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How I Manage My Time - The Triage System

2025-02-18 · Long video (solo, talking head or whiteboard) · Ali · recording, 22:49 · watch on YouTube

Topic: Productivity and time · mode: Explanation and tutorial · tags: His medical past, His own products discussed, Family, Lesson from a book, Sponsor segment present

Ali sets out the triage system, six time-management components he learned in eight years of medicine: the daily reset, the handwritten box method, real-time triage, the ward round protocol, intentional incompletion and the two-for-one hour rule, all built on accepting that the to-do list is infinitely long.

What is said

The parts of the video and what is said in each (★ — how much it matters to the video).

00:00:00 — Introduction: a time-management method from eight years of medicine

  • ★★ Ali learned his triage system of time management during eight years of medicine, as a medical student and a doctor, and uses it today to run multiple businesses and write books. — 00:00:00

00:00:23 — The triage system: the to-do list is infinite, so work in order of priority

  • ★★★ The key principle Ali took from working as a hospital doctor: the order in which you do things matters more than how many things you get done. — 00:00:23

    “the order in which you do things matters more than how many things you got done”

  • ★ In an emergency room patients are not seen first come, first served: the medical team triages them by who needs attention most urgently, so a heart attack is seen before a sprained ankle. — 00:00:23

  • ★★★ The fundamental time-management mistake, Ali says, is trying to do everything: the to-do list is infinitely long and cannot be finished, so all you can do is triage, as emergency doctors do every day. — 00:01:22
  • ★★ On his first hospital placements as a medical student, Ali noticed that every doctor kept the day's to-do list on a folded piece of paper in their pocket, shredded it at the end of the day for patient confidentiality and started afresh on blank A4 the next day. — 00:01:51

00:02:09 — The daily reset: doctors' fresh paper to-do list and the morning manifesto

  • ★★ Asked by Ali why doctors used paper rather than an electronic system, a doctor told him the messiness of the list was the point: every crossing out and every new line is a conscious choice about whether a task is important enough for today. — 00:03:07
  • ★★★ Ali's daily reset: keep a master to-do list or task manager so you do not forget things, but every day ask yourself afresh what the most important things to do today are. — 00:03:37
  • ★★ Ali does his daily reset with the morning manifesto, a three-to-five-minute journaling prompt in his LifeOS Google Doc that he tries to do every morning, with three parts: prime, remind and plan. — 00:03:37 · Google Docs
  • ★★★ In the plan part of his morning manifesto Ali asks what today's adventure, the single most important task, is going to be and whether it is in the calendar. — 00:04:06 · daily adventure
  • ★★ Besides the day's main task, Ali picks one to three other tasks to complete if there is time, writes them by hand on a fresh sheet of his journal and limits himself to three. — 00:04:35

00:05:20 — Sponsor read for BetterHelp

00:06:26 — The box method: marking a task's status instead of ticking it

  • ★ Three of Ali's to-dos for the day: book a Valentine's Day dinner for him and his wife, film this time-management video and apply for his Hong Kong ID. — 00:06:26 · Izzy Sealey, Hong Kong
  • ★★★ Ali still uses the handwritten box method most doctors he met used: draw a box for each to-do and, instead of ticking it, mark different levels on the box according to the task's status. — 00:06:26
  • ★★ With the box method, a doctor half shades a blood test's box once the sample is sent to the lab, then fills it in and crosses it out once the result is back, checked and acted on. — 00:07:25
  • ★★ For filming this video, Ali draws the box method's diagonal line once filming is done and half shades the box once the footage is on his computer and uploading to Google Drive. — 00:07:25 · Google Drive
  • ★★ Ali finds the box method satisfying: you see a task's status at a glance and get a little dopamine hit from moving it forward before it is complete. — 00:08:23
  • ★ As a doctor Ali had dozens of tasks on his to-do list at a time. — 00:08:23

00:08:52 — Real-time triage: re-prioritising all day, urgent versus important

  • ★★★ Ali's real-time triage: in every moment re-prioritise the to-do list, since the order in which tasks were written down is probably not the order they should be done in. (hedged) — 00:09:25
  • ★★ When inbound arrives during the day, such as Slack messages, emails or a call from the boss, Ali says the to-do list made in the morning may go out of the window, and that is fine as long as you focus on the next most important thing. — 00:09:54 · Slack
  • ★★★ In Ali's life the truly important is rarely urgent and the truly urgent rarely particularly important, unlike medicine, where life and death are often at stake. — 00:10:53
  • ★★★ One of the biggest needle movers for Ali's productivity is recognising when he can ignore something urgent but not important for something important but not urgent, which requires being okay with things dropping. — 00:10:53
  • ★★★ Ali loves Oliver Burkeman's point in Four Thousand Weeks and Meditations for Mortals, which he calls really good books: if you cannot do everything on the list, you cannot have it all, and must let some things go. — 00:11:20
  • ★★ Ali says there are seasons of life when work takes a back seat: he is about to become a parent and wants to be present with the family. — 00:11:49
  • ★★ Trying to take everything off the to-do list and do all of the things is, Ali says, the true recipe for overwhelm, anxiety and stress. — 00:11:49
  • ★★★ Doing only one or two things a day, if they are the most important ones, would bring enormous progress in a year, Ali says, unlike ticking off many tasks and ending the day with movement but little progress. — 00:12:19

