The 120% problem

Work expands to fill 120% of the available time.

That is my unscientific conclusion after 56 years at work, reinforced by a recent conversation with a practice manager.

She described a familiar situation. Events, marketing, meetings, fee reviews, compliance, patient complaints. Every time things began to settle, something else arrived.

The list kept growing. Her working day did not.

I recognised every word.

As my own role has shifted towards developing the business, the space created by reducing some activities has promptly filled with new responsibilities. I still reach the end of the week with an unfinished list.

There is always more.

Once we accept that, we can ask a more useful question: which things deserve the time we actually have?

Efficiency means doing things right. Effectiveness means doing the right things right. You can be brilliantly efficient and spend the entire day on tasks that contribute very little.

Effectiveness requires judgement. It also requires the ability to say "no".

For practice managers, that becomes particularly important when the owner arrives with another bright idea.

A useful response is: “I can do that, but it means delaying this. Which takes priority?”

That is a professional conversation about consequences. The owner needs to understand what their latest request will displace.

Owners, give your managers permission to have that conversation. Then listen when they do.

Managers, review your priorities each morning. Protect the work that matters most. When something urgent arrives, make a conscious decision about what moves, and explain why.

Before agreeing to another project, ask what it will cost in time, whose time it requires, and which existing commitment will have to wait. Make that choice visible to everyone involved.

The unfinished list will probably still be there tonight.

Your job is to make sure the important work has moved forward.