Rethinking Work-Life Integration: When Work Takes Over Your Personal Life

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.

Maximize Efficiency and Achieve Work-Life Balance: The Time Priority Matrix for Physicians

Do you ever finish the day feeling as if the time raced by, but instead of making progress on your goals, you’ve just been putting out fires?

With a constant surge of urgent issues, combined with your daily responsibilities and opportunities, it can be challenging to prioritize effectively.

Using the Time Priority Matrix can help you to visualize not only where but how you are spending your time. By categorizing your daily activities, you will discover how your attention is being directed, and where you might be able to streamline and optimize the way you use this most valuable and limited resource.

This tool is also known as the Eisenhower Matrix. Former US President Dwight D. Eisenhower didn’t create the idea, but he famously referenced Dr. Roscoe Miller, a former president of Northwestern University, when he said: "I have two kinds of problems: the urgent and the important. The urgent are not important, and the important are never urgent.”

The matrix was subsequently popularized by Stephen Covey in his landmark book The 7 Habits of Highly Effective People.  It’s something that’s often taught to business leaders, but the concepts can easily be applied to physicians and anyone else seeking to take back some control of time and attention.

How to Use the Time Priority Matrix

Quadrant I tasks are both urgent and important. Ideally these are limited, but as a physician, these tasks are part of daily life.

The critically ill patient, the urgent report, the call from a worried family member. Often these issues are out of your control. But sometimes there is a way to mitigate the urgency, and that's where Quadrant II comes into play.

Quadrant II: Preparation, planning, and prevention fall into Quadrant II. By working in this quadrant, you anticipate and trouble shoot before trouble arises. That's what preventive care is all about.

You can also apply this idea to your own life. For example, if you're studying for your boards, taking a set amount of time every day for a few months will get you much farther ahead than waiting until the last couple of weeks to study. And learning a new skill or technique and making the time to practice it will ensure that when you need it, you'll be more confident and prepared.

Building trusting relationships with patients and colleagues also falls into Quadrant II. By taking the time and putting in the work at the outset, you’ll build trust and confidence. Ultimately that will enhance your ability to provide care more efficiently and collaboratively.

Work in this quadrant might not always be exciting or immediately fulfilling, but it will keep you on track to accomplish the goals that are meaningful to you.

You can apply Quadrant II ideas to your personal life as well. Think about your relationships, family, and other interests. What can you do to ensure that the things that matter to you outside of work are cared for and able to flourish?

Quadrant III is more problematic. In this quadrant, you're dealing with things that are not particularly important, but which require some urgency to complete.

As a physician, you're probably all too familiar with this quadrant. Interruptions, EHR redundancies and pre-authorization inefficiencies that have to be addressed are daily if not hourly occurrences. Some meetings and much email fall into this category.

Sometimes it can help to work on these things in "chunks" so that your attention is focused and you can be more efficient. This is known as task batching, and it can be a highly effective way to clear out some of the clutter that routinely piles up. Making it clear that these non-urgent issues will only be addressed on a certain day at a given time is one way to not only set boundaries but to limit interruptions.

Delegating whenever possible is an important aspect of Quadrant III management. For example, can someone else be assigned to fill out routine paperwork, leaving only the physician-specific sections for you to complete? Perhaps staff can be empowered to respond to simple patient requests for notes or documentation, or to schedule a visit when it’s clear that a non-urgent call or message requires more than a simple response.

Quadrant IV is where you have the greatest likelihood of clearing out some time and space. Mindless scrolling, low-value emails, watching random TV shows, and stressing over social media are good examples of this quadrant's activities.

Sometimes you need a little downtime, but being cognizant of how you are spending it may help you to gain some well-earned margin for the things that matter most to you.

It can be a great thought exercise to think through the way you are using your time. The Time Priority Matrix is a valuable tool that can help you to manage your workload and your personal life more effectively. By identifying and prioritizing tasks based on urgency and importance, you’ll have a tool that can enhance your productivity, improve patient care, and help you achieve a healthier and more fulfilling work-life balance.

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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.

Getting Unstuck: How a Simple Mind Shift Can Move Your Life Forward

If you’re a physician, you’re probably juggling patient care, administrative tasks, and personal responsibilities like a boss. But when you feel the need for something beyond the daily routine, it can feel daunting.

Whether it’s getting up to speed with a new procedure, launching a research study, trying to get some time for self-care, or considering making a complete change of practice or location, it’s easy to feel like you’re stuck in an endless loop, unable to break free.

In my practice as a physician coach, I frequently encounter these common challenges. It can seem overwhelming from the inside looking out. But there is a way through, and it begins with understanding why you feel stuck.

In this article, I’ll explore common reasons that physicians feel immobilized, and I’ll offer you some strategies that will get you moving forward with purpose.

Break the Cycle of Repetition

Doing the same thing over and over, expecting different results, is not only the classic definition of insanity but it’s also a common trap. Whether it's procrastinating on completing notes, avoiding difficult conversations, or never saying no, these habits can perpetuate your feelings of frustration and stagnation.

Routine can be comforting, since you know what to expect, but it may also be a barrier to growth. When you’re caught up in an endless cycle of repetitive tasks, it’s easy to lose sight of what matters the most to you.

Strategy: Starting small can open up a crack that allows you to see a little more light. As simple as it sounds, begin by introducing small changes in your routine. This could mean taking a different route to work, setting aside just 10 minutes a day to walk or stretch, or incorporating new learning into your practice. Sometimes, the smallest adjustments can lead to significant shifts in perspective and outcomes.

