Good afternoon, ladies and gentlemen. Our keynote lecturer this afternoon is Dr. Paul Mahopel. Dr. Mahopel began his career as a neuroscientist and today uses his knowledge of the brain, psychology, and leadership to consult, facilitate, and educate with organizations. Dr. Mahopel believes that effective leadership requires a holistic approach that requires emotional, spiritual, social, and systemic thinking skills. Both as an educator and a facilitator, he takes this holistic approach so that learners can connect more deeply with the content. In keeping with our focus on physician well-being, today, Dr. Mahopel will present Reducing Distractions in Order to Improve Productivity. This presentation will report on recent startling psychological and neuroscience research of the negative impacts of multitasking and will offer useful approaches to reduce distractions and enhance focus in order to improve well-being and productivity. Please join us in welcoming Dr. Paul Mahopel. Thank you. Thank you for inviting me. I'm here to talk, I'm the segment, if this is a Monty Python skit, I'm the segment that here's now something completely different, so this is going to be a change of gears. I like to talk about distraction and my background is a neuroscientist and now I spend my time consulting in organizations, particularly I work a lot with physicians. Over the last few years, I've been noticing something happening to the physician population and so I dipped into the research and so I'm presenting work that I've researched from other people, so I'm standing on the shoulders of giants, so I just want to acknowledge all the people that I'm referring to in terms of the data and the information I'm going to report today. So what I'd like to talk about is two things, I want to talk about distraction and how it's been progressively getting more and more and more, you might notice it yourself and I want to talk about what are the sources of this, what's driving this, why is it increasing and then I want to talk about the impact it may be having on us both psychologically and perhaps neurologically. And then I'd like to offer what we can do about this and there is some literature emerging that's really looking into things that we can, if you like, mitigate or even protect ourselves a little bit more. So I want to share with you three trends that we've seen in the last decade, the first one is that we are spending less time in front of other human beings, over the last ten years we've seen about a 33% drop in the amount of time we're spending in front of other human beings. I'm going to offer that that's significant in terms of our emotional and social interactions. The second trend is, as I was saying, distraction seems to be increasing, in fact Cheryl Turkle about a decade ago started to measure people in the workplace and wanted to see how long the average person at work could focus on a task before being disrupted. And about a decade ago it was about 12 minutes, just last couple of years it's dropped to three minutes, so we've seen a profound decline in people's attention span and this has been verified through cognitive testing that we can actually see people are unable to sustain their focus as compared to a decade ago. And the third trend is that we're seeing every single indicator of mental health, psychological disturbance going up, particularly anxiety and depression and particularly in young people. So every single one, in fact, what corresponds with this increase I'll offer is about when the smartphone sort of reached penetration, so about six, seven, eight years ago we started to see every statistic go up. So I'd like to talk about what I think may be underlying these three things. Now I don't know if you're aware of this but there's a body of literature that's starting to form around distracted doctoring and in this particular study they looked at perfusionists and another study looked at anesthesiologists, they looked at hundreds of physicians and residents and they just simply were monitoring them as they're working and found that about over half the time doctors were in a state of distraction on their phones, multitasking. It was interesting, even residents that were being observed, knowing they were being observed couldn't help themselves and were still grabbing for their phones and in some of these studies they find that, you know, 56% of the time physicians will pull out a cell phone during a medical procedure and 49% will send a text message during a medical procedure. So suggesting that there's something going on here that we maybe can't stop ourselves. Back in early 2000s, 2003 or so, a psychiatrist by the name of Dr. Edward Halliwell, who runs a clinic treating people with attention deficit like disorder, started to have these adults appear in his clinic, they were showing classic symptoms of ADHD but what was unusual was that these adults never were diagnosed as children with any sort of attention deficit disorder and he started to see more and more of these folks and he got a little suspicious going there's something going on here so he decided to do some research and in fact published several papers on this and a book and he discovered that these people that were showing these symptoms were what we call supertaskers. These are people that were in occupations that were constantly dividing their attention doing simultaneous things at the same time. So he was the first one sort of identified that this kind of behavioral pattern may be leading to some pathology. In fact he's coined a new diagnosis called adult attention deficit trait which is provoked by multitasking and high multitasking environments and here's just a list of some of the symptoms that these people exhibit and I don't know about you but when I look at the slide I can there's days where I can check