Focus on Physicians:
Insights, Ideas, and Strategies
Rethinking Work-Life Integration: When Work Takes Over Your Personal Life
With the rise of EHRs and telemedicine, the term "work-life integration" rapidly has become an administrative buzzword. However, for physicians who are expected to be always on duty, this approach can paradoxically increase stress and decrease balance.
In this article, I’ll explore why work-life integration might not be the promised panacea for getting it all done.
With the rise of EHRs and telemedicine, the term "work-life integration" has rapidly become an administrative buzzword.
Initially proposed as an alternative to the traditional "work-life balance" concept, the term encourages blending your professional responsibilities with your personal life. However, for physicians who are expected to be always on duty, this approach can paradoxically increase stress and decrease balance.
In this article, I’ll explore why work-life integration might not be the promised panacea for getting it all done.
The Myth of Seamless Integration
Despite the corporate happy-speak, work-life integration often translates to being ceaselessly connected.
For physicians, this means being perpetually available for patient queries, administrative tasks, training modules, and continuing education. This expectation of constant and immediate connectivity can lead to burnout and decreased job satisfaction
By definition, personal time is for the parts of your life that cannot be fulfilled at work.
Childcare, working out, maintaining relationships-- the list of things that pull on your personal time is endless. For the most part, these responsibilities and more require your full engagement.
But a focus on work-life integration can create an expectation of multitasking. This hits solidly against the basic tenets of the medical profession, which demands focus and precision.
Multitasking, as we all know by now, is a misnomer. Beyond the mental stress of juggling multiple tasks simultaneously, the unwieldy cognitive load can impair a physician’s ability to provide high-quality care.
The Impact on Personal Life
When work infiltrates all aspects of your life, personal time is often the first casualty. It’s common for physicians to find themselves checking emails during family time or thinking about patient care while trying to unwind.
Ultimately, you’re neither fully there for your patients nor for yourself and your loved ones.
While work-life integration is often hailed for its flexibility, it can lead to longer working hours under the guise of convenience.
Let’s be clear. You’re probably not bringing your toddler or your elderly mother to your office. And you’re not taking a walk with your EHR.
As someone whose parents were both full-time physicians well before the days of the internet, I can tell you from experience that it’s very unlikely that your home life is being integrated into the workday. A few furtive emails and rushed phone calls hardly count as connection.
Professional Implications
The stress and fatigue resulting from a lack of clear boundaries between work and personal life can increase the risk of medical errors. A tired and overworked physician is more prone to making mistakes, which can have serious consequences for both patients and the healthcare system.
But the threat of serious medical errors isn’t the only potential drawback of the constriction of your personal life. The consequences are not usually so blatantly obvious. Although it may be uncomfortable to admit, continuous engagement with work-related activities can lead to emotional exhaustion, reducing your ability to empathize with and care about your patients.
This diminished capacity for empathy and engagement can adversely affect patient satisfaction and trust, as well as outcomes.
The Bottom Line
For those in administration, creating a culture that supports and empowers physicians to do their best work is crucial. It’s time to go beyond talking points and take action. Removing unnecessary and burdensome “click work” is one way to reduce a physician’s load. Allowing support staff to handle simple messages and requests is another.
For physicians, establishing clear boundaries between your personal and professional lives can help to maintain your mental well-being, ensure the delivery of quality care, and support a fulfilling and sustainable personal life.
Despite the popular business-speak narrative around work-life integration, true balance often requires a clear separation of work and personal life, so that both may flourish.
If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.
If you’d like to learn more about my coaching practice, you can schedule a complimentary introductory meeting by clicking the link below.
How to Begin a Meditation Practice: A Guide for Physicians
As a cardiologist, a certified mindfulness meditation teacher, and a yoga teacher, I’ve been fortunate to learn from a diverse group of mentors, ranging from world leaders in cardiology to a former Buddhist monk. I learned about the power of meditation early on in my professional life and found that the presence and equanimity it cultivated inspired both my medical practice and my life outside of medicine.
You don’t need a guru or even a class to learn how to meditate. In this article, I’m sharing some simple ways that you can get started with meditation.
As a cardiologist, a certified mindfulness meditation teacher, and a yoga teacher, I’ve been fortunate to learn from a diverse group of mentors, ranging from world leaders in cardiology to a former Buddhist monk.
I learned about the power of meditation early on in my professional life and found that the presence and equanimity it cultivated inspired both my medical practice and my life outside of medicine.