Spring Free of the Inaction Trap

If you don’t take action, you will not get yourself unstuck. It’s that simple. But the fear of making the wrong decision often squashes the potential for change. That doesn’t mean it’s not important to think through your decisions. Be thoughtful and judicious, but don’t get stuck in an infinite cycle of analysis. Realize that taking action can mean taking the smallest of steps.

Strategy: Embrace the concept of ‘progress, not perfection.' Understand that inaction is a decision in itself, and it can be more harmful to your wellbeing and your future opportunities than making an imperfect decision. Start with very small, manageable actions that align with your goals and gradually increase the stakes as you build confidence.

Unaddressed Issues

Not dealing with problems as they arise means that they are given free rein to accumulate. Eventually these unresolved issues may begin to feel overwhelming. And as a consequence, this drag on your energy will make it harder to move forward. Whether it's patient care issues, administrative challenges, or personal matters, avoiding problems doesn't make them disappear.

Strategy: Commit to a proactive approach. Tackle important issues as they arise. You don’t need to solve every pressing problem on the fly. But by putting it in its place, it won’t be overlooked. That could mean delegating, scheduling committed time to address the issue, or even saying no. This not only prevents important issues from escalating but also builds a habit of facing challenges with purposeful action.

The Burden of Incomplete Tasks

Like unresolved issues, incomplete notes and tasks can be a significant source of mental load, leading to a feeling of being perpetually behind and unable to move forward. This is a very common issue for physicians, and one of the most important ones to get a handle on quickly. Your own well-being as well as your patients’ care depends on it.

Strategy: Get those notes done. Use templates, smart phrases, and any other resources available to you to make your notes concise, accurate, and useful. Prioritize and delegate the other tasks crowding your in-box. Addressing each task once and moving on, keeping your responses brief and succinct will help you get through your list. Consider adopting time management techniques, such as the Pomodoro Technique or time-blocking, to efficiently tackle your workload.

The Value Dilemma

Objectively, you probably know you’re valued. Despite the turmoil that many physicians face every day, your patients need you, and the work you do makes a difference.

But it’s easy to undervalue yourself, undermining your self-confidence. You’re not alone. Not believing in one’s own value is a common issue that affects how many doctors perceive their abilities and their worth. And as a result, you may miss opportunities, fail to stand up for yourself, put up with toxic working conditions, or take on projects that go against your won best interests.   

Strategy: Practice self-reflection and affirmation. Remind yourself of your achievements and the unique value you bring to your patients and the medical field. Journaling can be a very useful exercise. Keep a folder or a box with notes from patients and others who express appreciation and give yourself a few moments to revisit this when you’re feeling down.

Seek feedback from peers and mentors when you need it and consider engaging with a coach to build self-confidence and set achievable and meaningful goals.

Conforming to Expectations

Playing to other people's narratives is a common trap that can lead you down a path that doesn't align with your values or aspirations, leaving you feeling stuck in an unfulfilling or ill-fitting role. This is another theme that plays out for so many physicians. It often begins with family expectations, and it may eventually become a way of life.

Strategy: Define your own success. Take time to reflect on what success means to you, independent of anyone else’s expectations. Setting personal and professional goals based on your values and aspirations will ensure that your actions align with who you are and how you want to live your life.

Moving Forward

Feeling stuck doesn’t have to be a way of life. By understanding the underlying reasons and adopting targeted strategies, you can navigate your way out of the quicksand of stagnation.

Take the time to understand your value and remind yourself of the resilience that got you this far. Think of change as a catalyst. Create and then begin to implement a plan to take action, one step after another. Remind yourself that fulfillment is a process that can lead to unexpected growth and opportunities.

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

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)

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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.

Thomas Nordwest, CC BY-SA 4.0 <https://creativecommons.org/licenses/by-sa/4.0>, via Wikimedia Commons

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.

Starry Night, Vincent van Gogh, 1889. Public domain, via Wikimedia Commons

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.

And if you’d like to schedule a complimentary coaching discovery session, click the button below.

References

Fallon-O’Leary, D. Work-Life Integration Is the New Work-Life Balance. Is Your Team Ready? CO. July 2021.

McManus, I. Symmetry and asymmetry in aesthetics and the arts. European Review, October 2005.

Meyer, I. Balance in Art – Exploring Different Types of Balance Artworks. Art in Context. August 2023.

Saley, C. Survey Report: Millennial doctors still finding jobs the old-fashioned way. CompHealth Blog. April 2018.

Vincent van Gogh, The Starry Night. MOMA.org , 2019.

Why Are We Afraid to Talk About 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:

1. 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.

2. 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.

3. 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.

4. 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.

5. 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.

6. 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.

7. 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.

8. 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.

9. 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.

And if you’d like to schedule a complimentary coaching discovery session, click the button below.

References

Colville, G et al. Coping with staff burnout and work-related post-traumatic stress in intensive care. Pediatric Critical Care Medicine. July 2017.

Dyrbye LN et al. Work-home conflicts have a substantial impact on career decisions that affect the adequacy of the surgical workforce. Arch Surg. 2012 Oct.

Eschleman, K.J. et al. Benefiting from creative activity: The positive relationships between creative activity, recovery experiences, and performance-related outcomes. J. Occup. Organ. Psychol. April 2014.

Saley, C. Survey Report: Millennial doctors still finding jobs the old-fashioned way. CompHealth Blog. April 2018.

Saley, C. Survey: Work/life balance is #1 priority in physicians’ job search. CHG Healthcare. March 2022.

Sexton JB et al. The associations between work-life balance behaviours, teamwork climate and safety climate: cross-sectional survey introducing the work-life climate scale, psychometric properties, benchmarking data and future directions. BMJ Qual Saf. 2017 Aug.

Shanafelt TD et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. October 2012.