every single one of those items off and think that's normal. So back in 2003 maybe this was more abnormal perhaps today less abnormal. So I want to talk about multitasking so I'm going to test your knowledge though. I'm going to present some statements and I want you to declare whether you think this statement is true or false. Are you ready? All right. Multitasking will make you more efficient. Is this true or false? Wasn't very strong but okay. Multitasking will make you more creative though. Is this true or false? Okay. You know you do multiple things kind of little innovation going on there. No? Okay. How about this one? People multitask get better at it. That's a little weaker. How about this one? Multitasking will enhance certain brain functions such as memory and reaction time. How about this one? Multitasking is essentially benign. I guess I wouldn't be standing up here if I thought that, right? So I'm going to make the case that every single one of these statements are absolutely false. And I'll try to provide some evidence of why that is the case. Now one thing you need to know and this is based on hundreds of cognitive studies. If we take you into a lab and we ask you to divide your attention, we find that if you were to do things simultaneously or do them in sequence, if you do them simultaneously you lose about 40% efficiency. And the reason for this is it takes momentum to get into a state of focus and concentration. So for example if you're deeply focused and I interrupt you for one minute, it takes you about 12 to 15 minutes to regain the same depth of concentration that you had before the interruption. So you can see that there's a lag time and so if we're constantly switching our attention we never actually get into deeper states of concentration or focus which often impacts our effectiveness in our performance. Interesting enough, the more you multitask, the worse you get at it. In fact I found something very interesting, the more multitask you get worse but your self-perception of what how you think you're performing increases. So we get this dissociation that starts to occur. So it often this is why it's dangerous to multitask because the more you do it the more impaired you are but the better you think you're performing. So this is the dangerous aspect which may be driving why we're doing it more and more and more. Now I'm gonna offer that when you're on your device, when you're looking at a screen, particularly your phone or you're on the internet, that's been shown also to be a form of extreme multitasking. Because when you're online you might notice there's multiple things pulling your attention and it takes efforts to suppress and not to go down there. I don't know about you but have you ever noticed you've gone on to do some work, you're making a search maybe PubMed and then suddenly two hours go by and you're watching kitten videos and you're going how did I get here? That's an example of extreme multitasking, you're constantly being pulled. In fact I'll show you some brain images that show that digital multitasking is very extreme. So just to give you a sense of how profound the impact is, this was a particular study done in the University of Sussex and what they did is they asked two people to have a conversation for about a half an hour and but they had different conditions. Sometimes they were asked to have the conversation in the presence of a phone that was visible. Sometimes it was their phone, sometimes it was a neutral phone that didn't belong to the people. Or there was a condition where the phones, no phones were visible. What they found was when the phones were visible regardless if there was their own phone or someone else's phone, because afterwards they they did assessments of trust and empathy, they found that trust and empathy scores dropped in the presence of the phone by about 50%. Suggesting that it's interfering with our interaction somehow and having a profound impact on the quality of our exchanges. And what they found in the study, the reason was people would break eye contact and just to look at the phone. So often there's something very seductive about these devices because we constantly want to keep keep our eye on them and we're always checking them out. Even if they're not our own phones. But more importantly, Adrian Ward is a psychologist who is based out of San Diego at UCLA. He's done several really interesting studies with hundreds and hundreds of people, over five or six hundred people. And what he did is one of the studies he brought people in to do two types of intelligent tests. A standard IQ test and then a test for fluid intelligence, which is inductive or creative reasoning. And he had three conditions and he randomly ordered the conditions. And one of the conditions were you were to come in, complete both tests with your phone on the table. Second condition, bring your phone but keep it out of view, keep it in your pocket, purse, jacket. Third condition, the subjects were asked to leave their phones at home and come in and then do the test. What he found was a profound drop in both measures of intelligence when the phone was present. Around ten IQ point drop. Now ten IQ points is the equivalent of trying to pull an all-nighter and trying to function the next day. In fact, if you're interested, studies with marijuana smoking find it only knocks you down seven IQ points. So more intense than marijuana. In fact, even when the phone was hidden, they still saw a significant decrease in both measures of intelligence. In fact, he sort of looked at multiple studies and he's finding basically the closer the phone is to your person, the stupider you get, the more your scores drop. So I want to provide a possible explanation. So I'm just going to give a caveat here, which is the studies I'm about to present