Is your Practice Busy or Hectic?

This time of year the reply I often get from colleagues when I ask how their business is going is “Busy!”  This is often said with shortness of breath, decreased blinking, and other physiological signs of anxiety.  At the college I teach at, I often see my fellow faculty members commiserating with each other about how busy they are there.  I think lots of us are busy, but I think it is time to re-evaluate if we are really busy, or hectic.

The way I differentiate between busy and hectic is simple: ROI and organization.  When I am busy, I have most of my clinical hours filled, am up to date on my billing, know which week I am teaching on the syllabus, and returning phone calls or emails within 24 hours.  I am also eating and sleeping well.  That’s “busy.”  When I am “hectic” I am thinking “oh my god I have too many patients to see;” forget to do my billing (or avoid it;) unfocussed when I get ready to teach; and start “saving” (read sitting on/avoiding) voicemails and emails.  I also feel more of a pull to commiserate, to tell people how “busy” I am.  For me, talking about how busy I am when I could be doing something more productive is usually a sign that I am hectic, not busy.

Once you have started to feel more stress in your practice, pause immediately and ask yourself if this is a prod from your psyche to take care of yourself.  Have you done that?  Good, if the answer is you haven’t, and that you don’t have time to because you are too busy, you’re being hectic.

Now knock it off.

Really, I am suggesting it is that simple.  Other than an opportunity to review for self-care there is NO ROI on being hectic.  You won’t get more patients, you’ll get less. You won’t have more time by worrying or commiserating, you’ll have less.  You may derive a sense of self-importance from how crazy things are, but you aren’t really impressing anyone, including if you are honest, yourself.  So put down the cross, we need the wood.

Here’s a suggested checklist if you are still unsure whether you are being “busy” or “hectic:”

  • I miss appointments or double-book
  • I haven’t eaten today
  • I am avoiding the phone and email
  • I have complained to 2 or more people that I am busy
  • I feel like I am working too much, and making less than I usually do
  • I am behind on billing patients
  • I have open times for patients but can’t find the time to schedule intakes
  • I hate my office
  • I’m feeling cranky and dissatisfied with my clinical work
  • I can’t remember the last time I had a non-therapy conversation with a friend, or if I can it was over 24 hours ago
  • I feel a sense of dread when I think about work

You may notice that some of these can also be signs of burnout:  This is not a coincidence.  I firmly believe that if you don’t learn to distinguish between being hectic and busy, your business will fail.  It will fail because you burn out, and or because you sabotage your income streams to the point where you have to close up shop and go work for someone else.  And if you do that, you can guarantee they’ll help you learn the difference between busy and hectic the hard way.

So this weekend, take 15 minutes to sit and reflect, is my practice busy or just hectic?  And if you don’t think you have 15 minutes to do that this weekend, you already have your answer.  🙂


  1. Wow — this article is SO true. For me, the distinction between “busy” and “hectic” is really the distinction between healthy and unhealthy. Charity begins at home, and self-care. You have to “put your mask on first, then help others” as the airlines say. Excellent article we all need to hear.

  2. Hi Mike,
    I think this is a great article, clear and constructive. Copies will be printed out and shared with my colleagues in our private practice! Especially at this time of year when most of us are pulled in different directions/considering doing things in a better way/goals/resolutions, etc. Great content.
    It is quite rare for me to comment on a blog-but, I have great respect for your example of taking action, being productive in creative ways instead of the ordinary, and flexing with this era instead of “doing things the way they have always been done.”


  1. […] rushing around and ask yourself what are you worrying about?  Are you legitimately busy or being hectic?  Remind yourself that in this present moment, the people, places or things you may be avoiding […]

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