1/ Email inbox got you down?

This thread is designed for new chiefs residents (and faculty!) on a topic I got very little coaching on before my chief resident year: Email Management.

Keep reading for Tyler’s Top 10 email tips!

#TipsForNewChiefs Image
2/
My transition to chief year was abrupt. I went from being a decent doctor to a crappy administrator overnight. In this new role I went from receiving a few junk emails/day to hundreds of emails at all hours. The following tips are strategies that helped me survive my inbox.
3/
1️⃣ Set boundaries.

It's easy to be on your email 24 h/day- but it's okay not to be.

Unless I was chief on call I tried not reply to email past 6pm as that is family time. I also limited checking on weekends and vacation. Setting Do-Not-Disturb and downtime can be helpful. Image
4/
I still try (and continually fail) to abide by these boundaries now. Obviously buy-in from your colleagues is essential. I told my co-chiefs about my desire for boundaries beforehand and was grateful for their support and accountability in keeping them.
5/

2️⃣ Turn off notifications.

The constant interruption of beeps and pop-ups can really be distracting and disruptive when you’re focusing on more important work. I highly recommend turning them off and just checking your inbox at pre-defined times. Image
6/
3️⃣ Avoid the temptation to immediately reply to everything.

It’s important to be timely, but don’t feel you have to reply instantaneously all the time. You’ll be surprised at how many situations resolve themselves if you embargo your reply until the next morning.
7/
4️⃣ Long emails are a cry for help - try not to respond in kind.

Sometimes the best way to respond to a long email is to pick up the phone and talk to someone. It will save everyone so much time. Image
8/
5️⃣ Stay organized - use folders.

I use my inbox only for emails that I am actively working on. Everything else gets moved to a few organizational folders to avoid clutter and to help in referencing prior emails since the search function in Outlook is abysmal. Image
9/
6️⃣ Wish someone would sort the email for you? - Use inbox rules!

Inbox rules allow you to automatically route emails that do not apply to you to the appropriate place, such as the trash. They can be a great time-saver and help keep your inbox clean. Image
10/

7️⃣ Going to be sending the same email on a recurring basis? - Use templates!

The desktop version of Outlook allows you to use custom template files to easily load an email with correct formatting without having to search, copy/paste, and edit the last email you sent. Image
11/
8️⃣ Going to be emailing groups regularly? - Set up contact lists!

If you find that you regularly email groups that do not have established listservs you can create your own. This saves you from having to manually add everyone and accidentally forgetting someone. Image
12/
9️⃣ Need to remember to follow up on an item? - Use tasks and flags!

If you take an email and drag it to the tasks (clipboard) icon on the bottom left of Outlook, it will automatically create a to-do list item for you to follow up on and allow you to set yourself reminders. Image
13/
🔟 Need to remind someone else about an item? - Schedule an email reminder!

You can now schedule/delay send emails on both the Outlook web and desktop apps. This is really helpful for reminding busy faculty about the lecture you booked them for months prior. Image
14/
If I had to summarize I would say effective email management comes down to 3 things:
💌 Boundaries
💌 Organization
💌 Working smarter, not harder.
15/
A huge thanks goes to my former @uclaimchiefs colleagues @LizzieAbyMD and @jmjones204 who helped inspire some of these tips/tricks, as well as email super-user and all-around bad-ass @kelleychuang who taught me the way of email folder organization!
16/
Lastly, these tips are based on my personal experience and may not work for everyone. I am sure there are many others who would have different advice. What pointers would other #MedTwitter folks share for rising chiefs and faculty with regard to email?

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More from @TylerLarsenMD

31 May
1/ Did you know that you can import an Excel spreadsheet schedule into Google Calendar?

This thread is designed for new chief residents or any folks who schedule conferences/events and want to convert a spreadsheet into individual calendar events.

#TipsForNewChiefs
2/
During my time as a @uclaimchiefs we shared a google calendar to track tasks during the week. We also scheduled conferences via shared spreadsheets.

