Join host Dr. Leo Damasco and guest Dr. Anne Tsung as they dive into achieving time freedom through neuroscience and productivity strategies. Perfect for physicians transitioning to telemedicine, learn how to access flow states, set non-negotiables, and create timeless moments amid demanding careers.
How can high-achieving physicians reclaim their time and live with true freedom?
Dr. Leo Damasco sits down with Dr. Anne Tsung as she shares her extraordinary journey—from aspiring astronaut to working in Antarctica's South Pole—to developing her "Five Stages to Time Freedom" framework. Drawing from experiences in extreme environments like NASA and ICUs, she explains how to access flow states on demand, optimize chronotypes, and shift from external validation to intrinsic self-worth.
Tailored for doctors navigating telemedicine and entrepreneurship, the conversation covers overcoming perfectionism, setting boundaries, and using tools like journaling for peak performance. Whether you're battling burnout or seeking work-life harmony, this episode offers actionable insights to transform your productivity and presence.
Three Actionable Takeaway
About the Show:
Telemedicine Talks explores the evolving world of digital health, helping physicians navigate new opportunities, regulatory challenges, and career transitions in telemedicine.
About the Guest:
Dr. Anne Tsung is a NASA flight surgeon, triple-boarded in emergency medicine, critical care, and aerospace medicine, and founder of Productivity MD. A certified advisor in Performance Neuroscience by the Flow Research Collective, she developed the Five Stages to Time Freedom to help leaders access flow states and achieve timeless presence. From her work in Antarctica's South Pole to coaching physicians, Anne empowers high-achievers to shift from external validation to intrinsic worth.
Websites: https://zoomann.com
https://calendly.com/tsungannmd
LinkedIn: https://www.linkedin.com/in/ann-tsung-78541ab2
About the Host:
Dr. Leo Damasco – Pediatrician and emergency medicine doctor turned telemedicine advocate, helping physicians transition to digital health.
Connect with Leo Damasco:
Leo@telemedicinetalks.com
https://www.telemedicinetalks.com
[00:00:00]
Hey everybody. Welcome back to telemedicine Talks. This is, uh, Leo Damasco, your host for telemedicine talks, and We've been trying to get her on for a while and I'm super excited to have her on. This is Dr.
Anne Tsung. Dr. Anne s many accolades. She's a NASA flight surgeon, triple boarded in emergency medicine, critical care, and aerospace medicine. She's a founder of Productivity md, a certified advisor in Performance Neuroscience by the Flow Research Collective, and a former physician in the Antarctica South Pole.
Through her work at nasa in the ERs and ICUs and in the harshest place of the earth, she has developed the five stages to time freedom. And this is made to help leaders access flow, state on demand and achieve true time freedom. And the goal is to create timeless presence and beautiful moments that they will remember
Thank you for being on and thank you for being my coach for time Freedom. You know, we've been working together for a year. I wanted to get you on and kind of share [00:01:00] what you do with the entire world, so thank you for coming up. Oh, Leah, thank you so much for inviting me on, and I've also seen how much growth you've had.
So it's actually I guess what, is it rewarding for me as well? No, absolutely. 'cause it's very rewarding for me because you've opened up a lot more time and a lot more productivity. We're gonna get into that and you know how you do that and your kind of, your approach. I'm obviously a big believer 'cause I've been with you for a while, but, the question I ask now of every, guest that comes on is, Hey, before you started doing this, before you started coming on, you obviously have a lot of things on your plate and you've done so much awesome things.
Nasa, flight surgeon, you've been to the South Pole, things that people could only dream of, What did you wanna be when you grow up? Is that what you wanted? you had this list and you're like, I'm just checking it off now. Yeah. Yeah. I think, when I was very little, I wanted to become an astronaut because, I think I read some space books, planet [00:02:00] books, and from encyclopedia when I was young, in Taiwan, and then moving to Houston, being near the space center, visiting a space center in elementary.
so it had always been like wanting to be an astronaut, but, my path to get there was to become a physician first, because I went on the NASA website. And, essentially you can do anything that you want. Just be good at it, right? Be having like a more, advanced degree and then just be good at it.
So, that's what I did picked, a physician because it is rewarding. it's a job that you can go there every day and actually truly help people and it's stable financially. And I will tell you. Part of also that is, I will say after learning about myself more doing all these things, is because initially I was seeking external validation of self-worth.
Yeah. Because, having an Asian mom, nothing I did was ever enough. So it was ingrained in me that I had to get more certificates or do more and do harder things before I realized I just needed [00:03:00] The intrinsic value self worth. Long story short, no. And yeah, so, you went through this process.
now a NASA doc, ICU er aerospace Med, founded this productivity, coaching business, how did all that kind of just coalesce into what you're doing now and, gaining your knowledge and now just passing it along? How did you get from there to now where you are and what you're doing?