are just a handful of studies right now. So we can't draw any definitive conclusions, but at least they're suggestive and might explain some of these social and cognitive deficits that I've just been outlining. So what I'd like to do is go back 20 years ago when the first study was conducted when we looked at people, what was happening in their brains when they were going online. And this was done in 1999 by Gary Small at UCLA. And what he did is he found 12 people who were professed Google experts. He asked them to come into his lab. He basically just measured cortical electrical activity and asked them to do some searches and wanted to see what kind of activity patterns were occurring in the brain. For a control group, he found 12 people who never used Google. Can you believe it? They're human beings on the planet that never used Google. And he did the same thing. He said, do some searches. I'm going to record what's happening in your brain. Now, what he found was quite surprising, I would offer, that I don't think he even expected. The people that were Google experts, he found hyperactivity in the frontal region of the brain. In fact, activity that's beyond what we call in the normal physiological range of doing other activities. So he'd call it somewhat a hyperactivity in the front part of the brain. Controls, the control group did not have that. So he did something very clever, I think. He took these novice, 12 novice people, and then he asked them to come in for the next five days into his lab and practice doing Google searches for one hour. And the participants had to agree not to use or look at a computer any other time that day. And then on day six, he repeated the experiment. And so what do you think he found on day six when he tested the experts and the people who got five hours of practice with Google? Well, essentially, he found no difference now. Now this novice group was showing the same hyper excitability to the same degree as the experts. Now think about this. There's very few things in life where five hours of accumulated exposure will give you such profound brain changes in terms of activity. In fact, some neuroscientists have said that what the Internet has done to our brain is probably one of the most profound plastic events since humans invented the alphabet in terms of the rewiring capacity. So there seems to be something profound happening. So I'd like to explain what may be happening, might be accounting for this hyper excitability. If you may be aware that the prefrontal cortex, which is right behind your eyeballs, is a structure involved in what we call executive functioning, which is the ability basically simply to establish a goal that you're trying to achieve and get it done. Now you may know that goal-directed behavior is one of the most metabolically demanding things that your brain can do. There's nothing else your brain will do that will use as much oxygen or glucose. So those cells are working really hard. So it's actually very energy intensive. Now the reason it is because goal-directed behavior is quite complex. So your prefrontal cortex, what it does is it has to establish a cell assembly to remember what the goal is. So it has to keep that assembly active and those neurons have to keep firing so you don't forget what you're trying to do. And then there's another set of assembly neurons that monitor your progress and your steps towards achieving that goal. In fact, those assemblies do not shut off until you complete that task. So even if you stop, divert your attention somewhere else, those assemblies stay active. Now when you're trying to do two things simultaneously, in fact, multitasking is a misnomer. We can't technically multitask. What we really do is we toggle, we switch back and forth. So if you're trying to do two things simultaneously, you got two sets of goals, two sets, other two sets of neuron assemblies are monitoring your progress to achieve that goal. So it's like a juggler trying to keep multiple balls in the air. And you can imagine if you're doing this all day, it can be taxing and exhausting. So this might account for the hyper excitability that we're seeing due to the digital multitasking. It seems that when we're on our devices, it's an intense, very intense form of multitasking. Now, what are the repercussions perhaps of this? Well, I'll offer when they've looked at different kinds of digital multitasking, not all things are the same. In fact, if we were to have a spectrum, on the mild end of the spectrum would be something like television, which is generally one directional. And then the more you interact, the more you move up that spectrum. And what we'd probably call the crack cocaine of digital distraction is first shooter gaming. That we get the most intense response in the prefrontal cortex with gaming. Now, this particular study looked at adolescents. And what they did is they said, go ahead, game all you want. And what they did is they first took baseline measurements of activity in their brains, and then let them game and the bouts lasted anywhere between two to seven hours of gaming bouts. And then they went back and then recorded the brains and just did a series of recordings. Now, what they discovered was after a gaming bout, all the subjects showed decreased or no activity at all. In fact, lost their activity in the prefrontal cortex. And it took sometimes days for it to recover back to baseline. So just think about this, a profound bout of gaming, this intense digital multitasking seems to have overwhelmed the prefrontal cortex to the point of exhaustion that it can't recover until days later. They liken this to getting a temporary lobotomy. That's sort of how they described it. Because that's what they used to do in the old days, is scrape off the front part of your prefrontal cortex. So