How I Manage My Time - The Triage System

if you've ever felt like there aren't enough hours in the day or that your to-do list just keeps on getting longer no matter what you do then this video is for you in this video we're going to go over the six components of the triage system which is a method of time management that I learned during my 8 years of medicine first as a medical student and then as a doctor it's the same system that I use today to manage my time to run multiple businesses to write books and it's completely changed how I think about managing my time and my priorities so when I worked as a doctor in the hospital there was one key principle that changed how I thought about managing my time and it wasn't about being more efficient or having more discipline or building better habits it was about understanding the simple truth that the order in which you do things matters more than how many things you got done so think about an emergency room when patients come in they are not seen on a first come first Earth basis that would be absolutely catastrophic instead the medical team uses a system called triage they assess who needs attention most urgently if someone is there with a heart attack then they're going to get seen before someone who's there with a sprained ankle even if the guy with the ankle got there first but this is where it gets interesting because in the emergency room just like in life the work never stops there is always another patient coming in through the doors there is always more that could be done the to-do list is infinitely long and this is actually the reality that we're all facing today because your to-do list is never actually finished there is always another email you could send there is always another project you could start there's always another skill you could learn you could always be building your personal brand a bit more by writing more on LinkedIn and making a YouTube channel and all this stuff the problem is not that we have too much to do the problem is that we are trying to do everything and this is the fundamental mistake that we all make with time management we think that it is even theoretically possible to get on top top of everything to take off all of the items on our to-do list but in reality the mindset shift we want to have and the one that completely changed everything for me is to recognize that in a world where the to-do list is literally infinitely long it is physically impossible to get through the to-do list and therefore all we can do is what doctors in the emergency room do every single day which is triage we've got to make sure that fundamentally we are tackling things in order of priority and actually being okay if some stuff on the to-do list just never gets done because it's not sufficiently important and so now we're going to talk about the six core principles behind this triage method these are principles that work together to help you not just get better at managing your time but actually to make sure that what matters most is the stuff that actually gets done so when I was in medical school and I first started my placements in the hospitals there was one thing that I noticed pretty early on that was quite surprising which is that every single doctor seemed to walk around with a folded piece of paper in their pockets and they seemed to be writing things and scrolling things on that folded piece of paper and using that as their daily to-do list and then at the end of the day they would take that folded piece of paper that had their daily to-do list they would stick it in the shredder Machin type thingy because they couldn't carry it home because of patient confidentiality and then the following day they would take a blank piece of A4 paper from the printer in the hospital and that would become their to-do list for the next day completely fresh even back then and this was like 10 years ago I was a productivity Enthusiast and so I thought like surely doctors around the world have found a better way of managing their tasks rather than just this blank piece of paper that they just sort of refresh every single day and so I remember at the time asking one of the doctors that I was working with why do you guys use this like paper manual system why not use an electronic system or use the electronic patient records where you can keep track of all the tasks that have to be done for all the patients and she pulled out this piece of paper that had all of these like scrolling and markings off on it and everything and what she said was partly that the messiness of the to-do list was the point because every single time you cross something out every single time you write something down you're making a conscious choice about is this thing sufficiently important for me to do or action today over time I realized this is actually really powerful and this is where the idea of the daily reset comes in which is that every single day you are working off a fresh piece of paper rather than having all of your infinite different tasks on a to-do list where you're just being overwhelmed by like the incredible number of things that you have to do it's still important to have one of those like mastered task managers or project lists or to-do lists or whatever so that you don't forget stuff but the idea behind the daily reset is that every single day you are asking yourself AR fresh what are the most important things for me to do today the way that I do this in my life these days is something that I call the morning Manifesto this is a 3 to 5 minute journaling little prompt thing that I try my best to do every morning this is what it looks like it is in my life OS action Google doc and it's got three components Prime remind and plan so Prime let's connect to a body and Prime our day with gratitude remind let's remind ourselves of our key priorities so what were our quarterly quests and how are they going more details in that video up there it'll be linked down below as well about what the H quarterly Quest is I asked myself what were our top three outcomes for the week and how are they going this helps with prioritization and then within plan I ask myself the question of what is today's adventure I. E single most important task going to be and is it in the calendar and so this is one of the steps in my daily reset where every single day I'm asking myself what is today's highest priority item that I need to get done sometimes I didn't manage to do the thing yesterday and so the thing might carry over two today but then again it might not part of the triage system is recognizing that it's physically impossible to get through everything on your to-do list therefore we just got to focus on what are the most important things and this is one of those questions that helps us figure out what is that most important thing I also ask myself that if we have time what other one to three tasks will we complete today are those written down somewhere easily accessible for example an index card or the today view of our to-do list app Etc and this is where I use a pen and paper system I take a fresh sheet on my little Journal type thing and I write down physically by hand what specific tasks I want to get done today and I try and limit myself to just three things so I have my one most important thing and then I have one two or three different extra tasks that I could do in addition to that and those are written down on a piece of paper by the way if you're interested in how this entire system works together this is all part of life OS which is my personal productivity system that'll be linked down below now speaking of things that I learned in medical school another thing that I discovered is the importance of mental well-being and one way to improve your mental health and well-being is through therapy provided by better help who are the very kind paid partners of this video betterhelp is the world's largest therapy service and it's 100% online with better help you can tap into a network of over 30,000 credentialed and experienced therapists who can help you with a wide range of issues it's a platform that makes finding a therapist easy because it's online it's remote and by filling out a few questions better help can match you to a credential therapist very quickly then you can talk to your therapist however you feel comfortable whether it's via message or chat or phone or video call regardless of whether you have a clinical mental health issue like depression or anxiety or if you are just a human who lives in the world who's going through a hard time therapy can give you the tool tools to approach your life in a very different way you can message your therapist at any time and schedule live sessions whenever it's convenient for you and if your therapist isn't the right fit for any reason you can switch to a new therapist for no additional charge so let better help connect you to a therapist who can support you all from the comfort of your own home so if that sounds good you can check out betterhelp. com Al abdal which will be linked down below as well or you can enter my name Ali abdal during the sign up process and that will give you an exclusive discount so thank you better help for being the paid partner in this video and let's get back to it the handwritten box method for to-do list management now this is the method that most doctors that I met were following to do their to-do lists and this is the method that I still use for my to-do list many years later even though I'm not a doctor anymore it's still really really helpful as an entrepreneur as a Creator and so this is how it works basically the idea is you create a box every time you have a new Tod do nothing particularly fancy about that in my case these are three of the things I need to do today so book Valentine's Day dinner for me and my wife to film this time management video and to apply for my Hong Kong ID now in a traditional checklist once you've done with the task you would put a little tick in the little box but what I noticed when I was working in medicine is that doctors never really ticked the Box off instead they did something a little bit more sophisticated which is they had different levels of what happened to the Box based on what the status of that particular task was so there's a few different statuses that something could have it could have this where you've kind of made a start on the task but there's still quite a lot of stuff to do so for example if you needed to do a blood test on a patient you might use the diagonal line to indicate that you've requested the fotus to take the blood then when you saw that the blood was taken and had been sent off to the lab you would half shade in the box which shows that the the task is 50% done or whatever and then a few hours later when the blood test is back from the lab and you have checked the blood test result and acknowledged it and acted on it you would fill it in and then you would cross the thing out and so this becomes a very nice way of not having to remember what the status of specific tasks is but just having it straight on the piece of paper in my case what it looks like for example for filming this video I would do the diagonal line thing once I have finished filming the video I would half shade it in when I have got the footage onto my computer and set it to upload to Google Drve and then I would fully shade it in and cross it out when it's been uploaded to Google Drve and now it's gone to my team and it's not my problem anymore so I can safely forget about this particular task depending on what you're doing with your work in your life your status system might be different depending on what the task is obviously but I find this to be a very useful and also very satisfying way of managing a to-do list one of the core principles I learned around like what motivates us when I was doing research for my book field good productivity is that we feel really good at taking things off a to-do list right everyone's had that experience like the experience of making progress on a task feels good the problem is if you're only allowed to tick it off once you've completed the whole thing the thing might have multiple steps here with this method you you get the benefit of being able to see straight up what the status of a task is but you also get that little dopamine hit of being able to move that status of that task forward even if you haven't fully completed it just yet back when I was a doctor I did not have the luxury of only ever having three things on the to-do list I would have like dozens and dozens and dozens of things each time a new page whatever would come in from a nurse I would have to add a new task to the list but then managing this infinitely long list of tasks that is when we get onto component number three real time triage and this is really the Crux of this time management method it's really about recognizing as we said at the start that the to-do list is always going to be infinitely long you can never get through all of it and so your job as a competent professional whatever profession you're in whatever you're doing in your work or your life is to focus on triage I.