You're asking how everything. Got combined together. Yeah, exactly right. Because there's a lot of pathways here. Right. You know, the doctor pathway, then you went off and the NASA flight surgeon, you started your own. And now productivity, it definitely goes hand in hand, right? You have to be very productive, very efficient to get all those done in one lifetime.
And, you know, you're not even close to half of way through. Right? So how did that all get there? Yeah, I think I always wanted to optimize and be efficient and [00:04:00] do more. So I think my superpower, I realized was I'm the most efficient person that my friends know. So I realized that was my superpower actually, when I was trying to design my niche, because I could do so many things.
I could learn so many things. And in aerospace medicine, your training is learning all these different. Disciplines. Yeah. it's almost like an entire fellowship of learning, how a mission works, like orbital mechanics, radiation, a different type space, radiation, communication, with the astronauts training and like engineering, et cetera.
Long story short, I've had to learn different disciplines, be efficient at it. And I've become the most efficient person by leveraging va starting hiring my first va. When I was in fellowship doing a Amazon product, because I read the four hour work week. and then started doing Tony Robbins learning more about mindset growth since I was in fellowship.
right after Critical care Fellowship actually. So I think it was a combination of all of those experiences that caused me to create a brand. That's me, [00:05:00] separate from my physician world. And so in order to create a brand, I gotta figure out what is my superpower. And my superpower is time and efficiency.
And then so diving into more flow state getting performance neuroscience certified by the flow research collective. And then at NASA, I learned systems. I learned to be extremely detailed and like with micro steps because literally their procedures are like, turn those knot three times. Or like for a spacewalk or press this and turn this one time.
So I think it's all the combination of that. It's the spiritual work mindset work plus the tactical thinking combined together and then now creating this time freedom. five stages is time freedom, which I did not realize and only crystallized until I had. A ton of free time after going on the one and a half year sabbatical.
So I can travel with my kids for a year and we're still in the planning logistics phase, but being in with complete time [00:06:00] freedom, or what I thought was time freedom, but was fake time freedom for two months, made me realize that's not exactly time freedom yet. And actually that's a good point.
let's dive into that. A little background on how we met. It's, when I switched from brick and mortar, it was easy. Brick and mortar was easy, right? You were told when you needed to go on shift, you were told, you had a set time. This is on, this is off, right?
And it was easy to build my life and build everything around that. Now, the downside for that is. I was chained to that, right? Everything revolved around shifts. Everything revolved around factors that I couldn't control. And then when I went to telemedicine, you know, it kind of opened things up.
I attained more. I'm gonna say time freedom, but that's not necessarily kind of the term which you're calling time freedom. I gain more time to do things right, but. My problem was now how do I structure my life to [00:07:00] do what I wanted to do? And not just that, but to be fulfilled in what I wanted to do and
I didn't know that last part. That last part was the hardest part, and I still don't, I'm not totally understood and that, but I still don't get that last part, that's still work in progress because I think. That's the hardest thing. Right. Do what I want to do and be fulfilled instead of just doing for the sake of doing, because you think you need to be doing it
So Yeah. Tell us more about your system. You know, the five stages, time, freedom, and what you've realized in your journey. Yeah. you're essentially in time creator. You're in stage three going to time liberator. And that, I'll go more in detail, but that's like a classic example from a W2 brick and mortar job, or maybe even 10 99 contractor, but still,
Going into entrepreneurial, you're a time manager to a time creator. So let's talk more in detail. So there are five stages. The first stage, you are a time prisoner. And you are shackled by time because you wake up and your one-liner is, [00:08:00] I don't have time because you check your phone, you look at people's messages, you respond to other people's messages, you probably check your email right away and you start responding to other people, or you get sucked into social media right away and then you just like go down a rabbit hole and that you never come back to do anything that moves the needle.
And I'll say, a lot of times I'm in med school, college, sometimes I'm like pulling allnighters, waking up right before a meeting or Waking up right before like a class or something. Or it could be like last week I had, towards the end of my shift in my er shift, I had a central line I had to do plus, essentially I had to shock somebody at the same time.
And then there was like, three emss just rolling in. And I was completely reacting to people because, and I was like, the nurses were like, Dr. Sung, Dr. Sung And like, it was just like crazy cortisol. And I will tell you as we ascend through the stages, it is like max sympathetic to max parasympathetic.
So, that distinction's very different between two of the stages. Second stage is the [00:09:00] time manager, and that's when you're like using to-do lists, calendars, you. Feel like you're productive, you're doing things, you're busy, but yet a lot of times you're not moving the needle. Yeah.
Um, your one liner is, I'm so busy, but I'm so tired because you're doing things all the time by yourself and you haven't fully maximized, leverage or other people or systems or automation yet. I equate that to an ER shift where you are set schedule. You just gotta do it. You have a list of patients and to-dos and you are leveraging other people, but no.