If meditation sounds a little too nebulous, out-there, or maybe even intimidating, take heart from knowing that meditation is something that many of our key thought leaders practice on a daily basis. It’s not a new trend or a fad. In fact, mindfulness meditation has been incorporated into healthcare since the 1970s, when molecular biologist Jon Kabat-Zinn, Ph.D. founded the Mindfulness-Based Stress Reduction Clinic at the University of Massachusetts Medical School.
Meditation can enhance your skills as a physician, improving your ability to focus on details and remain calm under stress. It may improve your sleep quality and even enhance your cardiovascular health.
You don’t need a guru or even a class to learn how to meditate. In this article, I’m sharing some simple ways that you can get started with meditation.
Start Small
Begin with just 3-5 minutes of meditation each day. Even this short duration can offer significant benefits. From there you might try a 10-minute practice.
Some people prefer longer meditations, but it’s good to know that when scientists compared 10-minute to 20-minute sessions, there was very little difference in overall mindfulness measures.
Use Guided Meditations
If you're new to meditation, guided meditations can be very helpful. There are many apps and online resources that offer free guided sessions tailored to different needs and preferences. Some good options are Head Space, Waking Up, Insight Timer, and Calm. Most have free or introductory options.
Find a Quiet Space
It’s hard to meditate when there are too many external stimuli. Although you can learn to meditate anywhere, start by choosing a quiet, comfortable place where you won't be disturbed. If you can close a door and put your phone in do-not-disturb mode, so much the better. This will help to create a calmer environment for relaxation and focus.
Eventually you’ll be able to incorporate this sense of focus and ease into your daily life wherever you happen to find yourself.
Focus on Your Breath
A simple way to begin to meditate is to focus on your breath. Close your eyes and take slow, deep breaths in through the nose and out through the mouth. There are a number of different ways that the breath can be used in meditation, but there’s no need to overthink it. Just settle into a rhythm that feels comfortable. By bringing your attention to the sensation of the breath, you’ll use it to anchor your meditation.
Go for a Walk
Walking meditation is a legitimate and ancient form of mindfulness practice. Instead of using the breath as an anchor, walking meditation brings purposeful attention to the movement of your feet as they contact the ground.
Walking meditation is generally slow and contemplative, and often involves walking back and forth on a path. It’s not about getting from one place to the next. It can be done in the space of your living room, but there’s no reason you couldn’t use your walk from the parking lot to the hospital or office as a walking meditation. Most of the apps I’ve referenced above offer options for walking meditation.
Although traditional walking meditation is not fast, some runners find rhythmic running meditative when they mindfully attend to each stride.
Be Consistent
Like anything else, getting started with meditation is a habit to be cultivated. Since briefer meditations of 5-10 minutes can be highly effective, let go of any tendency to think that longer is better. Consider setting a goal of 3-4 five-minute sessions per week and see how that feels for you.
Don’t give up if you’re not noticing any difference right away. One study found that 8 weeks, but not 4 weeks, of daily meditation improved mood, attention, and fatigue.
Listen to Your Inner Wisdom
Keep in mind that meditation isn’t right for everyone. For instance, although many people with anxiety find meditation helpful, some people will experience worsening anxiety or an uncomfortable feeling of disconnection while meditating. Longer meditations (over 30 minutes) are often more problematic, and retreats can be especially triggering.
If meditation is not right for you right now, remember that simply taking a mindful pause can make all the difference in a hectic day.
If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.
And if you’d like to schedule a complimentary introductory meeting with me, click the link below.
How to Manage Interruptions and Limit Attention Residue: A Guide for Physicians
Attention residue happens when you switch tasks, but a part of your mind remains stuck on the previous task. The little breadcrumbs that remain can significantly decrease your cognitive performance and make it harder to focus. And once you’re interrupted, no matter whether the issue was urgent or trivial, it’s easy to switch over into another unrelated brain drain, such as checking your email or social media, rather than returning to the task at hand.
In this article, we’ll explore strategies that you can use to retake control of your mental focus, manage interruptions, and minimize attention residue in your daily practice.
It’s not just your imagination. It’s more challenging than ever to maintain your mental focus at work.
💉 EHR alerts
💉 Phone notifications
💉 Interruptions from staff
💉 Attention sapping apps
All of these and more conspire to make focus more difficult than ever before.
These constant interruptions and the lingering effects of shifting attention, known as attention residue, can severely hamper not only your effectiveness and productivity, but also your own well-being.