suggesting that this may not be a good thing for our brains. Subsequent studies, and this came out in the UK about five years ago, have demonstrated that perhaps there are some repercussions to this. In this particular study, what they did is they had people do a multitasking assessment. So they were rated on the degree that they multitasked in their daily lives on this instrument. And they were put into different categories of low, moderate, to very high multitaskers. And then they simply did volumetric brain measurements. And what they found was a positive, a correlation, a negative correlation. The higher you ranked on the assessment of multitasking, the less tissue they found, particularly in a structure called the anterior cingulate gyrus, which is important for social modulation, reading emotions, and parts of the prefrontal cortex. They actually saw less volume. Now we can't conclude that this is causal, because it's just a correlational study. But there is at least an association that we see that people that multitask more do seem to have less tissue in the front parts of their brains. Other studies have shown similar effects in not just multitasking, but gamers. One study looked at different gamers and found that they actually have a thinner prefrontal cortex as well. And also people that meet the criteria for internet addiction disorder have also shown cortical thinning. Again, it's not, nothing's conclusive, but they seem to be pointing in the same direction, suggesting that perhaps these intense digital multitasking bouts may be having a negative impact on our brain anatomy. Now, this is conjecture at this point, but I'm sharing what may be an explanation for this. Now, one of the things we've discovered is when you multitask, you actually activate your sympathetic nervous system, which is your fight or flight response. So as you may know, that when that system gets activated, stress hormones get released, adrenaline being the first one. And this might explain why you, when you first grab your phone or start to multitask, you might get that buzz. That's the adrenaline flow of when you first go grab your device or first go online. So that might explain the intense enjoyment in the initial phases. And then a second hormone gets released, which is cortisol. Now, cortisol has been linked to loss of volume and other disorders such as depression. And one of the things they've discovered is when cortisol gets secreted, it actually erodes different parts of the brain, particularly the hippocampus, which is important for learning and memory, and also the prefrontal region. So it might be, because we know that digital multitasking, we see stress levels go up, they actually skyrocket. So that may be one possible explanation that may account for the loss of volume that we're seeing. But there's no conclusive link at this point. It's just speculative at this point. Now, realize that we weren't designed to multitask. When we evolved, we, you know, for the most existence, humans lived in an environment that was pretty constant. The only time we would have to multitask was often when there was a threat. So let's say you've discovered some delicious berries, you're eating your berries, and then you hear a rustling in the corner in the bush. So you have to divide your attention because you're hungry, you need to eat, but you may be eaten. So you can see that when we did have to multitask, it was usually a stressful event. So it seems that when we divide our attention, that is already hardwired into our brains to evoke that stress response. So every time you pick up your phone and look at it, your adrenaline levels go up. And depending how long you're on it, your cortisol levels start to go up. Right? 30 days of continuous cortisol levels has been shown to lead to atrophy if you don't break that cycle. Now, I think there's a link to your profession. Particularly, we know that other professions that have high multitasking, we know that they're susceptible to a lot of stress, stress disorders. For example, air traffic controllers. That's one of the highest multitasking jobs. In fact, you may know that air traffic controllers, every day they work, they get about three or four days off before they're allowed to come back to work. And also, every hour and a half an air traffic controller works, he has to take 15 to 30 minute breaks. Because they realize that the constant multitasking creates a lot of stress and psychological duress onto the people. So the industry has built in safety measures. But I don't think I don't see that happening with physicians. But I'll offer that the nature of much of your work, not all professions, but much of it is due to your environment demands for you to divide your attention. So you're in a multitasking profession, I'll offer. Now, where I believe what's happened is we take that the demands of your job. Now we've layered on top screens, phones, emails. And I think that combination is put a lot of stress and duress on your profession. And for evidence, I'll offer this is the burnout rates. This is published by Medscape every year, it's gone up 20% of the last two years, the burnout rates for physicians. So right now, on average, 42% of all physicians, on average, are exhibiting at least one major symptom of burnout. Now, it's higher for females. It's about 48% for females and 38% for males. So females are even more susceptible, often because if they have families, they have the additional burden of taking care of domestic life. And if you're over 45, it's around 50%. So the older you get, the rates go much, much higher. Now, I don't know if you can see your particular profession here, but see if I can see it. Where are you? Urology, so 44%, so you're above the average. So you're slightly above. Now, interesting, when they look at the cause of this, at