E to do the most important highest priority things first when you're a doctor for example you can have your enormous list of all the Bloods you need to check and all the things that you have to do but then if you get a crash call if a patient's having a heart attack or whatever you and you have to drop everything and Sprint across the hospital if you're part of the crash team to hopefully do something about that and then while you're there you're getting three different pages on your pager and so straight after dealing with a cardiac arrest situation you find a phone you ring up all the people all the wards who paged you you add new tasks to your to-do list and in every moment you are strategically ret triaging rep prioritizing your to-do list just because you wrote things down in a particular order doesn't mean that is the order they should be done in fact it probably isn't the order that they should be done and this applies so much in life outside of medicine as well whatever we are doing we are always faced with the choice of there is an infinite number of things we could be doing but what is the next most important priority right now something like the morning Manifesto helps with this because you define your most important priority for the day right at the start of the day but then if you're a professional you're going to you're going to get some kind of inbound you're going to get slack messages coming in you're going to get emails you might get a call from the boss if you're running a team you might find out some information that like oh crap we're having a Personnel issue that requires my urgent input right now and based on that the theoretical to-do list that you created at the start of the day might go out of the window but that's okay because you are always focusing on the next most important thing there is a danger here which is to always think about what is the most urgent thing so urgent and important are two different types of things in the world of productivity there is this thing called the Eisen how Matrix that you may have come across and that is kind of getting at this idea that the stuff that is important and Urgent you have to kind of do immediately the stuff that is not important and not urgent you should probably just delete or ignore for now the tricky thing with this is what do you do about the things that are important but not urgent and what do you do about the things that are urgent but not important and I think with these two categories is really where the skill of being a competent professional or someone who's good at managing the time and priorities comes in because what I found in my life is that the truly important stuff is rarely urgent and the truly urgent stuff is rarely particularly important this is of course different than in medicine where you're often dealing with life and death and so the Urgent and important often do sometimes go together but still not always and one of the biggest needle movers I found for my own productivity is to recognize when I can ignore something that is urgent but not important for the sake of something that is important but not urgent and this requires the ability to be okay with things dropping being okay with all of the different balls that you're juggling some of them being dropped this is what I love about Oliver burkman's writing in 4,000 weeks and meditation to Mortals really good books is that if we assume a world where there's all these infinite number of things we could be doing and we also therefore assume that it's physically impossible to do everything on the list it follows naturally that it's actually impossible to have it all it's impossible to be executing uh fullon efficiency productivity creativity across all of the different domains of our life we are going to have to let some things go we're going to have to embrace mediocrity and embrace imperfection in quite a lot of the different areas of our life if we want to make real meaningful progress in others and so there may well be seasons of your life where you don't reply to every WhatsApp message or every every email that comes in your way there may be seasons of your life you know I'm I'm about to be a parent where work takes a bit of a backseat because I want to be present with the family or whatever the thing might be but in a world where we are trying to take everything off the to-do list trying to do all of the things that is the true recipe for overwhelm and anxiety and stress and so coming back to this idea of real-time triage in every moment we we need to be asking ourselves is this thing I'm about to do really the most important thing I could be doing right now and in a world where you only did one or two things each day but those one or two things that you did were the most important things for you to have done that day you would make an enormous amount of progress in a whole year compared to that situation that a lot of us find ourselves in where we take off all these things on our to-do list and we get to the end of the day and we think hm I feel like I did a lot of stuff but I don't feel like I made a lot of progress we have a lot of movement but not a lot of progress and if you're working in medicine and you're doing all of the lower priority urgent things that seem kind of urgent but you're forgetting the important stuff that you really need to get done you're going to get fired pretty quickly because that's not the job of a doctor the job of a doctor is not to do everything on the to-do list the job of a doctor is to do the most important things on the to-do list and I would extend that to the job of us as professionals who are trying to make the most of our time trying to be efficient productive trying to get stuff done trying to achieve our goals our real goal as it relates to time management is not to try to do everything that would be a recipe for failure our real goal is to make sure that we are prioritizing the most important things component Number Four The Ward round protocol so there is something that happens in hospitals at the start of every day which is that you do a ward round I. E you go around and you look at all of the different patients that you've got on your ward and for each of these patients you go to them you talk to them you look at the notes for the the patient you look at all the different Vital Signs and all the different like blood test results do you have any medical conditions at all and you figure out what is the next action step in the patient's plan that will move them forward in their trajectory to get them better and get them fundamentally out of Hospital how the hell does this apply if you are not a doctor well the reason it applies if you're not a doctor is that we can use that same concept as it relates to our projects and so this is the system that I use to keep track of my different projects I use a to-do list manager called things three but you can use whatever app you want now these are all of the different projects I'm working on in work and in life I've got my primary quarterly quest for my life and for my work my primary quarterly Quest For Life is the martial arts setup and my primary quarterly quest for work is to make life OS which is my productivity course and absolute Banger and you can see next to these I have a little Emoji so green means it is on track so yellow means it is off track with a plan and red means it's off track without a plan I do sometimes also use blue uh which means it is on Ice which means I'm not focusing on this