Resolving the current state of disorder in healthcare will require systemic change, including a fundamental shift in the functionality of many EHRs.
But protecting your headspace is a critical skill that can help you stay above the fray.
In this article, we’ll explore strategies that you can use to retake control of your mental focus, manage interruptions, and minimize attention residue in your daily life and practice.
Understanding Attention Residue
Attention residue happens when you switch tasks, but a part of your mind remains stuck on the previous task.
The little breadcrumbs that remain can jumble up your thoughts and make it harder to focus. And once you’re interrupted, no matter whether the issue was urgent or trivial, it’s easy to switch over into another unrelated brain drain, such as checking your email or social media, rather than returning to the task at hand.
Realistically, interruptions are a part of life in most medical settings. Apart from a few innovative healthcare systems, the current state of affairs creates the perfect setup for attention residue.
Each interruption requires a mental reset, which can take a considerable amount of time and effort. Ultimately this leads not only to decreased productivity and lost focus, but also to increased stress.
This isn’t just theoretical. Research looking at Emergency Department physicians and nurses has found that interruptions from a broad range of sources can seriously degrade the ability to remain focused and aware. What’s more, the disruptions in this study occurred on average about 11 times every hour.
Strategies to Regain Mental Focus
Ideally, our healthcare system leaders will realize the importance of creating pathways that will minimize interruptions. This process is underway in a number of medical systems. But even under the best of circumstances, interruptions are going to happen. Here are a few ways that you can limit the mental drain.
Prioritize and Plan
This can be a difficult step for physicians, since we don’t always have control over the way the day might go. But simply outlining your top priorities can help by giving you a focus and a “north star” for the day,
Start your day by outlining your top priorities. Whenever possible, highlight high-impact tasks when your mental energy is at its peak. For many people, that is the first thing in the morning.
Use tools like the Eisenhower Matrix (also known as the Time-Priority Matrix) to distinguish between urgent and important tasks, and mitigate those less important time-wasters.
Time Blocking
Whenever possible, consider setting aside specific time blocks for different types of tasks. For example, set aside uninterrupted time to study for your boards, or for administrative work. If you have some control over your schedule at work, scheduling similar patient visits may be helpful, so that your mental flow is less likely to be interrupted.
Communicate your schedule and your plan to create these focused blocks of time to your team (or your family) to minimize unnecessary interruptions. Getting buy-in from your schedulers and administrative staff can help to make time blocking work for you.
Mindfulness and Meditation
Consider incorporating mindfulness practices into your daily routine. Techniques such as deep breathing, meditation, or yoga can help improve focus and reduce stress.
Meditation in particular has been found to be helpful in improving attention, focus, and memory and reducing stress. Just like medication or physical therapy, it’s important to be consistent. In one study, it took 8 weeks of regular practice before the impact of meditation was clear.
Taking a mindful pause before and after each patient, study, or procedure is a great way to mentally reset. In many cases, even this very brief break can improve your efficiency.
Meditation might sound intimidating, but it’s really quite simple. This article shows you how you can easily get started. Don’t just think of meditation as something that you can investigate when you have the time. There is good evidence that engaging in a regular meditation practice can enhance your attention and mental efficiency.
Limit Multitasking
Multitasking used to be considered a superpower. But now we know that when people multitask, they often make more mistakes. And because of inefficiency, it may actually take longer to get tasks done than if each one was done separately. That’s especially likely if both tasks require mental energy, rather than rote memory.
By focusing on one task at a time, you may improve the quality of your work, reduce the cognitive load, and actually save time.
If you have tasks that are time-consuming and not realistically amenable to completion in one sitting, break them down into smaller, more manageable steps. That way you can think of each step as a separate and achievable task. It can be helpful to write each of these sub-tasks out and check it off the list when it’s completed.
As you knock out these smaller to-dos, you’ll feel a sense of accomplishment. That can reduce the attention residue that builds up when you stress about unfinished work.
Set Boundaries
It’s not surprising that research has found that interruptions increase the likelihood of errors, which may put your patients at risk.
What’s more, these unwanted intrusions also impact your own mental well-being, provoking measurably high levels of anxiety and annoyance.
Ideally, set clear boundaries with colleagues, staff, and patients regarding when you are available for interruptions.
When practical, limit social and nonessential chatter when you’re focused on something that requires deep thought or careful consideration. Reading studies, creating notes, reviewing charts, and developing treatment plans all fall into this category.
