Boundaries and balance: To thine own self be true

As a Medical Economics editorial advisory board member, I was privileged to read the finalist entries in the 2017 Physicians Writing Contest. The topic, “How I achieve work-life balance,” is of keen interest to all physician readers, since from day one of residency we struggle to prevent medicine from crowding out everything else that we value in life.

My first employer once told me, “Medicine comes first, everything else comes second.” Fortunately, our writers successfully found ways to order their life priorities.

All contest finalists shared wise principles to govern the continual, competing demands on our time and attention and crafted individualized plans to thrive in a profession at high risk for burnout. 

Essays covered a variety of themes. A few entrants briefly related personal challenges in attaining balance, then outlined practical strategies that any doctor could adopt to cope with a profession that does not stay within the boundaries we set. 

Other authors described a career path headed for unhappiness, realized they needed a profound change, and proceeded to creatively, and for some drastically, alter their job or themselves to boost their life satisfaction. Finally, a few physicians were suddenly hit by unforeseeable life events, and their resilience in finding a “new balance” was inspiring.

My conclusion after reviewing these entries was that success isn’t measured by money earned or number of patients seen, but by healthfully sharing our best gifts with our patients and the people in our personal lives, including ourselves. To reach their fullest human potential, doctors need time away from medicine to nurture other passions. Family is important, and one writer pointed out that our office staff are extended family. We need healthy interactions with both “family units.” 

Burnout is an important concept to address. It happens due to a mismatch between the worker and the job; a square peg trying to squeeze into a round hole. To relieve it, one can change the job, change the worker or change both. Studies validate our authors’ experiences, that either job/system change or personal change can effectively reduce burnout among health professionals.  

Professional medical culture does not historically promote self-care, and this culture needs to change. Ironically, two of my specialist colleagues boasted of their decades of long hours and sleep deprivation at a third doctor’s funeral, which came too soon because the busy doctor had neglected his own preventive care. 

We have a long way to go to reduce the stigma surrounding a physician seeking physical or mental health care.

In caring for ourselves and colleagues, we must recognize the fallacies in feelings of guilt, failure or shame if a doctor decides to temporarily walk away from medicine, work part-time, or seek treatment for physical or mental health issues. 

If we can change the culture in medical groups and hospital staffs to promote health for the healthcare worker through openness, honesty, empathy and support, fewer doctors will flame out.  

Elizabeth A. Pector, MD, is a primary care physician in Naperville, Illinois, and a member of the Medical Economics editorial advisory board. Tell us what you think of this year’s winning essays at medec@ubm.com.