Managing Personal and Professional Lifestyles.

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Managing Personal and Professional Lifestyles.

• Matthew C Dorn MSIII
• 5-19-06
• VCOM

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The Dilemma

• In an medical environment that continually asks
  physicians to know more, do more and be more, is
  it really possible to practice good medicine and
  still have something left at the end of the day
  to be a mother, father, wife, husband, partner,
  son, daughter or friend?

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The Solution

• YES
• But IT TAKES SOME HARD WORK AND THOUGHT.

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• Unfortunately the question of balancing personal
  life with professional life is not a question
  many medical students or physicians consider
  until it is too late.
• Female physicians and medical students are much
  more likely to identify the issues of balancing
  ones profession with their family life.
• In one study done in Australia only 37 of the
  male medical students or residents identified
  that family issues were a major determining
  factor in career choices.

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• Choosing a medical discipline with controllable
  hours was once considered a career trend confined
  to women, who now make up nearly half of new,
  U.S. trained physicians.
• But new research shows that the trend is a
  generation-wide shift in attitude toward work,
  not a gender issue.

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So What?

• What if I dont care to balance my personal life
  and professional life? All that stuff will work
  its self out on its own.
• Statistics show that if one does not consider
  this question before marriage or a major life
  commitment to a partner one has a 50 greater
  chance of long term failure within that
  relationship.
• Long term relationships provide, companionship,
  love, acceptance, encouragement, support,
  guidance, friendship, joy, and happiness.

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Epidemiology of Marriage

• The CDC reports the National Average Divorce
  Rate 37
• Overall physician Divorce rate in all
  specialties 32
• Psychiatrist 51
• Surgeons 33
• Internist 24
• Pediatricians 22
• Pathologists 22

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Best Medical Specialties

• A 1990 study defined 16 specialties as
  controllable -- a field that allows more personal
  free time for family or pursuits outside the
  office -- or uncontrollable, a field where there
  is little free time. Experts today still use the
  definitions when discussing work-life issues in
  medicine.
• Controllable anesthesiology, dermatology,
  diagnostic radiology, emergency medicine,
  neurology, ophthalmology, otolaryngology,
  pathology, psychiatry
• Uncontrollable family medicine, internal
  medicine, general surgery, obstetrics and
  gynecology, orthopedic surgery, pediatrics,
  urology

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• Now we know the problem what is the
  solution??....

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Solution

• There is no one way to do anything. Likewise
  there is no perfect way to balance personal life
  with professional life.
• "There is no five-step plan it just takes hard
  work. Balancing your role as a parent and a
  physician is one of the most complicated issues
  in medicine right now because it gets to gender
  issues, generational issues, and how you
  construct a career that allows you to stay
  resilient, states Wayne M. Sotile, a clinical
  psychologist in Winston-Salem, N.C.

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The Keys for Balance

• Those in the know both physician-parents and
  industry experts agree that some keys to
  meeting the demands of balancing personal and
  professional life are
• Assessing personal values
• Choosing among career, family, and income demands
  
• Reconsidering the physician's traditional role
• Seeking the support of their practice partners
  and family
• Create outside support systems

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Assessing Personal Values

• More Money/Prestige or more time with family?
• Having a family means learning to set limits,
  says Jennifer Shu, a San Diego pediatrician.
• "One main reason I can say no to extra work is
  that my husband and I made a concerted effort to
  try to live below our means."

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Make Choices

• Choosing among career, family, and income
  demands.
• If you are able to make the sacrifice of a
  reduced income you will be more flexible to
  choose family over profession.

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Build A Support Network

• Ask for help and allow yourself to be helped.
  Get your children involved--work together as a
  team. Recruit friends, family, neighbors, bosses,
  work colleagues, etc. and ask for their support.
  
• Find other parents to help or hire a nanny to
  help care for younger children. Find help such
  as housekeepers, gardeners, etc. to help with
  household tasks. Create back-up and emergency
  plans always have a contingency plan.