least the self-reported cause, the most common response is, I'm trying to do too many things at once. Looking at screens, particularly electronic medical records. In fact, I've been working with a group up in Vancouver, in British Columbia, where I'm from in British Columbia, and they've noticed when they've introduced electronic medical record systems, they've seen burnout rates increase by 30% in their staff. Now, there's now studies emerging that are looking specifically at physician multitasking. In this particular study, this was done with internalists and emergency docs in a hospital setting. They looked at several hundred physicians, and what they did is actually followed them around minute by minute and wanted to gauge what percentage of time they were actually in doing things simultaneously. It was about 21% of the time. Interestingly enough, they were doing stress measurements, so that we can measure cortisol very easily with your saliva, and verified that when they were in multitasking situations, that stress levels, cortisol levels, went up. What's really interesting is, when they checked in with the physicians and said, do you think you were more stressed when you were doing that? They underestimated by 50% the actual impact the multitasking was having on them. So they're underestimating by half the impact. So remember I said, the more you multitask, the more dissociated you get? 50% is high, suggesting that that's indication of high multitasking and losing the awareness of the impact that the multitasking is having. You might have heard the parable, I don't know if this is true or not, but they say if you take a frog and you throw it in a vat of boiling water, it'll immediately leap out. But if you take a frog and put it in a pot of cold water, and slowly turn up the temperature until it boils, the frog will actually boil to death. It won't jump out. Because it's a progressive incremental change. And I suspect that's what's been happening with distraction. It's incrementally increasing. That we're almost not noticing that the impact it's having on us cognitively. Interestingly, one of the biggest multitasking things that we do in the workplace is checking email. I know at least the statistics in Canada, the average Canadian checks 150 times a day. It's almost every six to seven minutes. In a moment, I'm going to tell you what is considered safe. And that you'll see it's way beyond what they consider a safe amount of checking. Now they notice multiple studies that have shown that when you check emails, stress levels go up. The amount you check your emails is correlated with the degree of stress or burnout that you exhibit. It's also negatively correlated with your productivity, your sense of wellbeing, and even your overall engagement. And so, I saw a study where physicians on average are checking about 25% of their day is spent checking emails. I'm privy to some research that's going on right now in Eastern Canada, in Ontario, where they're measuring eMERGE docs because they've noticed the productivity of their physicians have dropped tremendously. And in this particular study, again, they have people with little clipboards that follow the physician for an entire shift, marking every minute what they're doing. And then what they do is they check in with the physician after the end of the shift and say, okay, in a typical hour, how many minutes do you think you were in front of a patient? The average response is about 30 minutes. In reality, it was about 12 minutes per hour. Then they asked them, how many minutes in a typical hour do you think you were in front of a screen? And the responses range from never to very low, and the average was 27 minutes. And more interestingly, when they asked, how many patients do you think you saw in your entire shift, the average response was 18, but the average amount of patients seen was seven. Again, suggesting this big disconnect that's happening, that we're not aware, perhaps, of the impact the distraction's having on us, the degree by which it's impairing us. And you may be aware that in 2014, the DSM-5, which is the manual that psychiatrists and psychologists use to diagnose mental health disorders, they introduced this idea of internet addiction disorder as being a real disorder. Subsequent studies have shown, in terms of brain chemistry, dopamine release in the ventral tegmental area, which is associated, so they show the same brain chemistry response as any addict. So for example, when your email sound or your notification sound goes ding, we can see dopamine being squirted in your brain, just like an addict, when they see a beer, they go, dopamine gets squirted. So it shows all the similar brain chemistry that we see in any other addiction. So here's the criteria, showing a preoccupation of being online, showing tolerance, and this is a really important aspect, because you might notice that the aggressiveness of ads is increasing, and the reason is because our tolerance is increasing as well. You know, just a few months ago, I was on a flight and I decided to watch a movie to unwind, and I was watching Lego Ninja, and after about a minute, I was having a seizure, because the frames were changing so quickly. I couldn't, I had to turn it off. I was too overwhelming, too overstimulating. And I realized, for young people, that's probably just the right amount, maybe teetering on boring. And now think about it, like, if we went back in the 1950s, take a young person, make them watch a movie from the 50s. You know, the camera would stay 10 minutes, never move, in one spot, where the two actors may be debating what kind of tea to drink. But people back in the 50s in the theater were riveted by this, they were eating their popcorn, couldn't believe how exciting this was, because our threshold was much lower. Today, that's