Without you being there, the shift won't happen. Yeah. Like you have to be the doctor. You're still training time for money in a way. So a lot of us in the W2 jobs or like when I was a resident or when I was a fellow, I felt like I was more grown up. That's pretty much where I was a time manager or a lot of executives too, have a ton of meetings, throughout their entire day.
Instead of like any sort of deep work, they're actually just in [00:10:00] meetings all along and like taking notes for the meeting to spread it to other team members. So, any questions between that first and second stage before I move on? No, and just a point too, and you mentioned it, it's funny 'cause you have five stages, and you kind of ascend through and you send through, openness, fulfillment, and, sympathetic versus parasympathetic.
And, ideally you want to send to like the fifth stage, but it's funny that the second stage is where a lot of people. That's our goal, right? I wanna be ER staff, I wanna be the ER attending and manage the er, but yet they don't necessarily realize that, that's still very sympathetic, activating.
It's very stressful and. A lot of us now are realizing, as evident by burnout, as evident by, the medical community, the doctor community thinning out and doing other things, you're just quitting all, all together. Is that this is not an optimal stage to live in. You know what we thought that, hey, this is our pinnacle [00:11:00] goal.
This is what we're gonna do for med school. we're really only scratching the surface of what we can do. So getting that realization was interesting for me . Yeah, you don't realize how much more energy you could have until you're out of that.
Yes. But the problem is you've been trained that way. You've been trained to, your default as a med student intern, resident is a time prisoner. You were told this is what you need to do. Make time, make time, make time, and then you go home tired. You're like, blah, I didn't get anything done. I just got beat up, pimped out, so forth and so on during shift.
Now as an attending, you're like, oh, this is great. Right? You're not getting beat up as much, but little do a lot of people know that, it's part of the problem. you're stuck in that mindset. Yeah. And a lot of us are, happy in our W2
and our 10 99 too, because it's easy. Yeah. You clock in, you'll clock out and it's done. You're still training time for money. And I was just talking to an attending who's been out for many years and I gave them an idea. I was like, why don't you just tell them that you can't work like [00:12:00] Wednesdays 'cause you know, for a date night?
And he was like, I never thought I could just tell them . Yeah. What a bad doctor, right? How dare you ask for what you want and what you think you need. Why aren't you thinking about the institution and the patients? You bad doctor, right? Like, gosh, you know, this is where we're stuck, right?
We are stuck happy in this kind of stage because that's what we were trained to do. A little clinical monkey stage. this mindset is so crazy. It's so ingrained in us. And, the cortisol fire hose, what I call it, during er shift is like no joke. Where you are really paying with your nervous system for the next two days, and diving a lot into the polyvagal theory where your hypers sympathetic and then takes you like two days for the hypoarousal state where you're just like blank.
Yeah, like blank stares. Like my husband caught me with a blank stare after that. I feel like after that shift, the following day, it was just like when my kids were just like staring [00:13:00] blank. Yeah. He was just like, whatcha looking at? You know, it's funny 'cause in telemedicine I work kind of the same hours, maybe even more hours, but.
After that, I've worked a couple shifts, mind you, in the er, I went back, after watching the pit, I was like, I'm going back. it was funny you said it, my energy level after that shift, it wasn't even a hard shift, after that shift I was just beat and I was just like,
I, now I remember. it just totally drained and you're right. and I think because of, you know, just firing on all cylinders all the time. Yep. The cortisol fire hose and the stimulation for all the alarms. Maybe some psych patients, some anger, all that stuff.
Sadness. Yeah. All on you. Right, right. Anywayyes, a lot of us are in the time manager stage and the next stage, the third stage is what I call the time creator stage, and that's where. a lot of us feel like that is true time freedom because you start leveraging virtual assistants or maybe hiring people.
You start looking at other ventures like telemedicine, having more flexibility [00:14:00] with your time, starting your own in a way, maybe starting your practices, tying yourself down depending on how you do it. But essentially other ventures to hopefully stop training time for money, like real estate, et cetera.
Mm-hmm. And so. You start automating, delegating, having systems. You start buying your own gym sets at home so you can save time, et cetera. And then you start, aligning your deep work with your chronotype. And we'll talk about chronotypes too, but it's your peak energy Everybody has three types.
Two are usually in the morning, one is usually nine, four to 9:00 PM So you start saying, oh, I have my top three priorities. I can do it here. You prioritize your family, you prioritize your workout, your health. And yeah, you freed up so much time that you're like, oh my God, I have so much time. Which is where I was when I went on the sabbatical.
And so when opportunities comes like a new course or a new knowledge or a new conference, you're like, or a new collaboration like. Okay. That looks good. Maybe I'll try out. Okay. I don't know if I like it until I try out. So you try out and you say yes.
Or maybe [00:15:00] another telemedicine platform. 'cause you don't know how much you like it until you try out that telemedicine platform or nurse practitioner collaboration anyway. So one yes. Leads to like 20 open loops. 20 open tabs that it's like dangling open, like the tabs on your laptop. And so I was like, I have all this freedom to create whatever I want, but why am I so stressed?
