Living a balanced life

Do your days begin with a sense of panic rather than pleasure? Are you certain you'll disappoint someone-at home, at work, or probably in both places?

Perhaps you come home exhausted after a long day seeing patients and dealing with office administration, mumble something to your family, glance through a medical journal (skimming articles that you know you won't remember), and gear up for the next day, knowing that it'll be the same. Maybe you spend a good part of your afternoons feeling guilty because you're missing an important soccer game that means a lot to your child or realizing that you're running late and may well miss the first act of the play your spouse got tickets for months ago.

For many doctors, the work/life balance has shifted out of kilter. Perhaps it was fine at one time, but as your workload, partnership, and family life changed, you wound up with more balls in the air than you can juggle comfortably. There's no single ratio for work/life balance-the optimal for a 60-year-old may differ from that of a 35-year-old with small children.

Define your priorities. This is the crucial first step to restoring balance. Examine the most important pieces of your life. Consider the categories of family life, professional/intellectual life, financial stability, spiritual/ethical values, social life, and physical/health status. If these groupings don't cover the major elements of your life, create categories that do. Figure out how well you're doing in each of these areas, as well as each one's value to you. If you feel unsatisfied or unsuccessful in a key area, you need to put more time and effort into it. In doing so, you might pretend that you're looking back over your life: What will make you feel that you spent your time in rewarding and worthwhile ways? The answers should serve as a guide as you make daily decisions on how to best use your time.

Compare your real life to your goals. Examine how much your life actually reflects what you internally prioritize. Track your time in 15-to-30-minute increments for a week. You can use time management software, but several sheets of paper will do fine. Divide your activities into fairly specific categories, such as driving, patient care, meals, phone calls, meetings, exercise, and family time. Record the information as you go through the day. Recall is often inaccurate, and if you try to reconstruct your time later, you may get it wrong.

Once the week is up, analyze the results. Are you spending time on things that matter to you? Stephen R. Covey, author of The 7 Habits of Highly Effective People, uses a 2 X 2 matrix of urgency vs importance. Chances are, some of your activities are neither important nor urgent. Cut them out.

Make meaningful changes, not hollow promises. Are you biting off more each day than you can chew? As the saying goes, "You can do anything, but you can't do everything." Narrow your activities down to the few things you really care about.

Learn to say No to activities that don't enhance your own life or those of the people you love. If you'd feel guilty about refusing to do certain tasks, consider why. Can you delegate or hire someone else to do them? For instance, is it really necessary that you mow the lawn and weed each week?

Communicate your priorities clearly and effectively to colleagues or employers. Recognize that you must make choices and compromises. Since needs change over time, revisit your decisions periodically. If your children are currently your first priority, and your career, while important, is secondary, you might consider deferring membership on hospital committees. You can return to the extra career activities after your family responsibilities have decreased.