TORONTO-Ask just about any resident or young physician just starting out in practice how his or her personal life is going and the most common response you will likely get is, What personal life? or something to that effect. To those in the early stages of their medical careers, the concept of a personal life may seem like a distant and unattainable dream.
Young surgeons just starting out are often faced with a confluence of variables which can lead essentially to the perfect storm, said Linnea Peterson, MD, of the Virginia Mason Medical Center in Seattle. Trying to balance all of the various pulls on your finances, your thoughts, your time and energy can be overwhelming and isolating. It can be daunting, to say the least.
Very strong anecdotal evidence and countless case studies, however, suggest that it is indeed possible to have both a rewarding professional life and a satisfying personal life. It takes planning, hard work, and commitment, though, according to those who have managed to achieve that much-sought-after work-home balance.
To discuss how they survived some of those early challenges in their careers and how they are dealing with current challenges, Dr. Peterson was joined by a panel of seasoned otolaryngology professionals for a special session, Living La Vida Loca: Physician Career and Family Balance, at the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) Annual Meeting. The program was sponsored by the Academy’s Young Physician’s Committee.
The panelists included M. Jennifer Derebery, MD, of the House Ear Clinic in Los Angeles; Robin T Cotton, MD, of Cincinnati Children’s Hospital; and Richard V. Smith, MD, of the Albert Einstein College of Medicine in New York.
First, some bad news
Early career burnout is a critical issue. A recent article by Dr. Robert Ossoff and colleagues quoted a burnout rate among residents as high as 86 percent. Now this wasn’t burnout in the sense of throwing in the towel and quitting, but burnout rates in terms of measurements of emotional exhaustion, personal accomplishment, and depersonalization, Dr. Peterson said. Residency training is excellent at teaching us how to work up complex medical issues, how to do technically challenging surgeries, how to critically evaluate a scientific article, and how to do research, but when it comes to integrating challenges and goals into real life, we’re left to our own devices.
Take Advantage of Support Systems
There are support systems and proven strategies that can be taken advantage of to help young physicians get past some of these early pitfalls and perhaps even attain a semblance of balance in their lives along the way. First and foremost, all the panelists agreed, trusted mentors can be worth their weight in gold.
And you’ve got a universe of mentors out there to help you, Dr. Derebery said. I’ve had many and have been so fortunate in my life. They can be friends, associates, co-residents, even your patients. They are all around you, just look for them.
Dr. Cotton agreed, adding that establishing a value system early on is another key to attaining that dream of balance and maintaining it throughout one’s career.
I think you have to truly value your work, he said. I love my job and I’ve never felt like I didn’t want to go to work. But I also value my home as a haven; I do not take work home.
Dr. Cotton believes the value of time away from work cannot be overestimated and should never be discounted. He doesn’t even take his computer with him when he goes on vacations and highly recommends that others pick up that same habit. He recalled a young colleague who was preparing to leave for a week of vacation to visit relatives and was planning to take his laptop with him.
When I asked him to promise me that he wouldn’t take his computer with him, he said he didn’t think he could do that. I said, ‘You are about to spend a week with the people who mean the most to you in your life. I can assure you the hospital will be here when you get back, whether you take your computer or not, and when you retire and the hospital no longer cares about you, your family will.’
Issues Change as Career Advances
Now, some more bad news, followed almost immediately by more good news.
The challenges don’t end when you complete your residency and are firmly established in practice.
Balance at work varies as you move through your career path, Dr. Smith noted. When you’re a resident, it’s really uncontrollable; you’re really subject to the will and at the mercy of the people that you’re working for. As you get into mid-practice, which is about where I feel like I am, you can start to control your work requirements to some extent.
Taking personal control of your schedule, according to Dr. Cotton, is an important first step in managing the balance between your home and work lives.
The only thing I micromanage in my life is my schedule, he said. My secretaries do not run my schedule for me, so I am in control. That allows me to be personally responsible and it gives me the framework to allow for flexibility when the unexpected arises.
And when a spouse and children enter the picture, the unexpected can arise in waves. All three panelists spoke to the challenges of balancing work, parenthood, and dual-profession marriages.
If you have children, they are going to define much, if not most, of your life decisions from that point on, Dr. Derebery said. But I’ll tell you, there’s no better cure for writer’s block than a babysitter who’s going to be there for only three hours.
Hiring that babysitter every now and then, however, highlights another important point on which all the panelists agreed: Don’t be shy about outsourcing and delegating as much as possible, both at work and at home.
Delegation is very important, Dr. Cotton said. One of the most important things to me, especially early on, was a good business manager. I would advise you to get a very good business manager to whom you can delegate and who is going to be very loyal to you.
Dr. Derebery could not agree more strongly. Outsource all you can afford to, and I can’t emphasize that enough. Whatever you pay for nannies, babysitters or anything else is going to be much less than you will pay for a divorce settlement or psychiatric fees, she joked.
When delegating or outsourcing, however, is not an option, the only alternative may involve using a word that many physicians find difficult to utter.
You need to learn to say no sometimes. I admit that I’m not real good at that, but I’m getting better, Dr. Smith said. Of course, there are consequences to consider. If you’re going to say ‘no’ to an invitation to speak, or a paper to write, or a committee to serve on, there will be professional consequences. On the other hand, if you say ‘yes,’ there will be home consequences.
Now, the final good news.
You can have it all. You just have to accept that you might not be able to have it all at once, Dr. Derebery said. There are times when you have to stage things in your life. But life is what happens while you’re busy making other plans, so don’t wait until tomorrow to start living. Enjoy it now.
©2006 The Triological Society