A Poverty of Attention

With emails, instant messages, Teams messages, text messages, social media, the internet, and artificial intelligence, the amount of information that we all have at our fingertips can make it almost impossible to focus on the important work that we are doing as teachers and physicians. Information overload is defined as having so many mental inputs that it becomes difficult or impossible for one’s brain to absorb the information. This inability to absorb the tremendous amounts of information that daily assail us leads to feeling paralyzed and unable to make any decisions or complete any tasks. Information overload is associated with burnout, stress, decreased work performance, and lower job satisfaction.¹

The work of family medicine is the epitome of information overload. Having just returned from the STFM Annual Spring Conference, I was reminded yet again of the breadth of family medicine and the tremendous amount of information we receive on a daily basis. We are tasked with taking information from patients and learners, quickly assessing if the situation is emergent, and deciding next steps. For many of us this happens in the context of a 15- to 20 minute office visit or a quick precepting encounter with a resident. And it happens while we simultaneously endeavor to remain present and focused on our patient or learner. Relationships matter in family medicine, but relationships take time and focus. Herein lies the paradox.

The contents of this month’s Family Medicine provide a snapshot into the life of a family medicine educator. In their insightful study of medical students’ priorities when applying to a 4 year family medicine residency as opposed to a traditional 3 year program, Dr Skariah and colleagues found that students consider their future scope and depth of practice, their desire to care for specific populations, and seek to acquire specialized skills (eg, obstetric skills). The desire for an extra year of training is rooted in the perceived need for more time to learn the many skills necessary to practice family medicine.² Dr Lu et al. discuss the requirements for residencies in designing a dermatology curriculum.³ Using a Delphi method, the authors queried family physicians and dermatologists about the most important dermatology content that family medicine residents need to know. The 20 experts found 189 topics that reached high importance. Cabrol et al found that residents are using AI more than their faculty,⁴ a fact that will not surprise many of this journal’s readers. These articles demonstrate the wide-ranging concerns of our faculty.

I appreciate the quote above about information overload, by Herbert Simon (a Nobel laureate in economics), because the notion of information consuming my energy and attention resonates with me. The overload comes at the expense of the people and patients at hand. Our daily allotment of attention is limited, and when it is drained by the often unimportant information thrown at us, it leaves us with insufficient attention for the most meaningful people and activites in our lives. Family medicine faculty live this reality every day.

So, how can we manage information overload and the constant pull of multitasking? Much has been written about how to mitigate information overload, but there is no clear evidence for one specific intervention.^1,5 Many of the strategies studied for managing information focus on limiting inputs while we are working (eg, turn off notifications for email, put your phone on airplane mode, or mindfully focus on the patient or learner while you are in their presence). However, those strategies, while optimal, are not always feasible. By thinking about limiting the amount and type of information that is coming in, we can more effectively attend to the work that needs to be done. We can strive to nurture this effort of limiting inputs by being mindful of our own priorities.

Obviously, there is no one-size-fits-all method to limit distractions and improve productivity. Managing information overload will be an individual project. We must look at our own work habits and see how we can limit information overload and focus more of our attention on essential tasks and relationships.