Friction Management in Modern Medicine

The strategic art of dialing friction up and down to protect your sanity

Friction Management?

Friction management is the work of boundaries, and it might just be your secret weapon against overwhelm. In this episode, we dive deep into how technology has reduced friction in ways that are actually making your life harder, and what you can do about it.

The Problem: When "Convenience" Creates Chaos

Epic Chat, Teams, and other instant messaging systems were designed to make communication easier. But here's what actually happened: they removed the friction involved with interrupting you, creating a constant stream of non-urgent interruptions while you're trying to provide patient care.

Picture this: You're in the exam room with a patient, fully focused on their care, when ping "Mrs. Jones checked in 17 minutes late for her 20-minute appointment. I know the cutoff is 15 minutes, but should we see her anyway?"

Now you're the bad guy. The front desk person avoided their discomfort with enforcing policy, Mrs. Jones gets to bypass the boundary, and you're left making split-second decisions while trying to care for the patient in front of you.

This is friction management gone wrong.

Where You Need to DIAL UP the Friction

1. Non-Urgent Staff Communications

Stop answering every ping immediately. Create friction by:

• Simply not responding to non-medical, non-urgent messages
• Using auto-responses: "I am currently seeing a patient and cannot answer non-urgent questions. If this is a medical emergency, contact [appropriate person]."
• Making staff think twice before interrupting you

2. Patient Portal Messages

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

You are not resourced to spend 5-10 minutes crafting thoughtful responses to detailed medical questions outside of visits. This isn't about not caring—it's about sustainable practice.

3. Difficult Patients Who Constantly Disagree

You're allowed to set boundaries with patients who:

• Never agree with your medical advice
• Can't communicate effectively with you
• Continue returning despite constant disagreement

Let them know they're welcome to seek other opinions or see different providers. You don't have to be everyone's doctor.

4. Non-Medical Tasks That Don't Light You Up

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

Make it more expensive (in time/resources) for them to voluntell you.

Where You Need to DIAL DOWN the Friction

1. Getting Your Notes Done

• Use AI scribes or human scribes
• Create dot phrases and templates for common documentation
• Write less, u