Doctors Don’t Need Yoga, They Need Time to Smoke

Walking through the expo floor at the HLTH USA conference in Las Vegas, I couldn’t help but feel like I was in some weird mix between a tech convention and a futuristic farmers’ market. Stalls displaying shiny new AI technologies that promised to revolutionize healthcare. In theory, at least. But somewhere between the AI-powered ambient scribes and smart scheduling systems, I started to wonder where we’re actually headed.

Maybe it’s just age, but I’ve been thinking a lot lately about the forces that shaped me into the doctor I am today. The old “pressure makes diamonds” saying gets thrown around a lot, but I’ve always found it a little pretentious. I’m no diamond, that’s for sure. I’m more like one of those rocks you trip over on the sidewalk — rough edges, generally unremarkable.

But could it be that the hardest times in life are what help shape us? I’ve spent an obscene amount of time writing or dictating patient notes, and often not in a timely fashion. But maybe, the hours alone reliving that patient visit in my head is what forced me to actually crystallize my thoughts about that patient.

There’s this growing concern about how technology is turning us into mindless drones, but honestly, I don’t think it’s the machines. It’s us. We’ve become mentally lazy. I mean, when was the last time someone really sat down and wrestled with a tough question? Even more, how often do you see people making time to just wonder? The kind of questions that keeps you up at night, staring at the ceiling, wondering?

These days, thinking feels like a lost art. Everyone’s too busy scrolling, clicking, and swiping their way through life. Smartphones, social media, endless notifications — it’s like we’ve created this giant vacuum of distraction. And don’t get me started on multitasking. It’s like we’ve collectively decided that doing one thing at a time is for suckers. And guess what, doctors are generally highly capable people in who adapt and persevere at probably higher rate than the average population. Give us less time, more clicks, more tasks, we push through all for our patients. But it sucks- we are taking on moral injury and our brains are quietly overheating.

It’s not just the distractions, though. There’s this cultural obsession with being “productive.” As if filling every second with something vaguely useful is the secret to happiness. But let’s be honest, it’s exhausting. We’ve traded contemplation for busyness, and somehow we’re surprised that everyone’s stressed and miserable. Who could have seen that coming?

I’m not going to sit here and blame technology. God knows, I’m all for anything that makes life easier.

In fact, AI in healthcare should be used for three things in healthcare: things I don’t want to do, things I can’t do well consistently, and things that I can’t do.

So clearly, I have zero qualms about letting a AI or a robot take over some of the more mind-numbing tasks in my day.

Then the real issue is how should we use the time that technology is supposed to free up?

Perhaps we should bring back smoking.

There was a time when doctors smoked. And no, I’m not advocating for a return to lung cancer. But those smoke breaks? They represented something valuable — time.

Time to pause, to think, wonder, and to chat with colleagues. Whether in a break room, outside the hospital, or crammed into a poorly ventilated lounge, those moments of informal connection were where the magic happened. People consolidated thoughts, swapped ideas, shared observations, learnings and occasionally stumbled on breakthroughs.

Fast forward to today, and those spaces have all but vanished.

Now, nurses spend more time with paperwork than with patients. And doctors? We’re drowning in a sea of administrative tasks, with little room for reflection or collaboration. We’ve gotten so caught up in making healthcare more “efficient” that we’ve accidentally squeezed out the humanity.

Let me hit you with some stats, because why not? Nurses now spend only 31% of their time with patients. The rest of their time is sucked up by coordination, paperwork, and, I assume, trying to find a functioning printer. This is insane. I remember having this ah ha moment as a surgeon- I asked myself why do my patients stay in the hospital after an operation? Its because they need nursing care- that’s it. Everything else can be done as an outpatient, so if the backbone of hospitals is nursing, why are we “managing nurses” as a cost center first of all and so poorly?

Meanwhile, inefficiencies in healthcare coordination cost the system over $12 billion a year. And while we’re busy trying to figure out how to leverage technology to fix the system, patients are delaying care, getting sicker, and, in some cases, dying.

Ok, back to smoking.

Those smoke breaks, which might have been terrible for our lungs but were oddly beneficial for our collective brains are long gone. What else is long gone are the spaces that once fostered those meaningful conversations. Hospital libraries? Gone or shoved into some digital corner. Surgeon lounges? A relic of the past.

Technology, as wonderful as it can be, isn’t going to fix this. Sure, we can automate tasks, streamline processes, and slap an AI on every problem we can think of. But none of that is going to restore the culture of reflection and connection we’ve lost. And without that, we’re just spinning our wheels — more efficient, sure, but also more robotic, less innovative, and, dare I say it, less human.

So, what’s the answer? Do we need more yoga in the break room? Maybe a weekly cookie celebration? No. What we need is real time to connect. Time to have actual conversations — conversations that aren’t squeezed in between tasks or interrupted by a pager. Time to think critically about the work we’re doing, to wrestle with tough questions, and to hash out ideas with colleagues. You know, the kind of stuff that leads to breakthroughs.

The good news is that there are signs of a shift in the right direction. More executives are waking up to the consequences of a decade’s worth of strategic decisions that has culminated into what we have today, and we’re beginning to see the creation of spaces for more meaningful discourse. In fact, I’m writing this mainly as a result of the thoughtful conversations have emerged at HLTH, thanks to the support of organizations like the AMA, who made a deliberate effort to bring physicians to the table. It’s a reminder that when healthcare professionals are invited into the conversation, real progress can happen.

Doctors and nurses don’t need to start smoking again. But they do need to reclaim what those smoke breaks represented: a chance to pause, reflect, wonder and engage with each other in a meaningful way. Without that, we risk losing something irreplaceable — the spontaneous, organic flow of ideas that has always driven innovation in medicine.

And if we lose that, well, we might as well hand the whole thing over to the robots and call it a day.

- Salim Afshar