Yeah. And then I realized that it's because I was saying too many yeses. I have this pressure to optimize. I know I can make it happen. So I juggle things to make things happen, and it was just too much essentially. So that is where a lot of us are, the entrepreneurs, the founders, executives, and that's what I call fake time freedom.
so. Compare that to the next step. What's the next step in true time freedom? So the next step is even more about what I call the stage four is the time liberator. And as a time liberator, your one-liner is, does this multiply or drain my [00:16:00] energy? You're a time liberator because you're not even considering if you have the time anymore.
It's more like, if this deserves my energy. And does it align with my purpose? Does it align with my non-negotiables? And if it does. If it's a hell yes, then okay, it's a yes. But typically you're working on two business goals per quarter and not like so many open tabs. Okay? So your nervous system state is actually more parasympathetic.
You're calm, you're not stressed. You have a few focus and you know, that's it for the quarter or for the year versus all of these yeses that you need to follow up with. And that's the next stage to time freedom. And I can go onto to the FIP stage or do you have any questions about these? I, I do. And actually pointing that out.
'cause you're right. a lot of us, you know, as we transition over, we hit that third stage. Now, you know, you describe the stage as having time to say yes, but still having almost physical mental constrictions. [00:17:00] Because now that Yes becomes more things you need to do. More things that are now weighing down on you.
And it's funny 'cause coming from the manager to the liberator, step two, three, right? You know, that Abel's like, oh, this is great. I'm creating my own time, I'm creating that. But I think part of the problem too is that mindset where we always wanna say yes, right? We always wanna say, Hey, the more the better.
How do you get better as a doctor? Read more, study more work, more da da da. And it's there. You transition over, you've created this time for yourself. You've created processes, you've opened up things. You're choosing when you wanna work, so forth and so on. But then you're still busy.
You're right, because you just keep on piling it on. And it's that question from the third to the fourth, where is it worth my time? And I think that's one of the hardest things I had a problem with, and I still do. Is it worth my time? [00:18:00] Because right now, every little time I have now, 'cause there's so many opportunities, I'll just fill it.
I'll fill it and like, this is cool, you know, I'll fill it and then I ask myself, why am I so tired of it at the end? Like, why is there so many things? And like I've created all this time yet? I don't have much, time, yes, I have time to work out, hang out with my kids, so forth and so on.
That's part of the time thing, but still there is that feeling of, I gotta fill every single minute honestly. Like, yeah. If I don't hit my goals, like my day is separated by the minute, and if I don't hit those constrictions I place for myself, then yeah, it just there's nothing left.
Right. I just feel full again. So, it's interesting to get that mindset going. And especially in telemedicine, you have so many different platforms. Oh, absolutely. You have PCA opportunities, nurse practitioner collaborations. Yeah. Just so many new companies up and coming and, [00:19:00] every Yes.
You say it's like, you have limited ram in your head space and your cognitive space and any Yes you say will slow you down cognitively. So, and I think I'm slowly getting over that Is excitement of the new and it's like, oh, this is cool.
This is a new opportunity. I'm gonna take it because I think it's cool. but I've never really asked myself that is it worth my time? I don't think I even realized I could ask myself that. Because, that means I had a choice, right?
That means that I had a choice whether or notthe idea of my time being worth more than just what my time is Is still an alien concept for me. You mean I have a decision whether to, actually choose what I want to do with my time and like, prioritize and actually say,
Instead of is time worth me I was asking myself, am I worth the time it's just kind of a weird flip the script kind of situation there. Yeah, [00:20:00] and that's exactly it. That's what's called the Time Liberator, because essentially the first three stages. You're bound by time I can create the time.
Yeah I don't have time, whatever. But when you get to the fourth stage, it's not even about whether you have timer anymore, you choose the time, but it's really about your energy, your alignment, your purpose. So it's not about, you can always make the time as a time creator, so you juggle things and fit things in.
But if it's not even worth your time or worth your energy, then. You don't even go down the rabbit hole to fit it, if that makes sense. So for example, I was offered this opportunity to go to a conference for a day and I knew it was gonna drain me 'cause for the travel and everything, I was gonna be away from my kids.
I knew that, and I knew these five stages I was like, I think I'm being a time creator right now, but, let me just look right. I went down a few rabbit holes looking at flights for about 15 minutes. I went down that rabbit hole and then I caught myself and then anyway, it wasn't worth it because the flights were too long.
I couldn't get back in one day, so whatever. But if I was a true time [00:21:00] liberator that day, if I had enough like discipline, I wouldn't even have done that. Like, it's not even worth it. Right? Yeah. how do you get there? What's the secret sauce? how do you switch your mind into believing that, Hey, this is the way I should think, or I'm allowed to think this way almost.
