Your Focus Is Under Attack and It's Not Your Fault

Jennifer Frank, MD


September 08, 2022

I'm reading a fascinating book right now — Stolen Focus by Johann Hari — about our societal attentional crisis. My own need to read this book is underlined by the fact that I have now had to renew it three times because of my own difficulty focusing on reading a book long enough to get through it in the 2 weeks allotted by my library. I've always been an avid reader but have noticed a decreased ability to focus for the long, uninterrupted periods of time needed to both read and understand what I've read. Like everyone else, I've grown accustomed to brief snippets of news and information that make it difficult to adjust to lengthy articles which require sustained attention.

Hari outlines the scope of the problem but also offers many potential solutions. What has struck me so far is how much overlap there is with recommendations for achieving work-life balance. For example, adequate sleep and healthy food is important to fueling the attentional parts of our brain (in addition to the other parts which result in optimal functioning). Additionally, he points out how our love-hate relationship with our devices erodes our ability to focus (and how artfully Silicon Valley has designed apps to hook us). Finally, he identifies the 24/7 nature of modern work which used to be the realm of only doctors, the military, and chaplains but which now includes most professions.

I would argue that the 24/7 nature of medicine has expanded beyond emergencies — appendicitis, a patient in the ICU who was crashing, and imminent delivery — to include unfinished charts and issues considered emergent only by our patients who are accustomed to near-instantaneous responsiveness from everyone with whom they interact.

Just as surely as these factors challenge our focus and attention, rendering us unable to critically read a complex book or digest a journal article (even The New England Journal of Medicine has introduced 3-minute video highlights), they threaten our ability to achieve work-life balance. Very few of us want to disconnect from work in order to connect to a different electronic platform. If only I could get these charts finished at a reasonable hour, I could finally get home so that I can binge-watch "Euphoria." Work-life balance is supposed to afford us the opportunity to engage with the people and activities which are worthy of our time, attention, and focus. Realizing that it is not just work responsibilities that are keeping us from the things we want or aspire to do is sobering.

As Hari points out, some of this is individual responsibility; Big Brother is never going to stop by your house at midnight to physically remove the Roku controller from your hand and send you off to bed. However, the problems were not designed at the individual level and will not be fully solved by individual willpower and responsible behavior. This is similar, I think, to the challenges with work-life balance and burnout. Individual behavior does play a role but only within the larger context of systems that are designed, and, indeed, remain successful through the very designs that make it so hard to achieve balance (or focus).

Our electronic health record contributes to, rather than alleviates, interruptions. In an average day, I can be interrupted by a Microsoft Teams message, an email, a phone call, a staff message, a secure chat, a message via the patient portal, a patient call, or by someone physically coming to my office. While I do have some control (such as turning off email notifications), some of this is unavoidable; while working, we have to be available in case an urgent issue arises. The challenge, of course, is that the urgent gets buried in everything else.

Even without a simple solution (despite the many recommendations out there), I find it comforting to recognize that it is not just a personal failure, that it is the dysfunction of the system in which I find myself. Where I can exert control (such as closing my office door when I need uninterrupted time or batching messages), I should. Where I am a victim of a system designed to interrupt me, I can spend more time being thoughtful about the response needed and less time mindlessly reacting.

Do you also experience the attentional void in which we live much of our lives? How do you improve your focus and attention on an individual level?

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About Dr Jennifer Frank
Jennifer Frank has the unbelievable privilege of being a family physician, physician leader, wife, and mother in Northeast Wisconsin. When it comes to balancing work and life, she is her own worst enemy because she loves to be busy and enjoys many different things. In her spare time (ha!), she enjoys reading suspense and murder mysteries as well as books on leadership and self-improvement. She also writes her own murder mysteries and loves being outdoors.
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