thing right now it's just it's being stalled by something or other this is a very useful thing to be keeping track of it's like every quarter every 90 days whatever we have a finite number of key projects that we want to move forward I recommend having one primary Quest this is the quarterly quest which is the one most important thing that you want to move forward in each quarter in work and in life but then for all of the other projects it's worth having a status to know okay how far along is this project and is it still relevant I also like to make sure that I've always ordered my projects in order of priority so actually these are my weekly review questions every week so I did one this morning part of plan is have we updated our to-do and project list so quests and projects are arranged in priority order every project has a clear next action and every project has an up-to-date status on track off track with a plan off track without a plan and on ice so each week and I did this this morning for example I look at this thing and I'll be like all right cool are quests and projects arrange in priority order okay well actually you know what the Crea a club thing is actually more important than the art thing for now so let me just sort of like reorient that or whatever the thing might look like now operation don't die you know what actually that's you know right now baby supplies takes priority over that CU I need to go to the local department store to pick up like some items for the baby that's due to arri in if few months and so I'm just sort of making sure I've ordered thing in priority order again speaking to this idea that it's not about doing everything it's about doing the right stuff in the right order of priority and then crucially the next thing is that every project has a clear next action this is one of the things that I really learned when when I was doing these Ward rounds when I was working as a doctor and when I was a medical student which is that every single day you want to be making a plan for the patient and continue is not allowed to be a plan like I would often hear doctors complain about this like if one of their colleagues wrote continue is the plan they' be like oh continue is not a plan continue is not a plan because every SLE day we need to make sure there is one action that we can take to help that patient progress on their Journey similarly we need a next action for every single project so for my make life of was a banger I've got my next action point which is talk to kin regarding what needs to be done and I've got a meeting with kin later today voice pal I've got a few different actions voice pal is an app that me and my team have built to help make writing easier and more fun so if you have lots of writing to do in your work or life then you might like to check it out company relocation I've got WF which means waiting for waiting for tsj our accounting firm to come back to us with some sort of plan for like relocating my business to Hong Kong and it's totally okay for waiting for to be a next action step in medicine it will often be sort of waiting for occupational therapist and physiotherapist input or waiting for nursing home to get back to us but we have to write that as an action step because you're awaiting input from some other external service it must be documented as part of the plan for baby supplies my next action step is a trip to soo for my art Adventure my next action step is to actually draw something for Creator Club my next action step is to post in socials for martial arts setup I don't have a next action step but it's all it's basically there because I've booked my next few sessions of muii and so the next action step is sort of basic within this little stuff that I've got here when I do events and stuff and people ask for my advice about how to manage their to-do list or like projects or priorities or when I'm doing my course sessions I see that almost no one does these two things almost no one has a status for each of their projects and almost no one reliably has a clear next action step for each of their projects if you just do those two things just like color code it in terms of status with the traffic light system and make sure as David Allen tells us in getting things done that every single project has a next action step you'll be way better at managing your time than most people are because almost no one does these two very sensible things which doctors do as part of the wardr protocol where you make sure you have checked the status of every single patient and you've made sure you have a next action step as part of the management plan all right so that brings us to component number five which is intentional incompletion this is a story I read about in my book but basically in my first week of being on the emergency department I had a runin with one of the senior doctors because I was feeling a bit of a hero complex I was like you know what I'm going to I'm going to see all these patients I'm going to you know I'm I'm here as like a junior doctor first year first year out of medical school and I'm going to I'm going to I'm going to save the day and I saw my first patient and it took like an hour and then I looked at the list and looked at the waiting room and it was absolutely teaming with patience like it was completely full and I was like all right cool I'm going to be a bit more efficient with the next patient and so I saw the next patient in like 50 minutes I was like yes and then I looked at the waiting room and it was still completely full and then I saw the next patient in like 50 minutes and I looked at the waiting room and it was still completely full and then it got to lunchtime and I said to myself you know I'm not I'm going to skip lunch because I want to make sure I can like get through these patience maybe I've been a little bit inefficient cuz it's like my first week here and so like I'm just going to power through and I'm just going to see more patience and I had a conversation with one of the Consultants who was on call whose job it was to sort of manage the junior doctors and make sure they were taking their breaks and what he said to me at the time was that you know no one is going to die because you've taken a lunch break the waiting room will always be full the patients will always be there to see it's more important for you as the doctor to be rested so that you can be on form for the other patients that you're seeing rather than burning yourself out because you're like choosing not to take a lunch break just because the waiting room is full and this was something that in almost every single placement that I did when I was working as a doctor and even when I was a medical student the Consultants were always looking out for are the Juniors taking enough of a break are they taking a lunch break are they are they are they taking a little coffee break are they leaving work at a reasonable hour and so really the skill you end up cultivating as a doctor is intentional imperfection recognizing that it is part of my job to take a break even though there is still stuff to do it is part of my job and part of my role to go home at some point in the evening even though there is still stuff to do again comes back to our point that we made at the start there's always going to be stuff to do I find that this is something that a lot of my entrepreneur friends struggle with my wife is also a crator entrepreneur and she really struggles with this she gets it gets to 8:00 p. m.

