Focus on Physicians:
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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 Find Your Creative Spark: A Guide for Physicians
As physicians, we learn to practice from an evidence-based standpoint, checking the data, keeping up with the literature, and following carefully researched guidelines. But as crucial to good patient care as this is, providing the best care requires the ability to go deeper, connecting a series of disparate dots, asking probing questions, and creating trust.
Having your own creative practice can stimulate this stronger connection by giving you tools and insights that come from a less rigid view of the world. And at the same time, creativity can be a refuge, offering an escape and a form of mindfulness that is often difficult to access in our precision-driven world.
As physicians, we learn to practice from an evidence-based standpoint, checking the data, keeping up with the literature, and following carefully researched guidelines. But as crucial to good patient care as this is, providing the best care requires the ability to go deeper, connecting a series of disparate dots, asking probing questions, and creating trust.
Having your own creative practice can stimulate this stronger connection by giving you tools and insights that come from a less rigid view of the world. It’s not suprising that a British study found that people who engaged in creative activities at home were more likely to discover creative solutions to problems at work.
And at the same time, creativity can be a refuge, offering an escape and a form of mindfulness that is often difficult to access in our precision-driven world.
You don’t have to have talent or special skills to begin a creative practice. It can be something that you do for yourself alone. But once you get started, you may find that your imagination awakens, opening your mind to new techniques and ideas that might never have occurred to you if not for this artistic exploration.
In this article, I’ll discuss how you can awaken and nurture your inner artist.
1. Just Get Started
Do the work. It sounds simple, but overcoming inertia can be the hardest part. You don’t need a grand plan, a fancy camera, or a fully equipped studio. Just begin and set the wheels in motion. Your first step doesn’t have to be perfect; it just has to be taken.
2. Embrace Imperfection
Check your perfectionism at the door. For people immersed in the creative arts, imperfection is not just accepted; it’s often celebrated. Express, explore, and learn. Give yourself the freedom to make mistakes and be messy. This is a crucial part of the creative journey, and it’s how new ideas are generated.
3. Inspiration Appears While You’re Working
Waiting for inspiration is like waiting for the perfect moment – it rarely comes when you're idle. To borrow a phrase from mindfulness meditation, creativity is about being in the now. As Picasso is famously quoted, “Inspiration exists, but it has to find you working.” The muse, that elusive spark of creativity, is not impressed by your aspirations. She finds you when you’re in the messy midst of creation.
4. Set Aside Time for Creativity
Schedule your creative time just like you would for any appointment. Whether it’s 30 minutes a day or a few hours once a week, having a dedicated slot for creativity can open windows in your mind and give you room to explore. If it feels overwhelming, commit to simply 10 minutes each week, and see where that takes you.
5. Explore Different Creative Avenues
Creativity means different things to different people. You might enjoy writing, while someone else might find solace in painting, dancing, or playing an instrument. Simply wandering around intentionally with your phone’s camera can be a form of creative play. If you have time, taking a weekend class in pottery or some other art form could be a fun place to start. If you’re not sure how to start, experiment with different forms of creative expression to find what resonates with you.
6. Join a Creative Community
There's something magical about being part of a community that shares your passion. Look for local art classes, writing groups, photography clubs, or online forums. Share your work, get feedback, and enjoy the collective creative energy. These communities can offer support, inspiration, and a sense of belonging. And unlike your practice as a physician, no one will expect you to be perfect or have all the answers.
7. Pause, Reflect and Adjust
Every now and then, take a step back and reflect on your creative journey. Stay curious. What have you learned? What do you enjoy the most? Where has your creativity taken you? You might choose to keep a creative journal to celebrate your milestones, explore the unexpected detours, and maybe even recalibrate your goals.
Integrating creativity into your life isn’t just about producing something; it’s about the process, the joy, and the journey of self-discovery it brings. It can be a form of meditative practice, and an escape hatch from the rigidity of a schedule and a task list.
As a physician, you have a unique perspective of the world, shaped by your experiences and the people whose lives you’ve touched. Infusing this perspective into your creative endeavors can lead to something unexpected, tangible, and uniquely yours. By exploring your creativity without self-judgment, you may find that the insights you discover enrich and deepen your relationships with others, including your loved ones, patients, and colleagues.
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.
And if you’d like to schedule a complimentary coaching discovery session, click the button below.
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.
And if you’d like to schedule a complimentary coaching discovery session, click the button below.
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