Are you a procrastinator? How could you, a busy physician with a thriving practice and a full personal life, possibly procrastinate? There's so much you're doing. Procrastinators don't get things done, right?

Not necessarily. Procrastinators are often labeled as “non-doers,” and they're not; they're really very busy. In fact, some of the busiest physicians I've seen are procrastinators. They work hard, but they're usually working in ways that don't make the most effective use of their time. So, if you're procrastinating, how can you tell?

There's a recognizable pattern to procrastination. For example, think of yourself in the following situation: You need to return a call to a patient who is often argumentative. Your reaction to the situation (the cause for procrastination) might be that you're uncomfortable. So, you create an excuse — “I'll make the phone call after I've finished seeing patients.” Then, instead of making the phone call, you choose an alternate behavior —“I'll write that referral letter for Mr. Brown that's due next week.” The result? Temporary relief because you've avoided the task. But soon, that gnawing feeling of having something unpleasant hanging over your head will return, and then you'll either find another excuse or finally make the phone call.

How to stop

To kick the habit of procrastination in every area of your life, consider these suggestions:

Set meaningful goals. If you don't have goals, you may not be aware of where you're heading so it won't really matter if you procrastinate. That's one way to rationalize it, but it won't get you very far. Yet setting goals that have no heart or meaning won't do you much good either. For example, does the goal “clean out the garage by September” motivate you? Probably not. But perhaps restating the goal as “I want to simplify my life” — and recognizing that cleaning the garage is one way to reduce clutter — will motivate you because it connects the task to something you value: a simplified life. You'll be more likely to tackle an unpleasant task if you see the larger value in it.

Don't believe in magic. Are you still hoping that a large block of time for some project will magically appear? Stop. Decide that the project is important enough for you to schedule its beginning and completion dates on your calendar. If it's not important enough to merit calendar space, then perhaps you should drop the idea of working on it. Even scheduling something to start six months or a year from now is better than waiting for a block of time that's never going to come.

Make good choices. “You can do it all.” Have you heard that one — or do you tell it to yourself? Well, it's a myth. No one can do it all, so choose carefully what you will do in this lifetime. If you're doing something important to you, then you aren't procrastinating. There should be no guilt in admitting that you're working first on what's most important and letting other tasks wait. But if letting things wait leaves you feeling a loss financially, personally, professionally or in terms of your self-esteem, then you need to get tough on procrastination. The state of your relationships with your patients and your loved ones may be the best indicator of whether you've invested your time well or procrastinated about something really important.

Deal with the unpleasant. Avoiding something unpleasant is the No. 1 reason why people procrastinate. Try taking one of these approaches when you face an unpleasant task:

• Do it. There's an adrenaline rush from knowing you've completed an unpleasant task. Finishing something you've been putting off will energize you for the rest of the day.

• Don't do it yet. If you're not sure what to do, putting off an unpleasant task may be wise. It's called “prudent postponement.” Perhaps a better approach will surface once you sleep on it.

• Ditch it. If the task has been hanging over your head for a long time, maybe you don't really need to do it.

• Delegate it. Delegation can be a great way to procrastinate less. If you're someone who feels that you need to do things yourself to get them done right, you may think that delegating tasks isn't worth the time and trouble it takes. But think about it this way: Figure your hourly salary and then decide whether, for example, having a staff member get bids from an office interior decorator isn't a better investment of your time and money than doing it yourself.

As is the case with most time-management problems, overcoming procrastination must begin with self-awareness. The key is to identify your own personal pattern of procrastination so you can motivate yourself to switch gears.