You’ve been honing your patient-centered care skills, practicing active listening, and keeping interruptions to a minimum — a real feat given studies showing physicians often interrupt within the first 11 seconds of a consultation.

But today, you’re running behind in clinic, and the anxiety of a packed schedule is hijacking your focus. Like a quick social media swipe, you find yourself mentally moving on to the next patient before finishing with the current one — a habit known as “nexting.”

When you catch yourself in this state, owning the moment is key, said Mitch Abblett, PhD, a clinical psychologist in Wellesley, Massachusetts, and author of The Owner’s Manual to Thriving Relationships (Johns Hopkins University Press). Sometimes, that means stepping in intentionally.

Abblett advocates for what he calls “compassionate interrupting,” a technique he teaches his clients.

“We own a moment in a relationship when we really get with the fact that it is only the moment that we have,” Abblett said. “We are going to be most connected and creative if we can be only in that moment without fixating on time-based stuff, like the next thing in the future, or ruminating about the past.”

Crucially, there’s a difference between nexting because you’re rushed and letting your mind wander in response to something a patient says. Knowing the distinction can help you decide when to compassionately interrupt and when to lean into wandering thoughts, which new research suggests can boost creativity and happiness.

Nexting vs Mind Wandering

When you’re “nexting,” you’re effectively ruminating: your mind stays locked on the pressure of staying on schedule. Forthcoming research from Samuel Murray, PhD, an assistant professor of philosophy at Providence College, Providence, Rhode Island, who studies mind wandering, suggested that verbalizing a distraction — naming it out loud — can help halt rumination.

“Naming the stressor is very important for breaking out of those ruminative cycles and getting back into whatever you want to be focused on,” Murray said.

Similar to Abblett’s suggestion of acknowledging to a patient that your mind is jumping ahead, mindfully labeling your rumination is rooted in behavioral science showing the practice can reduce the tendency itself, as well as any distress when it does happen. 

Rumination and nexting shouldn’t be confused with mind wandering — which can actually work in your favor, Murray said.

While nexting feels like an urgent, stressful tug back to your schedule, mind wandering is more like open exploration. A patient mentions a detail, which triggers an association, which leads to another thought.

“Rumination does not have adaptive benefits like mind wandering,” Murray said. “When you get fixated, it’s emotionally taxing and stressful. But with mind wandering, there are real benefits to following those trails.”

How to Interrupt Compassionately

When you catch yourself thinking “I’m running behind” or feel the urge to interject, Abblett recommends acknowledging it directly to the patient.

You might say: “My mind is running ahead here. I don’t want to give you the impression that I’m not listening to what you’re feeling or experiencing right now.”

Then, invite the patient to steer things back: “Where are you at with what we’ve talked about so far?”

“That move does something in that moment with the patient,” Abblett said. “They feel like you are right there in the room with them, and you’re owning the fact that your mind kind of went away.”

It benefits the clinician, too. Shifting into self-awareness changes your brain state — moving you off the task-driven dopamine track and into a more social, serotonergic state of engagement. “Now, you’re upping the odds of making a genuine connection,” Abblett explained.

While a compassionate interruption helps steer the conversation, Abblett found that the moment immediately following is where real trust is built. No matter how strong a read he feels he has on a client, he makes a habit of following an interruption with one of three phrases:

• “Tell me about your experience of this symptom.”
• “Help me understand how you’re experiencing this — because you’re the expert on your own body.”
• “I’m wondering if it feels true that…”

“I always use the caveat that I don’t know what’s in you,” Abblett said. “And it always deepens things.”

The Benefits of Mind Wandering in Clinic

Mind wandering got a bad rap in the early 2000s. Popular research at the time — including a widely cited 2010 study titled “A Wandering Mind Is an Unhappy Mind” — suggested that losing focus carried a heavy emotional cost, and doctors were even encouraged to use mindfulness to stamp it out.

Recent research, however, tells a different story. Scientists now view mind wandering as a powerful cognitive tool. When researchers re-examined those early studies, they realized that while fixed rumination makes people unhappy, freely moving thoughts actually boost mood and fuel creative breakthroughs — a phenomenon often called “the shower effect.”

Murray said this shift makes intuitive sense: our brains evolved to slide naturally between total focus and open-ended exploration. Mind wandering is not a flaw to be corrected — it’s adaptive.

Think of your mind operating on a two-dimensional grid, where one dimension (the executive control system) helps you focus and the other (the salience system) allows you to pick up on things that feel meaningful or relevant (like a patient’s offhand comment about stress) and pulls your thoughts along a chain of associations. The two systems work together and “constrain your thoughts to a greater or lesser extent,” Murray said, keeping you focused while still allowing for creative leaps.

You can’t force your mind to wander, but you can lean into it when it happens.

“Inquiry is all about trying to find the next best question,” Murray said. “Sometimes you need that wandering mode of cognition to land on a question you’d never discover if you were just trying to brute-force your way through in a focused mode all the time.”

Ultimately, catching your mind wandering in clinic isn’t a failure of attention — it’s a mental breather that can lead to better insights for your patients and less burnout for you.

“It’s important to find time and space to just let your mind go in whatever direction it wants,” Murray said. “Beyond the clinical setting, it’s something very important — and it gets harder every day as digital technology crowds into every space around us.”

The experts cited in this article had no relevant disclosures.