a funeral and I had to do all cell culture, which took 2 hours/day) or just because no one else will do it (next week I will be pooling mouse plasma consistently for assays)
• Looking up protocols, emailing people about protocols/methods
• Meeting with collaborators or potential collaborators (see above re: time spent waiting)
• Going to seminars of interest, lab meeting, journal clubs, etc... I limit this a LOT, but I do need to get myself out there
• Reading

And then of course there is the unique heartbreak of science, when hours/weeks of writing will result in a rejection  or weeks/months spent on experiments will yield absolute no usable data.

Writing all this out is helping me realize that I need to better schedule my days. I talked a big game last year about limiting email checking, and setting aside time for writing, but I have not yet done any of this. If I could spend one hour a day on writing papers, one hour 3 times a week for reading, limit my email checking to 3 times a day, and lump clinical busy-work to 3 concerted 30-60 minute sessions a week? Come to meetings armed with something constructive to do while waiting (maybe save email checks for these times or bring clinical/research related-reading)?

Any advice?