Work-life balance: A laudable-and laughable-goal

As a physician, finding time for a personal life outside of the daily pressures of a medical practice can be daunting. 

Working to improve patients’ health while meeting government and payer regulations, keeping an eye on practice finances and managing a staff often leaves today’s doctors with little extra time or energy. Fortunately, many physicians do find ways to have a fulfilling life both inside and outside of their practice.

For this year’s Physician Writing Contest, Medical Economics asked readers how they achieve a satisfying work-life balance. The result is a series of personal and professional anecdotes on how being a physician doesn’t mean sacrificing other interests outside of practice. Physician authors shared their own approaches and provided peer advice knowing that there is no silver bullet or one-size-fits all solution to maintaining balance.

In this issue, we present our contest winners for 2017, selected by our editorial team and physician advisers. In future issues, we’ll present honorable mention submissions offering additional tips and insight from physicians to physicians.

Second Place

Work-life balance: A laudable-and laughable-goal
By Jennifer Frank, MD

When I told my husband that I was going to submit a story on the topic of “How I achieve work-life balance as a physician,” he asked me when. “Right now,” I replied. “No,” he said, “I mean when are you going to achieve work-life balance?” When indeed?

The simple truth is that achieving work-life balance is like achieving world peace–a noble yet unattainable goal. The best we can hope for is to move in the general direction of work-life balance. Better yet, we can strive toward work-life integration, a much more apt description of what most of us hope to realize. 

I think of work-life balance as leaving for work on time every morning, being able to eat lunch and departing at 5:30 on the dot every evening. This would mean I have a predictable and manageable amount of work, am able to take care of the personal (eating), and have time for my family, exercise, hobbies and friends. While I’ve had days like that, they are not the norm and probably never will be. 

Work-life integration is deciding not to even attempt to answer the either-or question of work or life. It recognizes that our lives are wonderfully connected and complex. Integrating the many facets of ourselves allows us to honor that which is most important while recognizing the reality of shifting priorities and competing demands. 

To that end, I do not make unnecessary choices. If I am weighing exercising or spending time with my children, I can decide to go ice-skating with them. Tonight, my sister was ill, and I stopped by her place to examine her and render a medical opinion. I was able to integrate my roles as a physician and sister. While many things may not lend themselves to this type of alignment, some will.

Establishing priorities is crucial to managing the pull between the personal and the professional. There are times when work is unquestionably the top priority, such as being called to the hospital to deliver a baby. At other times, home life or personal commitments are the most important, such as attending the birth of your own child. 

What is most significant at any given moment is dependent on many situational factors, so I do not always choose work over home, but I also don’t always choose home over work. Once my priority is identified, I have the “what” answered and need to focus on navigating the “how.”

This is similar to what physicians do every day–triaging patient needs. Chest pain or stroke symptoms are top priority, and when we are faced with these in a patient, we know instinctively that the athlete’s foot or the sprained ankle has to wait. It would be great to be able to do it all, but when we can’t, we must prioritize. Triaging personal and professional demands affords you clarity to decide on a course of action.

Flexibility is a second ingredient to successfully managing the competing demands of home and work. This week I was asked at the last minute to give a patient education lecture at the hospital. The presentation was scheduled for prime-time in my house–that period between dinner and bedtime when my kids need me the most. It was hard to agree to give up that precious time, but it became easier when I arranged my schedule so that I could be home well before dinner and spend time with my family before I left for the lecture. 

Setting boundaries gives you room to navigate the many roles you fill. This applies to every facet of your life because pretty much anything–from being a surgeon to serving as the school board president will eat up the time and energy you are willing to give to it. 

I noticed an alarming trend a few months ago–6 a.m. meetings. Like all physicians, I am accustomed to 6 a.m. rounds, but purposely scheduling a meeting at that time crossed a boundary for me. I blocked my calendar from 6 to 7 a.m. every day with an appointment that says “no meetings.” 

Doing this did not change those meeting times. They still happened without me, and I am sure that some may regard me as not being a team player, but this was a personal boundary for me that I needed to honor.

This also applies to boundaries at home. When I am on call, I’ve established boundaries around my time and the expectations from my family. If I need to take a call or work on the computer or go to the hospital, my family knows that I must meet those commitments. Therefore, I don’t schedule family events when I’m on call.  

Finally, I believe in the importance of personal and professional vital signs or scorecards. This is a way to keep track mentally of how you are doing at balancing your roles and your energy. For me, exercise is part of my personal tracking system.

On a day when I can exercise, I know that I’ve made enough space for everything. Since work meetings, family obligations, sleep and other demands will encroach on my exercise time, I recognize that on a day I get to exercise, I’ve been able to manage the important things and still have time left over for something that is important to me.

For work, it is how much time I have to spend documenting or finishing phone calls at the end of the day. When I have an hour or less, I know that my workload was manageable and am able to get home for dinner. If I feel stressed, I can ask myself whether I’ve been able to exercise lately or how much extra work is left for me at the end of the patient day. This usually points me in the direction I need to address and fix. 

Work-life balance is a laudable if laughable goal. It is impossible to perfectly balance the complexities of our lives as if we were completely compartmentalized humans. We are mothers and fathers and surgeons and pediatricians and friends and daughters and writers and painters. The many facets of who we are individually naturally overlap, compete, connect and complement each other. We are most integrated–all the parts of us connected–when we honor and acknowledge the fluid nature of our lives.