Some things I've been struggling with lately:
Management vs. Leadership. This concept is new to me and very eye-opening. I spend a LOT of time on "management" of my program---handling day to day issues, schedules, staffing, increasing patient volume. I spend little to no time on "big picture thinking"---i.e. articulating the long term goals for the clinic. Things like research ideas and collaborations, optimal care models, enhancing our education strategies, etc...
And that is what really counts. When people look at my performance as a leader, they will not see the fires I put out, or the optimization of schedules & fill rates. They will look at the research output, the novel care models, the recognition from trainees.
Deep Work. I have been time-block planning before I knew it was a thing, and it used to work pretty well, but lately my "blocks" for writing/research are being consistently encroached upon, and I have a lot less of them overall given my clinical work & meetings related to the admin role. Its all about hyperactive hive mind here (Cal Newport's term)---checking emails or EMR and reacting. I actually lost a 2hour block of writing time yesterday morning and tracked what I did in that time. Its boring but it was related to rotation schedules for student, editorial role for a journal, scheduling meetings, and patient messages. Those things didn't take up the WHOLE time, but the constant task switching made it impossible to actually make progress.
Other things that take up my deep work blocks: appointments for myself or kids (they can't happen during patient care so...) and other similar "homing from work" activities. And then...general laziness/distraction. If 85% of my week is taken for, my brain sometimes sees this time as a break.
I know discipline is the answer---discipline to not schedule things, check email or EMR, and just DO the thing I'm supposed to do without wasting time.
I'm also still working on the "showing up" part.
Damn this year has been hard.
Just writing this out was motivating. I need to do better here.