the most excruciating, boring thing you could make someone do, is watch a movie that doesn't change, right? So just to show you how, every year, they're estimating it's about a 20, 28% increase in terms of what grabbed our attention last year. They have to increase by 28% to get at the same level. So we're definitely showing tolerance. A lack of control, the inability to stop when we say we shouldn't. I'm only going to be on for a few minutes, a few hours go by. Showing withdrawal symptoms. I sometimes, when I give these talks, I ask people to put their phones to the corner of the room and I can hear the anxiety, or I get other people to fondle other people's phones just to see the reaction. Sometimes people get a little, because we're psychologically very attached to them. We stay online longer. It may impact our work, our relationships. We may conceal it. You're under the covers at night, still on your phone, hoping your spouse doesn't see you. Or we use this form of escape to unwind, and I'll offer it's the opposite. It doesn't help us unwind. So you have to understand there's two facets to it, any addiction. There's what we call the wanting, which is the craving, and the liking, or the pleasure. Now, the first time you got your phone, I'll offer that the pleasure was the best in the first time. It's true what they say. The first time is the best time. But your desire or craving for it was the lowest. But over time, craving increases. But what's interesting is your enjoyment actually decreases over time. So now when we're using the phones, people aren't happy. I spend a lot of time in airports. Everyone's on their phone, and no one's smiling. No one's, I feel like I'm in a bar and people are intensely drinking. I'm just getting it down. You can see the pleasure's gone, but just to feel somewhat normal, we have to grab it constantly. In fact, one of the symptoms of the craving is boredom, a lack of stimulation. That life is not stimulating enough, and that's why we're constantly getting it. We're standing in line in the coffee shop and waiting, and we don't want to wait, so we decide to pull out our phones. I do a lot of cycling, and I can tell you every time I'm on a trail around my house, which is beautiful, we have old-growth rainforest, I see people, I'll always pass someone now cycling with the phone in front of them, because this is not stimulating enough anymore. We need, it's the craving that's driving it. So I want to offer a fable, if you like. This comes from Italy, and this is a story about an Italian farmer who had this incredibly hard-working donkey. This donkey was amazing. It could carry twice its own weight. In fact, it was so amazing that people would come from Italy just to see this donkey in operation. It was so amazing. One day, the neighbor of the farmer, who had this awesome donkey, said, wow, you're so lucky to have this great donkey. And the farmer goes, well, yes, he works hard, but he eats a lot of food. So the neighbor suggests, well, why don't you cut his feet in half? He goes, ah, that's a good idea. I could save some money. So he decides to cut the feet in half. What do you think happens to the donkey? Nothing. The donkey still works at the same degree. The farmer is ecstatic. He's, not only does he has the best donkey in all of Italy, he's saving money now because he's feeding only half the amount of food. So he decides, ah, maybe I can save a little bit more money and cuts the feet half again. What do you think now happens to the donkey? The donkey keels over in the field and dies. Just like that. And this is, I think, a good metaphor for what we're doing to our prefrontal cortices. We can get away with it for a while. We can bombard it. We can over hyper-stimulate it. But there's a point where I'm seeing donkeys tip over in your field. We're approaching 50% burnout rate in your profession. 20% increase in the last two years. I think donkeys are starting to fall over because we can't get away. We're smart people. So it's not like a massive impairment, but it's a slow degradation that suddenly drops off. So what I'm going to invite you to think about is your, you know, your prefrontal cortex is the holy grail of your brain. It's the most recently evolved part of the human brain. And it's the thing that we associate with being human. Our empathy, our compassion, our ability to anticipate, to think long-term, to make good choices, to be ethical. This is all housed in the prefrontal cortex. And what we do is realize that, I said, this is one of the most energy intensive uses when you have goal-directed behavior. So every time you make a choice, you're actually depleting your charge, if you like, on your prefrontal cortex. You only have a finite charge. And it turns out that we know when we plot people that you make your best choices in the beginning of your day and as your day progresses, as your charge goes down, you actually, for the same amount of work, you're actually getting less, you're getting less done. And you're more likely to fall and be impulsive, more likely to stay online longer as the day progresses, because the structure that helps you initiate discipline is the structure that's directly being compromised, I'd offer, when we're on our screens and when we're multitasking. So this idea of spend your resources wisely. So here's what I'm going to say. When you're waiting at Starbucks for your latte and you have this compulsive urge to check your phone, you think you're being efficient. I'm just going to check a couple of emails so I can stay on top of it. I'm going to offer the cost and the benefit ratio doesn't make sense because you're depleting it and the benefit doesn't really make sense. And what they show in the literature is it's high frequency checking in small bursts tend to deplete it more. You're actually