Low-tech ways to get organized

In the past I, like many physicians, suffered from a progressive, or even debilitating, condition: chronic preoccupation. Its chief symptoms are a tendency to be physically present but cognitively elsewhere. In an attempt to manage this condition-a natural consequence of the nonstop heat and pressure that characterize the life of a busy internist, I applied pearls gained from various life-planning seminars.

A recovering techie, I started using electronic storage devices almost 20 years ago in an effort to stay organized. Unfortunately, the three biggest problems I had with my first Casio persisted with my later PDAs. For starters, at crucial moments the unit almost invariably ran low on juice. Second, it took too long to enter the information. Third, it often wasn't at hand when I needed it most.

So I came up with a 50-step system to stay organized the low-tech way. The first step-actually, the first 43 steps-requires 12 file folders (one for each month of the year), and a 31-day desktop organizer. I keep the folders in a desk drawer, and in each one I store reminders of tasks and events that are scheduled for that month, even those events that are years away. So I know immediately where the program for that wilderness medicine or board recertification course is. The Christopher Lowell 31-day bill organizer has a slot for each day of the month, as well as drawers for my wallet, keys, and ring (and, unfortunately, my pager).

I create new folders for my favorites

Method 46 to stay organized is to keep several additional folders in the file drawer for "as needed" topics and peruse them at quarterly or semiannual intervals. I have one folder for home projects, and others for various hobbies. I've tried scanning interesting articles into my computer, but it's much faster to put the pages in a folder; and I still have the folder, which is more than I can say for the Windows 98 system into which I scanned several articles.

For important and time-sensitive work-related material I have a red folder in my briefcase (number 47). I have another folder (number 48) that contains journal articles and handouts that I'd like to read during downtime; for example, when waiting at other doctors' offices or at the auto shop.

My briefcase also contains an annual datebook (number 49) so I can keep track of my call schedule, time off, vacations, sporting events, concerts, and family activities.

I am particularly proud of method 50. Because I don't wear a fully stocked hospital coat (the weight caused chronic neck pain), I was having problems managing all the necessities for rounds, admissions, and especially discharges. I ultimately found a multipurpose business portfolio made by Wenger, the manufacturer of Swiss Army Knives. It has an external pouch large enough to hold a stethoscope, and internal slots for prescription pads, a paperback pharmacopia, an infectious disease reference, hospital billing cards, on-call telephone message pads, two pens, business cards, a reflex hammer, and a neurologic tuning fork. And there's room for my preprinted admission and discharge order sets and a full-sized notepad. All of this in an all-weather bag that sports a stylish red badge with a white cross that looks remarkably like a medical emblem. I feel like I am carrying the little black bag for the 21st century.

Not only does this "system of 50" save time; it enables me to minimize clutter. In my view, office clutter represents a subliminal scream and a sign of being overcommitted to the office or even of compassion fatigue-wanting to do so much for so many for so long that very little actually gets done.

Certainly, we all have days when the office or hospital gets the better of us, but a balanced life requires a balanced calendar. My system of 50 isn't perfect, but because it has helped me to dramatically reduce clutter and better manage my time, I can be a better doctor. And I don't have to upgrade an electronic device or go out at midnight for AA batteries.