Use simple visual cues, like a closed door or a "Do Not Disturb Unless Urgent" sign. Distractions can’t all be eliminated, but taking these and other attention-preserving actions will likely build awareness and respect for your focused time.
It can also be helpful to set expectations with patients and staff that non-urgent in-box messages will only be addressed during or after certain hours of the day.
Conclusion
Maintaining mental focus requires practical, intentional strategies and consistent effort. By experimenting with some or all of the steps I’ve listed above, you will enhance your ability to concentrate, manage interruptions, and reduce attention residue.
Developing these practices will not only improve your productivity but also contribute to better patient care and support your own vital well-being.
If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.
If you’d like to learn more about my coaching practice, you can schedule a complimentary introductory meeting by clicking the link below.
My Podcast Appearance on Dr. Bill Lombardi’s Journey to Better
It was a thrill to appear on the legendary cardiologist Dr. Bill Lombardi’s podcast The Journey to Better. I was honored to be invited onto the show to discuss mindfulness, goal setting, and combating burnout.
It was a thrill to appear on legendary cardiologist Dr. Bill Lombardi’s podcast The Journey to Better. I was honored to be invited onto the show to discuss mindfulness, goal setting, and combating burnout.
Dr. Lombardi is one of the highest-volume operators for complex PCI and chronic total occlusions in the world. He has been open about his own struggles with well-being in this high stakes and intense field of cardiology. His episodes will resonate for cardiologists, but also for any physician who has experienced the struggles, highs, and lows of caring for patients in today’s world.
What if You Don’t Know What You Want Next: A Physician’s Guide to Finding Direction
As a physician, you've dedicated years of your life to the practice of medicine. But there comes a time in many physicians' professional trajectories when they feel a need for change and a yearning for something different. Maybe you feel stuck, unfulfilled, or underappreciated. Or perhaps you simply crave a change of scenery.
It can often be difficult to envision what that change should or could look like. In this article, I’ll give you some strategies that will help you to gain clarity and direction when you’re not sure what you want next.
As a physician, you've dedicated years of your life to the practice of medicine. You spend the better part of your waking hours staying current on the latest research, honing your skills, serving your patients with compassion and care, and collaborating with your colleagues and staff.
But, like many doctors, there may come a time in your professional trajectory when you feel a need for change and a yearning for something different. Maybe you feel stuck, unfulfilled, or underappreciated. Or perhaps you simply crave a change of scenery.
In this article, I’ll give you some strategies that will help you to gain clarity and direction when you’re not sure what you want next.
Sometimes the direction to take is crystal clear, but it can often be difficult to envision what that change should or could look like. From medical school to residency and beyond, your path up to this point has probably been clearly marked. As you reached one milestone, the next was likely in view.
It can be comforting to know where you are going next, but it’s not uncommon to find yourself longing for a shift in your professional life that doesn’t conform to the well-worn trail. Whether you're considering changing the way you practice, adjusting your working hours, exploring opportunities outside of clinical medicine, or even contemplating retirement, the uncertainty can be daunting.
Change is often uncomfortable and unsettling, especially when you’re blazing your own path. It's essential to remember that this feeling of ambiguity is a natural part of any career evolution. It’s easy to get stuck at this point, instead of recognizing that this period of contemplation is the first step in a new direction.
Although it’s important to think things through, I’m a firm believer in the adage that action creates clarity. Action however, does not have to mean commitment or a big shift. Giving yourself time and space to actively explore what is possible can make your next steps more clear.
If you’re feeling like you’ve come to a standstill, here are some ideas that can help pull you out of the rut and find some serious traction that will move you forward.
1. Reflect on Your Values and Goals
Take some time to reflect on what truly matters to you, both personally and professionally. What are your core values? Have you identified specific long-term personal and career goals?
Understanding what drives you and what you hope to achieve can provide valuable insight into the direction you should take. If you’re unclear on how to express your personal values, my Values Workbook can help.
2. Assess Your Skills and Interests
Consider your strengths, skills, and areas of interest outside of medicine. Are there particular aspects of your current practice that you enjoy the most? Are there skills you possess that you haven't had the opportunity to fully utilize? Or maybe you’re curious about acquiring new expertise.
Exploring these ideas can help you identify potential career paths that align with your strengths and interests. Don’t be afraid to consider possibilities that may not obviously relate to the practice of medicine. Simply asking yourself what lights you up may spark new ideas and connections. One exercise that can help you discover these connections is a mind map.