she's been grinding at work all day there's still stuff to do and she's like oh but I I feel like I haven't gotten through all of the things in my to-do list and I have to be like Izzy come on like when was the last time you felt like you actually got through everything on your to-do list she was like uh basically never and I was like yeah like how how about we start like winding down how about we have some food let's go out for dinner you all that kind of stuff I kind of have to coax her through I hope she won't let me saying this I'm sure she won let me saying but I have to kind of COA her through getting off the computer because she has this thing of like I need to make sure I get through the to-do list and so for me that first week in the emergency department was when I realized oh okay it's it's okay to leave things unticked off and to leave some patients waiting to be seen so that I can go grab lunch so that I can I can grab a coffee it's okay to hand over things to the evening team if there's truly stuff that's urgent and important that needs to be done overnight so that I can go home when it hits 5 6 7:00 p. m. Whatever Whenever my shift is supposed to end of course every now and then there's going to be like some life-threatening emergency that means you stay stay around for an extra 2 or 3 hours but for the most part if that's happening all the time that is just a recipe for Burnout in whatever profession you're doing and so we're going to end with component number six which is the two for one hour rule this is something that I learned from one of our professors in medical school where she she she had like an email newsletter that she would send to uh the medical students and one of the things in it was a really good quote that I think about a lot which is an hour before 9 is worth two after 5 I now think of this as the 2 for one hour rule like if you get up early and do something before work before 9:00 a.