I think the first step is like, it's gotta be trusting your gut. It's gotta be like a hell yes. there's like, yeah, maybe that's when you need to find out more information. Yeah. Then it becomes a hell yes. But the easiest thing, the hell yeses are easy. You just say yes to it. Everything is a no unless it's a hell yes.
And then maybe limiting to no more than two business major goals per quarter that you focus on and chunking it down. And then.
Just go through, walk through what you're gonna be diving into all the way through and see if you feel like it's gonna inc, excite you or drain you. So if I say yes to opportunity and I fly there. And I do this and I give this talk. Or if I accept this opportunity, it's telemedicine. I will [00:22:00] go through like maybe 30 days of credentialing all the paperwork.
Yeah. But imagine the patients you'll see. Imagine the interactions. That's when you need to find out more information. Does it energize you? Does it align with what you wanna do, or do you feel like it's draining? And what about the fomo? Like how do you get over the, Hey, you know what, if I'm missing out?
Yeah, it depends on what you're talking about. The other way I think about it though, is what are you missing out on if you say yes to this, actually? Yeah. Yeah. I remember one of our talks and I think it was just prioritizing something, and once you framed it that way, you know, kind of the light bulb went off.
I was like, crap. I almost felt embarrassed that I thought about, option A because option B was just so obvious that if I missed out on that, I would've missed out on a lot, I couldn't even believe I was thinking about option A.
Taking over option B. once you made me realize, hey, you're gonna be missing out on this really cool thing [00:23:00] that you're never gonna get back you know, with your kids so forth and so on. I was like, why am I even thinking about this? No, it's funny how, just that slight rework in framing and approach, resulted in kind of a big swing on, how I felt about missing out on option A. After that, it was just like, no, there's no fomo, because It's just totally obvious. This is the obvious answer, now once you've the non-negotiables for yourself, once you have your health set, your non-negotiables regarding your family, then you have a standard that you measure yourself.
And you know, sometimes you have to look at it like, is this transient or not transient? Like say if you're going to a conference you're gonna miss a few nights with your kids, can you make it up. Can you make the space and free up times before and after? For one-on-ones with them instead.
And then you have to look at it, whether something you're saying yes to is actually something that's, repeating and ongoing. and if that's then that's probably a definite no. But if it's a transient thing and you can make it up to them. [00:24:00] Then it may be okay if your gut tells you it's gonna be a great opportunity.
Yeah, yeah. so the fifth stage, I will say, once you're at a time liberator, and I'll say like, you can flow through all these stages in one day I'll tell you a day that I had. But the fifth stage is what I called a time transcender. And that's when you say to yourself the one-liner is all there is.
Is this moment. Now time doesn't exist. It's timeless. You are not managing what I call clock time, and you're managing their presence time essentially. And the reason I say that's true time freedom is because a lot of us, I'm sure on our death beds, we will remember those memories that we've created.
Where time didn't exist, where, you know, say your kid took the first steps where you're looking at your kid's eyes and you're laughing, you're connecting, or you're gossiping with your girlfriends or you're surfing, the time does not exist [00:25:00] during those moments. And those are when beautiful memories are created.
And then we go through stage one all the way to stage four. have more wide space so that we can spend more time in those timeless moments, or flow state is what I call it, where you have maximum creativity, focus and productivity. Uh, energy as well. Yeah. and it's like the zen state of time, right?
You just kind of float through it's effortless and tying it back to kind of the flow state that's exactly, kind of where you wanna be, and that's a time that you achieve that, right? you just do things without even having and thinking about doing things because it just happened.
So yeah and, uh, you can be in micro flow, you can be in macro flow, and that's like a micro flow is like, I don't know, you're drafting an email like that's like deep and creative. You're really into it. Or maybe like you're creating a slideshow and the macro flow is like hours, like two, three hours.
You're just in a zone, maybe four hours, maybe a whole entire day [00:26:00] where you're just like in flow. And the only way you can achieve flow. Is when you have space, when you have less restrictions, less clock time. Like for example, I don't know if I told you this, like I had a one-on-one date with, I had nothing on my calendar for one day and I have five hour date with my daughter, with my one and a half year old.
Oh, that's cool. Yeah. It's a completely different feeling than if I had something in the afternoon, like a one, even, like a one hour, 30 minute thing in the afternoon. Completely different. Oh, yeah. Feeling Absolutely. It hangs over you, you know? Mm-hmm. You're always thinking about that one thing.
You're not necessarily in the scenario fully. Mm-hmm. Right, because there's always something hanging over. Mm-hmm. Yeah. That's amazing. Yeah, that's an example of like a macro flow day, but it's a different type of flow from productive work flow.
Yeah. It's more of like group flow or like a one-on-one flow with your kids, the people you love and you give them presents and attention, versus like you're always worrying about something else [00:27:00] that your appointments, your meetings, your zoom calls, et cetera, your patients. And I think an important point that you made too earlier was that, you know, in any given day, you could be in stage one through stage five and back to stage one.