3. Seek Guidance and Support
Reach out to mentors and trusted colleagues. You might also choose to work with a coach. Sometimes, an outside perspective can provide valuable insights and help you see possibilities that you may not have considered on your own. While a coach will not tell you what to do next, a coach will help you uncover your own answers. That’s because coaching is a supportive process designed to accelerate your capacity to explore your options and take effective action.
4. Explore Your Options
If you're unsure about the specific direction you want to take, make some time to explore different opportunities and try out new experiences. This could involve taking a course or attending a meeting focused on anything that interests you, volunteering, traveling, or joining an organization or group that resonates with you.
These explorations don’t have to have an obvious connection to the practice of medicine. Experimenting with a variety of options can help you clarify your priorities and identify what intrigues and inspires you.
5. Embrace Flexibility and Adaptability
Your path doesn't have to follow a linear trajectory. It's okay to pivot, change direction, or investigate new opportunities at any stage of your life. Be true to yourself, but keep in mind that it’s always a good idea not to burn any bridges along the way.
When you embrace flexibility, you’ll often find unexpected and even surprising opportunities that may otherwise have gone unnoticed.
6. Take Small Steps
Thinking about a professional change can feel overwhelming, especially for physicians. More than most other professions, we often feel defined by the work that we do.
Remember that you don't have to have all the answers right away. Break down your goals into smaller, manageable steps, and focus on taking action consistently. Simply commit to just one small step at a time.
7. Practice Self-Compassion
Be kind to yourself as you navigate this process. It's normal to feel uncertain or indecisive when you’re facing an important change. Practice self-compassion and remind yourself that it's okay not to have all the answers immediately.
Trust in your abilities and know that by putting in the work, you will find your way forward.
As a physician, you have proven that you are resourceful, intelligent, compassionate, and hard working. By taking the time to reflect on your values and goals, seeking guidance and support, exploring and creating your options and opportunities, and embracing flexibility, you will stay open to possibilities, and you will find your way.
If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.
And if you’d like to schedule a complimentary introductory meeting with me, click the link below.
Rediscovering Your Why: A Road Map for Physicians
If you’re questioning whether you’ve chosen the right job, the right specialty, or even the right profession, you’re not alone. Most physicians go through cycles of doubt, revisiting old decisions when things aren’t going well.
Dissatisfaction today doesn’t always mean that you need to make a drastic change tomorrow.
But if this seems like a theme song that just won’t stop playing, then it might be time to rediscover your why.
If you’re questioning whether you’ve chosen the right job, the right specialty, or even the right profession, you’re not alone.
Most physicians go through cycles of doubt, revisiting old decisions when things aren’t going well. That can be very normal, and over time the chances are good that these periods will become less frequent.
Dissatisfaction today doesn’t always mean that you need to make a drastic change tomorrow. Sometimes short-term pain and sacrifices are necessary to get you where you want to go.
But if this seems like a theme song that just won’t stop playing, then it might be time to rediscover your why.
Often when you feel unfulfilled or frustrated at work or in your personal life, it’s because you are not living a life that feels authentic to you.
Perhaps you are trying to live up to someone else’s ideal
Maybe your life has moved in a different direction since you first chose your current path
It could be the job itself that has changed or not lived up to your expectations
Perhaps you simply need to rediscover the reason that you chose to become a physician so many years ago
"Finding your why" is the process of discovering and understanding the deeper purpose or meaning behind your actions, goals, and choices. It's about identifying the core values and beliefs that drive you and give your life a sense of meaning and fulfillment.
This concept is often associated with personal development and leadership, and it's a key element in the philosophy of Simon Sinek, an author who has been hugely influential in the business world. Sinek argues that successful individuals and organizations are those who are able to articulate and align their actions with a clear sense of purpose or "why." In fact, one of Sinek’s most popular books is called Find Your Why.
The idea is that when you have a clear understanding of why you do what you do, it can serve as a powerful motivator and guide for decision-making. It can help you stay focused, overcome challenges, and find a greater sense of satisfaction at work and in your personal life as well.
As Sinek puts it
Your why is your driving force
Your how is the actions that you take to bring your why to life
Your what is the manifestation of your why—the actual work that you do
Once you understand your why, everything else starts to make sense. Your decisions will become clearer and your actions more purposeful and meaningful.