Importing the spreadsheet allowed me to view what conference was scheduled without constantly referencing the spreadsheet.
3/
To start we’ll need a basic spreadsheet to schedule events.

For this tweetorial we’ll use an example of a Noon Conference spreadsheet and include “Day", “Date", “Title", “Speaker", and “Notes" as headers though for this spreadsheet the headers are not critical. Image
Read 12 tweets
17 Jan
1/ Why are hypodermic needles and IV catheters referenced by gauge numbers?

And why does the needle diameter get smaller as the gauge number increases?

Let's explore the obscure history of IV sizing in the following #histmed #tweetorial.
2/ The gauge numbers on modern hypodermic needles are adapted from the Birmingham Wire Gauge (BWG), a system developed during the Industrial Revolution in the early 1800s to standardize the British cottage industry of iron and steel wire manufacturing.
3/ As early as the 1200s wire was made through the process of wire-drawing, which involved pulling iron rods through a conical hole in a draw-plate or gauge.

The resultant wires could then be drawn through successively smaller diameter gauges to produce thinner wire.
Read 11 tweets
18 Nov 20
1/
Why does obesity cause a "falsely low" B-type natriuretic peptide (BNP) in patients with heart failure?

I often hear this used to explain unexpectedly low BNP results, but I've never really understood why.

Let's explore in a #tweetorial.

#medtwitter #cardiotwitter
2/
Before we answer this question, a quick poll.

What is the main physiologic mechanism of BNP?
3/
BNP is a hormone secreted in response to ventricular wall stretch. It binds to natriuretic peptide receptor A (NPR-A) which ⬆️ cGMP in various tissues to exert MANY effects including:
⬆️ Natriuresis
⬇️ RAAS
⬇️ sympathetic tone
& so much more!

cardiovascmed.ch/article/doi/cv…
Read 19 tweets
17 Apr 20
1/ "Who feels comfortable evaluating a tracheostomy?"

Today on the wards we talked trachs. Though we see patients with trachs regularly I find it is a topic that few learners are comfortable with.

The following 🧵 is my "Hospitalists' Guide to Tracheostomies"
2/

Where are trachs placed anatomically?

Trachs are placed between the cricoid cartilage and the sternal notch around the 2nd to 4th tracheal ring. These can be placed surgically or percutaneously at the bedside.
3/
Anatomy of a Trach

When evaluating a trach, I find it helpful to consider the following:
🔹 Diameter - Is there an inner cannula or single lumen?
🔹 Length - Is it regular size or an Extended Length Trach (XLT)?
🔹 Cuffed or cuffless?
🔹 Fenestrations present?
Read 15 tweets
18 Feb 20
1/
Does atelectasis cause post-operative fever?

I occasionally hear atelectasis listed in the differential diagnosis for early post-op fever (EPF) but this idea has never made much physiologic sense to me.

Let's explore this question in the following #tweetorial.
2/
Like many US medical students, I first learned this central dogma of post-op fever on my surgical clerkship through the perpetuation of a rather cumbersome and inelegant mnemonic involving the letter W.
3/
Despite its ubiquity, however, there is little published evidence to support this idea. One of the largest systematic reviews on the topic found that in 7 of 8 studies there was no significant association between atelectasis and early post-op fever.

PMID: 21527508
Read 19 tweets
29 Jul 19
1/ Why are EKG waves named starting with the letter P? What happened to letters A through O?

I’m guessing you’ve probably never wondered this, but if you’re curious, here’s a brief historical #medthread / #tweetorial on how the EKG waves got the names they did.
2/ The first electrical tracings of the heart were obtained in 1887 by A.D. Waller, a British physiologist and physician, who used a Lippmann capillary electrometer to capture the tracings.

ncbi.nlm.nih.gov/pmc/articles/P…
3/ As a physiologist, Waller labelled the two waves on his initial tracing V1 & V2 based on their site of anatomic origin- the ventricle. He would continue, often rather adamantly, to refer to the electrical waves as A, V1, & V2 throughout his career.

sciencedirect.com/science/articl…
Read 11 tweets

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