Yeah, this is not all encompassing. You know, there's definitely transitions in between, but I think one of the big keys is to realize that, hey, you're creeping down to the lower stages. What do you need to do? To get yourself out of there. And sometimes, oh, you're right, sometimes you can't escape it.
You know, you're put in a situation where you can't escape it. You know, you're in an ER shift and people are crumping around you. You're stuck. You know, you can't just be like, nah, we're not gonna let that happen. Whatever happens, happens, I'll talk to the family later. You know what I mean?
That's probably not the best answer, So how do we make ourselves more efficient? I think this, gosh, you worked really hard with me to even scratch a surface of [00:28:00] that and there was many different kind of approaches that you made and different realizations. You know, you kind of mentioned it, you know, what's your chronotype?
Things like that. So what kind of things do you focus on to help people become more efficient, to help them? Situate themselves so they could achieve, transcendence and through these flow states. Yeah, yeah, for sure. I think, I'll tell you about the one day where I had like all five, and I'll tell you maybe from stage to stage, the actions you can take to ascend to the next.
The day where I had all five was like a week or two weeks ago. I had, you know, my time liberator blocks with my daughter and you know, with swimming. And then next, right after swimming, I had a one-on-one date for an hour with my husband, and then right after that, then I became a time manager. But, well actually I became a time creator and manager because of my ERA block, I now often focus on the first 30 minutes where it's not too busy.
I see one or two patients. Very little cognitive load. I have one or two quick. Things that move the needle, like sending [00:29:00] one email or responding to one licensure paperwork. So I would become a time creator in that container of the time manager, just the first 30 minutes and move the needle. And then, yes, towards like the last six hours of my shift, it was like a complete time prisoner.
And then I had to like, you know, after shift shake off, like the shower just shake that energy off and like decompress. I think it's super important to realize, first, diagnose yourself what we just talked about, what stage you spent the most time in. And I think a perfect way to do this is perhaps like go to the episode website, copy and paste the transcripts of what we talked about, then put it into your GPT to load it.
So understand what time freedom is and everything. We talked about five stages, and then after this, what you'll do is every single day for a week, you will dictate to your GPT your time audit. Instead of doing it manually, you just say. seven to nine kids' time, nine to 11, telemedicine time.
One, two. Two is lunch, and then two to three is gym da da, da da. And you do that for a week. [00:30:00] Then it will tell you the percentages you spend in each stage. you may have to edit it a little bit, looking at the responses, if it's truly what it categorizes as, and then you'll have a sense of like maybe 'cause mine's different.
My clinical days is like mostly a time prisoner. Time manager. Yeah, a little time creator. But my nonclinical day, 75% is time liberator and time transgender. You'll see that there's a difference and then figure out what you need to assign. So as a time prisoner, I would say the most important thing you can do is to leave everybody else, serve everybody else in the afternoon.
If your chronotype is a third bird or a or you know, your peak zone is in the morning, then serve everybody else in the afternoon. Leave your phone outside your bedroom. leave your phone outside your office and disable all of your notifications as much as possible. Your texts, your calls only have favorites.
Be able to call you, and like, if you're working, like maybe patients, et cetera. And then grayscale your phone. [00:31:00] Essentially do the things that move the needle. Have your top three priorities the night before and execute the next morning first before you respond to anyone else. And then download the Freedom App that blocks all of your distractions, like social media or news.
So I would say that's Probably the most immediate steps to go from time prisoner to a time manager. Do you have any questions regarding that? And so what you're doing, basically, and this is assumed that you're chronotype now the chronotype for people that don't know what's a chronotype?
So you usually have three chronotypes of people. So it's the lark, third bird, or owl. And that means that each of us have a set time zone where we have the quickest cognitive energy the peak zone is what I call it. And in order to find out where you are, you wanna take away all of the, your sleep time, minus all of the caffeine obligation kids whatsoever.
Maybe remember a time when you're on vacation or [00:32:00] something, or when you are younger. When would you ideally like to go to sleep? Without caffeine, all that stuff. and wake up without an alarm. so you wanna take the midpoint of that time and then it determines your chronotype. So say for example, if you like to go to sleep at 10:00 PM wake up at 6:00 AM your midpoint is 2:00 PM and so your chronotype, if it's midpoint, it's before 3:30 AM then you are a lark.
What that means is that your peak zone to work is around between five to 9:00 AM so you wanna schedule all of your top three priorities deep work your flow block between five to 9:00 AM because you can go five times faster in your peak zone. And the next one, if you're midpoint of your sleep, is between 30 to about 5:30 AM Then you're a third bird.
Most of us are third birds, and then our peak zone is between eight to 11:00 AM. And then the owls, their midpoint is after 5:30 AM [00:33:00] So I tell these they're, it's really hard to be an owl, I think, in the society because they feel a pressure to wake up early, but they love waking up at like nine or 10, 11.