Knowing your why is so integral to being a physician that it’s surprising this concept is not routinely taught in medical schools. Discovering your why is not a “one and done”, check-it-off-the-list sort of thing, but it’s logical and easy to understand.
The process involves introspection and reflection on your values, passions, and the impact you want to make on the world. It means going beyond your surface-level goals and digging deeper into the fundamental reasons that drive your choices and actions.
To help you find your why, get a piece of paper or a journal and start writing. You could do this on your computer or your tablet, but writing by hand tends to engage the brain more fully than typing on a keyboard, encouraging a deeper connection with the words and ideas and improving later recall. Most importantly, choose a method and a time that works for you.
Consider taking a few minutes every morning or evening to discover the patterns and thoughts that arise. Here are some questions to get you started:
What do I find fulfilling about my current job?
What do I not like about my current job?
What values do I seek to honor in my work and in my life?
What other goals and aspirations, professional and personal, do I have?
What are my strengths, my natural talents, my soft skills?
What strengths and talents would I like to develop further?
What are the common ideas and threads that run through my life over the years?
What makes me happy at work, at home, and in my private life?
What do people thank me for?
What do I enjoy teaching?
What do I enjoy learning?
What keeps me up at night?
What moves me to take action?
What is my ideal day?
After spending a few weeks letting these ideas gain traction, create a mission statement that will encapsulate your why in a single sentence. To get started, ask yourself what contribution you wish to make, and what impact you hope to have. It doesn’t have to be perfect, and it doesn’t have to answer to anyone else’s expectations. Your statement can be a work in progress, but it’s a great way to begin to align your goals with a purpose that is genuine and fulfilling. Over time, knowing your why can become a transformative force.
P.S. If you want to learn more about defining your values, click here to sign up for my free Values Workbook.
DISCLAIMER: As an Amazon Associate I may earn from qualifying purchases, which means that if you click on one of the product links, I’ll receive a small commission. This helps support the website, for which I am grateful! Please do your own research before making any important decisions.
If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.
And if you’d like to schedule a complimentary introductory meeting with me, click the link below.
Using the Language of Art to Create Work-Life Balance
Most physicians cite work-life balance as a top priority. Yet there is little clarity on what exactly work-life balance means.
You might be surprised to learn that art theory holds the answer.
In this article we’ll explore ideas of symmetric, asymmetric, radial, and crystallographic balance. And you’ll discover why asymmetric balance might hold clues for your own unique form of work-life balance.
This article was published in a slightly different format on KevinMD.com
Most physicians cite work-life balance as a top priority. Yet there is little clarity on what exactly work-life balance means.
Some prefer the term work-life integration, as if your work and your so-called personal life should be intertwined. Work-life integration is a common buzzword in managerial circles. For most physicians, however, this way of life is already a reality. Taking call, working late, and keeping up with CME and recertification already mean that much of what might be considered personal time is already filled with work commitments. And so what “work-life integration” often means is that there is really no distinction between the two.
Under this construct, work may be expected to run freely into family and personal time without boundaries. Yet in most cases, the river only flows one way. Bringing your home and personal responsibilities to work may be neither practical nor desirable.
For these reasons, I believe that work-life balance (WLB) is a better goal for physicians. But what does balance even mean? You might be surprised to learn that art theory holds the answer.
Most people think about balance as a seesaw or a set of scales, with each element balancing the other to achieve a perfect equilibrium. This cliché is virtually impossible to achieve and may not even be desirable. Instead, there’s another more nuanced way to look at balance that I believe can help better inform your personal choices.
Before we go any further, it’s valuable to think about WLB as more than simply “work” and “life”. Work is an important part of life, and perhaps even a defining feature of the life you’ve chosen. But “life” isn’t just what’s left over after work. It can be useful to think about life as a array of different elements. Broadly speaking, these may include
Family
Friends
Leisure
Self-Care
Anything else that’s meaningful to you
Equalizing all of these factors our using traditional concepts of balance is just not going to happen.
But if we borrow the concept of balance from art theory, it all starts to make more sense.
In art, balance can be
Symmetric
Asymmetric
Radial
Crystallographic (Mosaic)
Let’s take a little detour into art theory so I can show you what this means.
Symmetric
Think of the typical balanced scale, or a mirrored pair.
This is the traditional way that we think of balance.
Asymmetric
The perception of weight across the composition may be balanced, but each element has a different size or mass.