better off just to spend a half an hour checking email in one block than trying to spread it out throughout your day. It's actually more taxing. Steve Jobs, who invented the iPhone, he was being interviewed once in his house and he was giving the interviewer a tour of his house and he opened up his closet and the interviewer saw like 20 black identical turtlenecks, 20 identical pairs of blue jeans. If you've ever seen Steve Jobs, you'll notice he's always wears that same clothing. So the interviewer goes, I have to ask you why on earth do you have this same outfit? And his response was, well, I don't want to waste any of my cognitive energy on choosing an outfit every morning because he's sensitive to the impact that's having on his ability to think later on in the day. In fact, Steve Jobs structured his day to produce unnecessary choice points so he could keep his reserves higher so he could spend it on the things that were most important and I think most of us are squandering it, particularly if we're on social media, which the cost-benefit ratio I'd offer maybe doesn't make sense. So what can we do about this? I'm going to offer you two things that we can do. I think we need to do both, the two-pronged approach. We need to contain and sustain. So containment really deals with the exposure. So treating our screens like radioactive material, you want to minimize your sort of interaction with it if you can. So the only thing that's shown to work, and this is 10 years, and the IT industry, by the way, has identified distraction 10 years ago as the biggest barrier because they started to notice their performance of their workforce declining rapidly and identified it was the fact they were in front of screens all day and it was impacting their ability to think and focus deeply. So they've started this 10 years ago researching this and the only thing they found so far that works is creating boundaries and intentional boundaries around how you will use your devices, when to check, when not to check. And what the literature shows is if you check more than four times a day your email, you're more likely to move into addictive patterns. Remember I said, at least in Canada, we're checking 150 times a day, so we've far exceeded what we'd call safe levels of checking. I actually adhere to this in the sense that I block periods of time in my day to check my email and then I have 30 minutes and I shut it down. So I have about three or four periods where I check email then I don't check it throughout the day. In fact, they've shown if you keep your email on, on your desktop, even if you're not checking, that will also reduce your cognitive, your IQ scores to 10 to 15 IQ points just knowing it's on because a part of your brain's monitoring. In fact, the more applications you have on your desktop, the more the decrease in any measure of IQ. The second thing is reduce multitasking where you can. In fact, there's a whole new craze going on called monotasking, which is this idea of we do one thing, complete it, finish it, then move on to the next thing. Remember, I said about a 40% loss of efficiency when you try to toggle. What I'm noticing now in the profession, particularly with docs, is I'm hearing more and more docs telling me they're bringing their charts home at night and working on weekends to make up for lost time. And I don't think it's just because your workload's increased. I think you're actually getting less done than you used to because of the digital multitasking is spreading you so thin. So if you can reduce it, reduce it and try to where you can. You can't, I realize, reduce it all. But one of the places we can is how we choose to use our devices. And the other thing is taking sufficient breaks. Again, I said air traffic controllers, they're mandated by law to take 15 to 30 minutes off every hour and a half that they work. I know your profession. I know how you guys work. And I know there's a badge of honor to push through to talk about how many hours you went without sleep. And I'll offer that that's maybe not good, particularly now in this day and age for your profession, that you may be increasing your risk of in terms of developing stress disorders. So the literature has shown that taking 13 minutes off of every hour, if we plot you through an eight-hour day, that your productivity stays more or less constant. If you minimize your breaks, you usually have a down curve as you progress through the day in terms of how much you actually get done. Again, as I said, depleting those reserves. So taking time, regular breaks. So just like high-frequency bursts of checking your phone seem to be very profound in terms of the impact, the opposite is true as well. Taking small breaks, high bursts, high frequency, short, seems to be very protective. And the other thing right now they're saying is you should go four hours in your waking, waking day without checking, looking at any screen whatsoever. So for most of us, that's gonna be impossible at work, but often it's in our leisure time. In fact, we are spending about a third of our leisure time now in front of screens than we did more than 10 years ago. So it seems like it's a double hit. We're having this profound sort of stimulation happening and we're taking away our recovery time. Things that I used to call evenings and weekends seem to be disappearing. Now, sustainment talks about how can we offset? So like planting a tree to offset the carbon in the air. So as I said, taking regular time off is very important. And I think for your profession, that's incredibly important that maybe we should be regulating you like air traffic controllers, that you should be forced to take time off. And the other thing, like we've shown in addiction theory, substituting something better. So when we grab our phones, when we have that craving, it's