How to Do It All


Six ways to work smarter, not harder.

By Sturdy McKee, PT, MPT

Time is the one thing of which we all have the same amount. How we manage our time is up to us.

Without the right tools, many physical therapists become distracted, and they do not accomplish half of that of which they are capable. The average United States worker states that 40 percent of their time is unproductive!

When talking to highly effective people about how they “do it all,” they often discuss a daily six-step praxis. Like me, they have full lives. I am a physical therapist, practice owner, entrepreneur, conference speaker, online advocate of physical therapy, husband, father of three, and community member.

The following six steps for working smarter, not harder, enable me to do it all. They only take about 15 minutes and, in my experience, save two to three hours at the end of the day. I do not know of any other tools that gives me that kind of return.

1. Know Your Big Picture Goals
What do you want to accomplish in the next three months or year? These “big picture” goals should drive your daily activities. Every three months, I sit down in a quiet place and review my long and short term goals. My short term goals must be milestones, which move me closer to my long term goals. I even have this time scheduled regularly on my calendar, so that I do not forget.

2. Brain Dump
Most mornings, I wake up to a brain pumping out a never-ending to do list. Where to start?

I start by sifting through the mental clutter. I write down everything that comes to mind, then I review that list for things I need to keep or discard. If one of the items on that list does not move me closer to my big picture goals, then I dump it. If it does move me towards my goals, but it does not need to be done now, I move to another list that I call the “lockbox,” which is a document where I write down important—but not critical—items.

3. Delegate, delegate, delegate
I then review the items that survive the brain dump and decide if I am the best person to execute them. I can choose to delegate a task or do it myself.

Most people think that if they do not have an assistant, they cannot delegate. I believe delegation only requires consent. Even if the person that I am asking is an employee who reports directly to me, I have to make sure that what I am asking them to do fits within their time constraints and capabilities, and that they are enthusiastic about helping me to complete it on time. Otherwise, I have set us both up for failure.

4. Uncover Your True to Do List for the Day
For the things that I do not delegate, I decide to either do that day or schedule for a later date. For example, if I need to send a group of emails that are not urgent, then I can block the time on my schedule later that day, or at some other appropriate time, to complete that task. I know people respond better to emails on Tuesday morning than on Monday. So, I schedule those to encourage the best response, rather than just having to hurry up and do them now.

After I schedule the “for later” list, I am left with a handful of things that need to get done today. It is a million times more manageable than what was in my head before the brain dump. I prioritize the items so that the most important, urgent or biggest impact items move to the top and get done first. Then I get to work on that list.

5. Deal with the Distractions
As I move through my “for today” list, I try to control any interruptions. I realize that things pop into our heads throughout the day. These interruptions create distractions and can use up some of our attention by trying to make sure we do not forget them.

I keep a “dream catcher,” which enables me to write down these random thoughts and ideas throughout the day so that I do not lose them. I keep this all in an electronic file so I can refer to it the following day when I am doing my brain dump. They then have an opportunity to be recycled.

6. Use Data to Tackle Your To Dos
I first learned about the importance of using data to make decisions from my grandfather. He was a retired United States Army Colonel who, when I was 10 years old, told me that if I did not learn anything else in life I had to learn how to make decisions. Unfortunately, he was not much more specific at that time.

I have since learned that data makes my decision-making better and more efficient. As a practice owner, I am most interested in data about how my clinics are doing. I do not try to collect, sort, and analyze it on my own. In the age of Medicare compliance and health reform, the data is simply too complex and vast. Personally, I use integrated revenue management cycle software made especially for physical therapists that puts the data at my fingertips.

An example of using data to make informed decisions is assessing insurance fee schedules. This topic seems to come up repeatedly. What is your cost per visit? What is your profit goal? The answer to these two questions makes it easy to look at a proffered fee schedule and decide right away whether to accept it at face value. If not, then you now know how to respond to the payer.

Using data also helps us in performance reviews, as every employee has their job accountabilities, core values, and key performance indicators mapped out. Thus, they know exactly how their review is going to go and can reach out if they need help.

By eliminating things that do not lead me toward my goals, delegating what I can, scheduling things to get them out of my brain, and tackling my to do’s with data has allowed me to work more efficiently than I ever have before.

It took me about three months to get into the habit of doing it regularly—that was 10 years ago. I use this process frequently, especially at times when there is getting to be too much to do. Much of it is now habit and is how I approach each and every day and project. It has become part of how I think.

Sturdy McKee, MPT, is the chief executive officer of San Francisco Sport and Spine Physical Therapy. He can be reached at


1. Survey Finds Workers Average only Three Productive Days a week. Website: Posted March 15, 2005. Accessed August 2014

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