This form of balance tends to create more interesting and dynamic images.
Radial balance
This type of balance uses a central focal point
Rays, spirals, or ripples radiate outward
Fragment, Peru c. 1000-1476 AD, Kate S. Buckingham Endowment, Art Institute of Chicago
Crystallographic (Mosaic) balance
A large number of elements share equal weight
There is no single focal point
For physicians, an asymmetric concept of balance can be especially useful. Think about the way you might create a rock garden. With asymmetric balance, you have wide latitude to play with different scale and elements. Compared to the symmetric form of balance, where both sides hold equal weight, asymmetric balance falls apart when the elements are too similar.
In asymmetric balance there is usually a dominant element, with the other components playing a supportive or bridging role. Often two smaller elements work harmoniously to balance a larger one. In an asymmetric painting like Van Gogh’s Starry Night, there may be some tension, but the image still feels complete.
Asymmetric balance can be interesting to play with. Moving one element often means that the others must also be moved in order to maintain a sense of harmony. This new configuration might strike a different chord and create different relationships between the pieces.
When thinking about your own WLB, asymmetric balance may be a good starting point to consider. As your priorities shift over time, your vision of balance may also change. The asymmetric model is a way to conceptualize a personal definition of balance that works for you.
If you’re looking for practical tips to help you take action on WLB check out my recent article, which also appeared on Doximity. In the article I include nine actionable steps to get you started.
How do you begin to define your own WLB? Sitting down with pen and paper and sketching it out in words or pictures is a great way to get clarity on your own ideas and to create your vision for the future.
If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.
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Why Are We Afraid to Talk About Work-Life Balance?
For many physicians, work-life balance (WLB) is the elephant in the room. In 2022, 85% of physicians finishing residency cited work-life balance as their number one consideration when choosing a job.
Dissatisfaction with WLB is strongly correlated with burnout, and is a common reason that many physicians choose to leave their current practice. Although women physicians tend to rate WLB as somewhat more important than men, among millennials it is a top priority for both genders. Yet physicians often avoid raising this crucial issue with potential employers and even colleagues for fear of being judged.
In this article I’ll give you nine ways to create your own version of work-life balance.
This article originally appeared on Doximity, where I am a 2022-2023 Op-Med Fellow.
For many physicians, work-life balance (WLB) is the elephant in the room. According to CHG Healthcare, in 2018, 63% of physicians finishing residency programs cited WLB as their number one consideration when choosing a job. In 2022, it was 85%.
Dissatisfaction with WLB is strongly correlated with burnout, and is a common reason that many physicians choose to leave their current practice.
Although women physicians tend to rate WLB as somewhat more important than men, among millennials it is a top priority for both genders.
Yet physicians often avoid raising this crucial issue with potential employers and even colleagues for fear of being judged.
This fear of judgment is based in reality: providing the best and most timely care to patients often requires self-sacrifice. We all know that medicine is demanding; we must expect to occasionally, or even often, put personal needs aside in order to care for patients whose needs can’t wait.
But it’s not uncommon for physicians to fall prey to the notion that consistently putting aside their own, or their family’s, well-being is necessary to answer the “calling” of medicine. Perhaps in taking on this mantle of self-sacrifice, the idea of wanting something more, or even something different, can seem disrespectful to the “priesthood” of medicine.
For physicians whose work requires collaboration and partnership with others in the profession, openly wanting more from life may also stir up fears of being perceived as weak, lazy, or not a team player.
While respecting these valid concerns, I believe that if you conquer the angst of admitting that you want more out of life and make an effort to seek WLB, you will find that your relationships, your sense of fulfillment, and ultimately the care you give your patients can flourish.
Research shows that not only do people who make time for family, hobbies, and health feel a greater sense of balance, but they may also become better physicians for it.
A British study found that employees who engaged in creative activities were more likely to discover creative solutions to problems at work.
A study of nearly 300 ICU staff members, including physicians, found that those who engaged in hobbies experienced less post-traumatic stress.
And a Duke study found that higher WLB measures among hospital staff, including physicians, correlated with greater patient safety and improved teamwork.
On the opposite end of the spectrum, not attending to life outside of work can have serious effects on both. A study of members of the American College of Surgeons published in 2012 found that those with conflicts between work and home life were more than twice as likely to experience burnout and depression. In this study, “home” was defined broadly as “personal responsibilities,” and included personal relationships, parental responsibilities, and spousal factors. Experiencing this conflict also meant that the surgeons surveyed were more likely to leave their current practice. Although work-home conflicts might be considered a subset of work-life balance, the implications of this type of conflict are significant.