a craving to get pleasure. Now, often your brain is a lot like your stomach. So it turns out your stomach, when you're hungry, it doesn't care what you put in it in the moment because it just wants to be stretched and it feels satisfied in that moment. Now, you could put junk food in there, you could put candy, chips, or you could put something nutritious. In the moment, your stomach doesn't care, but you know that as time goes on, that if you eat junk food, you start to feel not so good, your energy goes down, you might gain weight. It turns out your brain is the same way with regards to stimulation. Mother nature didn't anticipate humans having excess stimulation. In fact, our brains are primed to look for stimulation because we existed, most of our existence, in very stable environments where things didn't change. So paying attention to stimulation gave us an advantage for finding food and protecting ourselves. It seems that our brain doesn't discriminate well the quality, it just wants to be stimulated. So it's happy when you pull out that phone, it's like candy going, yes, it feels good. But you might notice, after a few minutes, that you're thinking, your clarity might go down. In fact, they show that, when there's studies with social media, they find that when you first go on, your mood goes up for about the first five minutes, and then after five minutes, we see a steep decline. And the longer you stay, actually, the more your mood drops. And the last thing I want to talk about is mindful meditation. So I just want to talk about some research that's recently emerged out of Australia and New Zealand. They've been studying the general workforce. They've looked at almost 8,000 people, studied them over a decade, and wanted to see what's the optimal amount of hours to work in a week to get the best performance. And what they find is, when you hit 40 or higher, a 25-hour workweek seems to be optimal in terms of the time you invest, in terms of your productivity. If you work up to 35 hours, there's a steady decline. So the time you put in, you actually get less for it. And what they've shown is, if you just worked a three-day workweek, compared to most people's five-day workweek, you're as productive as a person that works five days currently right now. And there's some studies that had companies who tested this out and found that, when people know they only have a three-day workweek, they actually focus more and they don't waste time. So they actually are productive and engagement goes up. They know stress levels go down in a three-day workweek, not the opposite, as you might predict. And if you exceed 40 hours a week, if you're over 40, you almost double your risk for heart disease, cancer, almost any ailment you can think of, almost doubles if you exceed 40 hours. Okay. Do you want me to stop? I just wanted to briefly talk about mindfulness. And this is something I think might be helpful. And so I want to define mindfulness as simply the process of paying attention on purpose. So unlike when we're distracted, what's drawing our attention is something external to us. It's being pulled like an addiction. That's why we're developing threshold because we depend on out there to sustain our attention. Mindfulness is the practice of building the internal focus muscle. You're choosing to focus, even if it's boring. So it's a process of being in the moment because when you're focused, you're actually in the moment. I just want to show that in the last four years, this is a peer-reviewed academic papers. I've looked at the efficacy of mindfulness. In the last four years, we know more about the efficacy than in the last four decades. So there's a wealth of good quality research papers. And basically the three things that we see, if we were sort of look at, and this is based on over 2000 controlled clinical studies, we see stress and anxiety levels go down, which is the opposite of when we're digitally distracted. We see more stable emotions and more positive emotions being experienced. And we see heightened cognitive abilities. We actually can see your IQ goes up when you meditate regularly. So you'll see that this is the complete opposite I would offer of what we're seeing when we're constantly being digitally distracted on our devices. And there's just literature that has shown the same effect with physicians, if you're interested. Ron Epstein's written a great book, came out about a year and a half ago, called Attending. He actually shares, he's a physician and he's done mindfulness-based studies looking on the impact on physician, in particular on empathy and compassion and stress and burnout, if you're interested. He's an author in one of these studies. And here's what's intriguing. Several studies have shown an increase in the volume in the exact same places that we see decrease the volume in people that multitask, in people that are gamers, in people that show, meet the criteria in internet addiction disorder. No one's yet shown if we can reverse it, but I'm hopeful perhaps that maybe a study will come out that will show that effect, that maybe we can replenish what we lose perhaps. So if I were to bet on a horse, I'm putting my money on mindfulness maybe being the best horse to help us offset some of these. So I'll leave you with a quote from Einstein. He said this in the 50s, which I think is quite revealing. He says, I fear the day technology will surpass our human interaction and the world will have a generation of idiots. And I think that's quite frightening how he sort of anticipated where the trend was going even 60, 70 years ago. So I'm open to any questions or points of discussion. Thank you. Thank you.

multitasking

distractions

productivity

well-being

mental health issues

digital multitasking

stress levels

mindful meditation

cognitive abilities