m. that actually gets you twice as much output as waiting till after work to do the thing the thing with medicine and the thing with pretty much every kind of demanding job is that it's really hard to get home from work and not feel frazzled there's lots of ways you can do that part of my book fil productivity is about making your work energizing and enjoyable so that you get home from the end of the day of work with energy left in the tank but even then even then admittedly it's really hard to get home from work with energy left in the tank I've heard this from so many sort of YouTubers as part of my YouTuber Academy and so many other people being like I want to do the side hustle I want to start a business I want to start a YouTube channel I want to write a book but by the time I get home from work I'm I just don't have any energy and I just want to out and watch Netflix or whatever the thing might be and so in those cases I remember the advice from this medical school Professor which is an hour before 9 is worth 2 after 5 if something is truly important to you and it requires Creative Energy it is a lot more effective to get it done before work rather than after work so a lot of my YouTube videos that I made I would get up earlier and I would film the videos before work because I knew that that's how they would get done when I was at work I would actively volunteer for the later shifts I would my favorite shift to do of all time when I was working as a doctor was 400 p. m.

until midnight I would try my best to swap with my colleagues who had families and stuff cuz they didn't want that shift cuz they wanted to be there with their families but I would love that shift Man start work at 400 p. m. finish at midnight that means I've got the whole day where I can do my YouTube videos and do my business and stuff and then I can drive to work at 3:00 p.

m. after having a nice leisurely lunch and then I can work from 400 p. m.

to midnight and I can drive for an hour home until like 1:00 a. m. sleep until like 10:00 a.

m. and then from 10:00 a. m.

to 3:00 p. m.