And yet, balancing your life is easier said than done.
Each of us has a different story. Personally, as a cardiologist I was able to find WLB, although it required a substantial degree of focus and dedication. While in practice, I wrote four books (admittedly health related), became a yoga teacher, and competed successfully with my horses. I also made time to travel and hike around the world.
However, these efforts were not without sacrifice: I had to give up significant income in order to take a half day off a week to train with my horses. And I usually chose to take most of my allotted (uncompensated) vacation time.
Finally, though I was fortunate enough to have an organized system of cross-coverage with my partners, the time off nevertheless meant that I was often catching up on EHR responsibilities late into the evening, sometimes even from the other side of the world.
Still, I believe the loss of income and long nights catching up on charts was worth it. Not only was my life richer, but my diverse experiences and friendships made me a more compassionate and open-minded physician. My patients were always curious about my adventures, and often felt more connected to me when they realized that I shared some of their own interests. And having the opportunity to “fill my cup” gave me more energy and enthusiasm for my work.
Your personal definition of WLB may change over time, depending on your personal commitments.
Admittedly, part of my ability to find WLB earlier in my professional life may be attributed to my decision not to have children, a situation that likely differs from that of many readers. My mother, a physician and parent of five, had a far more difficult time finding balance, and in truth I don’t believe that she was ever able to achieve it.
In the 21st century, there are more options for parents, but it’s still a complicated balancing act. If you’re a parent of young children, there are likely some hobbies and experiences that will need to be put on hold until the little ones are older. Instead, WLB for you may mean finding a way to create and protect family time.
So, how do you get started?
First, realize that there’s no shame in wanting or needing more. You signed up to be a doctor, but you may also be a friend, a spouse, a parent, or a curious human being who craves something new.
Next, create a plan that can get you the time and space that you need, while continuing to serve your patients and collaborate with your colleagues.
Below, I offer some things to consider while embarking on your new path:
Think about where you are in your practice. If you’re in training, achieving WLB for the duration of the program may not be a priority. If you are just beginning your career, it may take a few years to find your footing, and that’s normal. Whether or not they admit it, most physicians feel a little out of their depth when they first start out. Over time, you are likely to develop a range of practical skills that will make your day more efficient, leaving you with more personal time.
Realize that you might need to take a pay cut, or even a new position. If you need to take a regular day off, or even half a day, it may cut into your productivity. If you are not available, work may be shifted to your colleagues. Sometimes that’s welcomed, but many times it may not be. Weigh the risks, benefits, and the possible outcomes and make your decision from there.
Get help. It might cost you something, but could you benefit from a personal assistant, a babysitter, or a scribe? Just a few hours of help each week could free up important blocks of time that you could use to pursue a passion project, or to be more present for your family.
Consider your commute. Could you be using the time to enjoy an audiobook, catch up on CME, or learn something new? Or maybe even consider moving closer to work to create more free time in your day.
Learn to say no. Sometimes being on that committee or taking on a new project may be just the thing to move you forward professionally. But if you find yourself taking on more responsibilities than you must, realize that you are giving up the precious commodity of time.
Give up your perfectionism. Take just 10-15 minutes a day to get started on a new hobby, a quick yoga class on your iPad, or a morning walking meditation. You don’t have to go all in all at once.
Figure out where you’re wasting time. If you actually enjoy mindlessly scrolling your social media feeds, then maybe there’s no reason to stop. But if this feels like a compulsion, train yourself to put the phone away whenever possible and pick up a new project, go for a walk, or just sit with your family and read a book.
Sign up for a workshop. Take a couple of phone-free hours to learn something new about photography, bread baking, canoeing, knitting, bird watching, or anything else that catches your attention. No one will expect you to know what you’re doing, and you might discover a new passion and a new community.
Book a trip. Just go ahead and set a date perhaps six months out, put it on the calendar, and buy your ticket. The first step is often the hardest, but once you start, it’s easier for the rest to fall into place.
No matter what work-life balance means to you, realize that an ideal balance looks different for each person. It can change over the course of a lifetime.
The most important way to achieve it is to put your ideas into action. Your life will be so much richer if you consciously put in the effort, often in ways that you might not anticipate today. And you may find that in the process, you generate more joy, creativity, and resilience in your medical practice.
If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.
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