00:13:15 — The ward round protocol: a status and a next action for every project

  • ★★ On a hospital ward round, doctors see each patient, check the notes, vital signs and blood results, and decide the next action step that moves the patient towards getting better and out of hospital. — 00:13:15
  • ★★ Ali's primary quarterly quest for life is setting up martial arts, and for work making LifeOS, his productivity course. — 00:13:44
  • ★★ Ali keeps track of his work and life projects in the to-do list manager Things 3, but says you can use whatever app you want. — 00:13:44 · Things 3
  • ★★★ Ali marks each project with a colour status: green for on track, yellow for off track with a plan, red for off track without a plan, and sometimes blue for on ice. — 00:13:44
  • ★★ Ali recommends one primary quest each quarter, the one most important thing to move forward in work and in life, and a status for every other project. — 00:14:13
  • ★★★ In his weekly review Ali checks that his quests and projects are in priority order and that every project has a clear next action and an up-to-date status. — 00:14:42 · weekly review
  • ★★ In that morning's weekly review Ali moved his baby supplies project above his "Operation don't die" project, as he needs to pick up items at a local department store for the baby due in a few months. — 00:15:10 · weekly review

  • ★★★ On ward rounds "continue" is not allowed as a patient's plan, since every day there must be one action that moves the patient on; likewise, Ali says, every project needs a next action. — 00:15:39

    “Continue is not a plan”

  • ★★ Ali says "waiting for" is a fine next action, as in medicine, where doctors write down that they are waiting for physiotherapy input or a nursing home's reply. — 00:16:09

  • ★★ Ali is relocating his business to Hong Kong and is waiting for his accounting firm, TSJ (as heard), to come back with a plan. — 00:16:09 · Hong Kong
  • ★★ For setting up martial arts, Ali has booked his next few sessions of Muay Thai. — 00:16:38
  • ★★★ Almost no one Ali advises has a status and a clear next action for each project; colour-code each project's status like a traffic light and, as David Allen says in Getting Things Done, give each a next action, and you will manage your time better than most people. — 00:17:07

00:17:37 — Intentional incompletion: the lunch break in his first week in the emergency department

  • ★★ In his first week in the emergency department as a junior doctor, wanting to save the day, Ali took about an hour over his first patient and then found the waiting room teeming with patients. — 00:17:37
  • ★★★ When Ali planned to skip lunch to get through the patients, the on-call consultant told him the waiting room will always be full and it matters more for the doctor to be rested than to burn out skipping lunch. — 00:18:37
  • ★★★ Ali's intentional incompletion, the skill he says doctors learn: it is part of your job to take a break and to go home in the evening even though there is still stuff to do. — 00:19:07
  • ★★ Ali says his wife, also a creative entrepreneur, really struggles to stop work at 8 p.m. when there is still stuff on her to-do list. — 00:19:07 · Izzy Sealey
  • ★★ Staying two or three hours late for an emergency happens now and then, Ali says, but if it happens all the time it is a recipe for burnout in any profession. — 00:20:12 · burnout

00:20:29 — The two-for-one hour rule: an hour before nine is worth two after five; sign-off

  • ★★★ Ali's two-for-one hour rule, from a medical school professor's newsletter: an hour before nine is worth two after five, so doing something before work gets twice the output of doing it after work. — 00:20:29

    “an hour before nine is worth two after five”

  • ★★ Even with energising work, Ali admits it is really hard to get home from a demanding job with energy left; many in his YouTuber Academy want a side hustle but are too tired after work. — 00:20:58 · Part-Time YouTuber Academy

  • ★★★ If something is truly important to you and needs creative energy, Ali says it is far more effective to do it before work than after. — 00:21:27
  • ★★ As a doctor Ali got up early to film many of his YouTube videos before work, volunteered for later shifts, and his favourite shift was 4 p.m. to midnight. — 00:21:27
  • ★★ Working 4 p.m. to midnight left Ali 10 a.m. to 3 p.m. for his side hustles; he loved those shifts because he always had more energy before work than after. — 00:21:57

Threads in this video

Where the stories that moved here went next

Mentioned

Central: box method · intentional incompletion · triage system · two-for-one hour rule · ward round protocol

Also: People: Ali Abdaal's daughter · David Allen · Izzy Sealey · Oliver Burkeman

Projects: Creator Club · Life Operating System · Part-Time YouTuber Academy

Works: Feel-Good Productivity (book) · Four Thousand Weeks · Getting Things Done · Meditations for Mortals

Organizations: Netflix

Concepts: burnout · daily adventure · daily reset · Eisenhower matrix · Emergency medicine · morning manifesto · next action · quarterly quest · weekly review

Places: Hong Kong

Products: Google Docs · Google Drive · Slack · Things 3 · VoicePal

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