So usually when they wake up, I tell them to serve other people first. You know, they can do their workouts, they can do their journaling, meditation, and then fourth. To 9:00 PM is their peak zone. When everybody else finishes working, goes home or like starts winding down, that's when they're like in the zone.
But it's hard for owls because they feel the pressure to wake up the same time. So they often get two hours less sleep and then they often can't be as productive as they could be during the afternoon time. Yeah. And, that was a difficult thing for me to figure out, you know? And I think too, I was trying to force.
Well, I just work all the time, which is a problem, right? But yeah, I realize it. My most productive time we identified was the third bird time. And you know, once I started focusing on that time as my productive time, the times where [00:34:00] I, set meetings aside and actually do work, I got a lot more work done, a lot more productive.
So now really. The problem is trying to keep that time, you know, trying to be strict with that time and say, hey, and not have other priorities kind of creep on in. And you know, it's a give and take because, in order to shift from time manager to time creator The first step is you're matching what you're doing
With your prototype. So that can be. Picking er shifts that matches with that chronotype. So I'll tell you, you know, I sacrifice my peak zone for my kids time. I'm PRN right now. So I used to do nights, but it was like no more nights because it's really like a day before you're anxious about it.
The night of your tired. Yeah. The two days after you're like, dad. Yeah. You know, so it's not worth it. So my peak zone is like five to 9:00 AM But it's okay because. Now my ER shifts, it goes till like midnight or 1:00 AM. So I don't wake up at 5:00 AM yeah. After that I preserve my [00:35:00] sleep and I spend time with my kids till 9:30 AM I drop them off every morning as much as I can.
And I do my flow blocks towards the end of my Chronotype P Zone. so it's a realization that I know I'm giving that up for my kids, but that's okay because after my kids go to school, I will do whatever I can to extend, you can extend that peak zone by fasting or eating low glycemic foods and then just keep working all the way through.
Yeah. No, and it's funny you mentioned that too, the whole, there's really science behind what you do and a lot more than just. Moving your schedule around. And that's, initially, that's what I thought what productivity is right, is just I got these blocks of things I need to do.
How do I rearrange the puzzle so I could do more? You've introduced the idea thatI believe in it 'cause this has worked is that there's more to that. There's physiology behind that. There's your chronotype behind that and matching that [00:36:00] and just being aware of it. takes a lot more awareness and a lot more mindset switching to actually, get all that aligned.
Yeah, for the people who are listening, if you have diagnosed yourself in terms of which chronotype you are, I would suggest in your calendar now you can put down the Times chronotype peak zone so that every time that something wants to, schedule over that you know what you are sacrificing or what you are.
Giving up your energy, your peak energy. Is this worth my peak energy right now? Is this appointment worth my peak energy time or my trough time? Because as a third burden and, alar, your trough time is in the afternoon, and then as an hour, your trough time is in the morning. So do the little things. Low cognitive load in more of your trough time than your peak time.
Yeah. And how does diet and. What you eat, play into that too. 'cause that's a whole talk all in itself as well. Yeah, yeah. so I talk about, in the flow research collective, there's a ton of, over 10, maybe like 15 flow interventions and flow habits. One of [00:37:00] 'em is about eating and there's what's called flow meals.
And there's ritual meals. So ritual meals is like the everyday type of food. It's probably gonna be high glycemic, high carbs, sugar give you fo fu coma and you accept it. Fine, it'll be a ritual meal. But if you wanna do, you know as much as possible during your peak chronotype peak zone, then you eat a flow meal or you don't eat at all.
And that's why we talk about, you know, putting the continuous glucose monitor on you so you can test which foods actually raise your glucose a lot and cause it to peak and trough and then give you flu coma so you can avoid those during your peak zone. Yeah. that's hard.
'cause when I did that I found that Rice did that a lot. Being Filipino, I can't really have a meal without rice. So I was like, oh man, I'm gonna have to give that up if I wanna be productive. And it's true, after I eat, and ask anybody that knows me I'm out after I eat a big meal and I'm just not productive at all.
It takes an hour or two for me to literally wake back up. [00:38:00] And working. Yeah. If you, eat more like acid or fat, it could potentially slow the digestion of carbs. And I know we had talked about even the timing of meals. Yeah. absolutely. You willingly accept that it's a ritual meal with your kids and you're gonna eat rice.
But you're gonna move it a little bit earlier. So your food coma is a little earlier so you can sleep earlier Yeah. Well, yeah. That's what happens. But it's worked out, you know, since I've changed my schedule, you know, trying to get meetings in the East coast.
And waking up earlier relatively earlier for me. Yeah, It's worked out. Trying to move that mealtime just a little bit further and trying to kind of change what I eat or add things that slows that metabolism down. That's huge. Yeah. And I think that's all about being a time creator.
