How to Use Friction Management to Save Your Sanity in Medicine

Originally discussed in Episode 188 of the Ending Physician Overwhelm podcast

If you're a physician who feels constantly interrupted, overwhelmed by messages, and like you can never catch up, this isn't about your time management skills. It's about friction management; and once you understand this concept, everything changes.

The Hidden Problem with "Convenient" Technology

Epic Chat, Teams, and other instant messaging systems promised to make healthcare communication more efficient. Instead, they created a nightmare scenario where you're pinged constantly with non-urgent interruptions while trying to provide patient care.

Here's a typical example: You're examining a patient when your screen lights up with a message from the front desk: "Mrs. Jones checked in 17 minutes late for her 20-minute appointment. I know the cutoff is 15 minutes, but should we see her anyway?"

Now you're forced to make a split-second decision about policy enforcement while your attention should be fully on the patient in front of you. The front desk person avoided their discomfort with saying no, Mrs. Jones gets to bypass the established boundary, and you become the decision-maker for every exception (and either “nice” or “mean”).

This is what happens when we reduce friction inappropriately.

The Strategic Approach: Friction Management

Friction management is the intentional practice of making some things harder (inappropriate requests) and other things easier (necessary tasks that support your wellbeing).

Think of it as boundaries with a strategy.

Where You Need to INCREASE Friction

1. Non-urgent staff communications during patient care

Stop responding immediately to every ping. Create friction by:

• Not responding to non-medical, non-urgent messages
• Using auto-responses: "I'm currently seeing a patient and cannot answer non-urgent questions"
• Making people think twice before interrupting you

In the old days, someone had to physically get up and knock on your door to interrupt you. That natural friction made people consider whether their question was truly urgent. Instant messaging removed that friction, so you need to intentionally add it back.

2. Complex patient portal messages

When patients send multi-paragraph messages with detailed medical questions, increase friction by responding: "Thank you for your questions. These are important and I'd love to discuss them with you. Please schedule an appointment."

You're not being uncaring—you're acknowledging that complex medical questions deserve proper attention during dedicated appointment time, not squeezed between patients or after hours.

3. Difficult patient relationships

You're allowed to set boundaries with patients who consistently disagree with your medical advice, communicate poorly, or create conflict. Let them know they're welcome to seek other opinions or see different providers.

This isn't about refusing care,it's about recognizing when a therapeutic relationship isn't working and giving both parties permission to find a better fit.

4. Non-medical tasks that drain your energy

When asked to join committees, plan events, or take on administrative roles you don't want, create friction: "I'd be happy to participate, but I'll need dedicated admin time blocked from my schedule to do this properly."

Make it more expensive (in time and resources) for others to voluntell you for tasks that don't align with your priorities.

Where You Need to DECREASE Friction

1. Documentation and note completion

Make charting as frictionless as possible:

• Use AI scribes or human scribes
• Create dot phrases and templates for common documentation
• Write concisely with bullet points
• Customize your EHR to work for you

The time you spend drowning in documentation is time stolen from patient care and your personal life.

2. Saying no electronically

Create pre-written responses for common inappropriate requests:

• "That's a great question that deserves proper attention. Please schedule an appointment."
• "I'm not available to answer this question right now. If this is urgent, please [specific instruction]."

You can even use AI tools to help craft polite but firm auto-responses. Make saying no as easy as clicking a button.

3. Healthy living logistics

Reduce friction around anything that supports your wellbeing:

• House cleaning services during busy seasons
• Meal prep or healthy meal delivery
• Setting out exercise clothes the night before
• Registering for fitness classes with cancellation policies (creates helpful accountability)
• Childcare that gives you breathing room

If it helps you maintain your health and sanity, make it easier to access.

The Mindset Shift That Changes Everything

You are not obligated to be accessible for every non-urgent question just because technology makes it possible.

Your boundaries aren't personal preferences; they're professional necessities that protect your ability to provide excellent patient care. When you're constantly interrupted and overwhelmed, everyone suffers: you, your patients, and your family.

Strategic friction management allows you to:

• Focus fully on patient care without constant interruptions
• Preserve your energy for what matters most
• Model healthy boundaries for colleagues and staff
• Create sustainable work practices

Your Implementation Strategy

Start with one area where you need MORE friction:

• What boundary do you find yourself re-establishing repeatedly?
• How can you make it harder for people to cross that boundary?
• What auto-response can you create for the most common inappropriate request?

Then identify one area where you need LESS friction:

• What necessary task feels overwhelming right now?
• What healthy behavior could you make easier?
• What support could you add to reduce your daily friction?

The Bigger Picture

Friction management isn't about being difficult or uncaring. It's about being intentional with your energy and attention. When you protect your focus during patient care, you provide better medical care. When you require appropriate channels for appropriate requests, you model professional boundaries.

You have permission to manage friction strategically. You don't have to be everyone's 24/7 answer machine just because technology makes instant communication possible.

The goal isn't to make everything difficult—it's to make the wrong things harder and the right things easier. This strategic approach to boundaries can transform not just your workday, but your entire relationship with medicine.

Technology should serve you, not the other way around.

Ready to dive deeper into creating sustainable boundaries that actually work in your medical practice? Listen to the full episode on the Ending Physician Overwhelm podcast. If you're ready to implement these strategies with personalized support, join my email list for weekly messages of hope and practical strategies for physician wellness.