And that's when you're really, before that you're not thinking about your neurobiology But now you're really combining the tactics with your own neurobiology and what you're eating and how you're sleeping. and then you start hiring virtual assistants or other people to help you with your company, leveraging other teams.
Yeah. And then. you free [00:39:00] up so much time. Now it's setting your non-negotiables and sometimes your calendar can look like you're a time liberator, but now it's just the mindset catching up. It's just reframing that question. What am I saying no to? If I say yes, what am I gonna miss out on if I say yes to this?
Or does this deserve my energy? Is it gonna. Drain my energy or is it gonna multiply my energy? So that's the most important step to get to a time liberator, and then really to be a time transcender. It's all the steps before. So you have minimal distractions and so that you have enough nos to create a free day of nothingness so you can just flow through the day, or maybe a free morning of nothingness so you can just work on the business and flow and be creative, or just go surfing and not watch the time or when you have to get back to whatever.
No, that's amazing. Those times are few and far between, but when, I do realize that time it's just amazing just not having to worry and [00:40:00] just going when I'm ready, This is awesome. And yeah, this is all part of your, coaching, right?
And this is kind of how you walk through it. And I know we're coming up in time. But the last question I always ask is, Hey, so going back to your intern self day one of intern year, July 1st, we're not gonna put a year to it, but July 1st, what would you tell yourself? Baby doctor, intern day one.
If you could go back in time of everything that you know now, what would you tell 'em at that time? Yeah. You know, the very first thing that came up was your self worth is not dependent on how much you know. That's tough. 'cause all throughout school, all, pre-med classes, O chem, like you can't get through even thinking about med school and che and really do we ever use that?
But that's it, right? The threshold is how much do you know? How much can you remember and how much can you vomit it back up on a piece of paper and I'm gonna date [00:41:00] myself. How much can you, circle the right circles? Nowadays it's like computer, right? And you figure it out right there and there.
But yeah it's crazy, right? That's a way different mindset than what it is. Yeah. And I think we get so entrained in it and it still comes back to us as attendings. I feel like if you have a bad outcome or, Monday morning quarterback, you look back at a patient and sometimes you feel like, oh, why didn't I, like two weeks ago I was like, this guy was like, needed to be intubated, hypercarbic, all this stuff, but I missed his DKA because I was so worried about reversing his,
cosatu to intubate 'em. Oh, yeah. Yeah. So those times, and I'm still like, but you catch yourself earlier. Yeah. So yeah, there's nothing extrinsic how much knowledge, you know, you will never be able to know everything in this medicine. And, just know that everything that you've done is with your best intentions, with the knowledge that you know already at that time.
That's amazing. 'cause that is very difficult, especially for, our population as [00:42:00] physicians and entrepreneurs and really people just go-getters in general. 'cause Yeah that's how we were trained to grow and measure ourselves. So. yeah. Thank you for being here.
hopefully we could get you back on, 'cause there's so many things I'd love to talk to you about. I guess your transition to becoming more free, your kind of realization of what you're worth and how you measure yourself, things like that. I think it'd be all awesome for people to hear and for you to share.
But for now, how can people get ahold of you? how can they get coaching from you, those docs transitioning to telemedicine, trying to figure out how to make this work. it's worth talking to Anne and seeing how to make it work. Honestly, it's. Highly recommended. Totally helpful.
So how can they get ahold of you? Yeah, thank you so much. I think you can just go to zoom and.com and then you can book like a 30 minutecomplimentary advisory with me. [00:43:00] zoom Z-O-O-M-A-N-N no e dot com. Or you can go to Productivity MD the same Calendly is there and yeah, I am, you know.
I think I have 30 licenses on the way to 51. Great. So, doing telemedicine myself and, we'll be doing telemedicine during our one year travel. So I understand the realm of telemedicine. Well, anything I can share with you, just to create at least a weekly blueprint for you, setting your non-negotiables, figuring out chronotype.
I know everybody's circumstance is different and that's what the 30 minutes is for. So, feel free to, book a call and, you work with me or you don't work with me, it doesn't matter. I'm sure you'll walk away with something actionable that you can, use for yourself so you can achieve timeless moments.
That's what's true. Time freedom is definitely check it out. Heads up, she will keep you accountable. I've learned that the hard way. But it's needed. And really just talking to Anne about your non-negotiables and Trying to understand that idea of non-negotiables, right?
Again, [00:44:00] it's hard for us to do that, right? 'cause we're so used to giving up our ourselves for everything else. So, highly, highly recommended and thank you so much for being here. And again, hopefully we have you on pretty soon and, um, you get, update us on your journey. Thank you so much.
Yeah, thank you Leo, and everybody. Of course, go subscribe and check out telemedicine docs. If you're listening to it for the first time, leave a review. Super important. If you love what Leo's talking about, he is an expert in the telemedicine field, so do that.thank you.