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Building Support

• The healthiest physician marriages are those in
  which the family members understand there will be
  days when the duties of being a physician will
  intrude on family time.
• A 2001 study in the Journal of Applied Psychology
  found that incidences of depression, anxiety
  disorders, or substance abuse increased by two-
  to three-fold when work consistently interfered
  with family time. Yet, according to the study,
  which tracked nearly 3,000 men and women in
  several professions, those disorders were five to
  30 times more likely when family demands
  consistently interfered with work.

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Let Go of Guilt

• Guilt is one of the greatest wastes of emotional
  energy. It causes you to become immobilized in
  the present because you are dwelling on the past.
  Guilt can be very debilitating.
• Introduce logic to help counter-balance the
  guilt, you can stay better on course.

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Establish Limits and Boundaries

• Boundaries are an imaginary line of protection
  that you draw around yourself. They are about
  protecting you from other people's actions.
  Determine for yourself what is acceptable and
  unacceptable behavior from other people.
• Boundaries and limits define how you take charge
  of your time and space and get in touch with your
  feelings. They express the extent of your
  responsibilities and power and show others what
  you are willing to do or accept. Without limits
  it's difficult to say "no".
• For example, control the time you spend
  volunteering for schools, community
  organizations, your medical specialty, and your
  practice.

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Determine Your Own Standards

• Get rid of the notion of being a perfectionist.
  Start by making compromises--figure out where the
  best places to make the compromises are without
  short-changing yourself, your spouse, your
  children, your patients, etc.
• Live by your own standards rather than someone
  else's. Standards are about YOU and refer to the
  behavior and actions you are willing to hold
  yourself to.

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Create Time for Yourself

• Being a good parent, partner and physician means
  being good to yourself first.
• Use your mind to make some affirmations for
  yourself. Find ways to relax, relieve tension and
  minimize stress. Taking some time off for
  yourself will not only benefit you, but it will
  benefit your family tremendously!

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Time to do what?

• Spend time with children
• Spend time with spouse/partner
• Spend time with friends/family
• Spend time alone (exercise, recreation, hobbies)

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Get Organized Be Efficient

• Set priorities, work smarter not harder, delegate
  (and really let go!).
• Examples include, creating lists and saving them
  for re-use. Keep a main calendar centrally
  located to post everyone's activities. Using car
  time to talk and taking children along when
  making hospital visits.

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Plan Ahead

• Getting dates for work and family obligations as
  far ahead as possible in order to make plans and
  appointments.

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Live Close

• Living as close as possible to work and
  children's schools will help you save time and
  energy.

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Be Flexible

• Forgive yourself when things don't get done.
  Understand that things change at a moment's
  notice. Be ready and willing to assume
  responsibility for any of the tasks that need to
  get done at any time.
• Never get too comfortable, because as soon as you
  seem to get things under control, they change!

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Enjoy Quality Family Time

• Spend quality/focused time with your family. Give
  them your full attention. Develop rituals you can
  all look forward to.
• Create relationships with your spouse and
  children that are not incidental but rather
  instrumental to your success.

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Find Reliable Child Care

• Leave your kids in capable hands. Find someone
  you feel comfortable and confident in. If you're
  feeling ambivalent about working or about leaving
  your child, etc. do not show it--your child (at
  any age) will pick right up on it.
• Feel proud when you've found someone who fits
  into your needs. Get involved with your child's
  care providers by communicating frequently and
  observing interactions between caregiver and your
  child.

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Make Your Own Holidays

• As a physician you will invariably have to work
  on any and all holidays. Celebrate certain
  holidays before or after the actual day. Make a
  big deal as if it was the real holiday.
• Include the rest of your extended family in this
  as much as possible. By doing this, the rest of
  your family does not miss you being present for
  the special day and they get to share the
  experience with you.

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Achieve an Integrated Life

• Keep things in perspective. Create harmony in
  your life--a mixture of work, family and friends.
  
• Remember, there is no single formula for balance.
  It is a personal decision how one combines
  spouse, children, friends and career.

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What about the dual physician household?
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Dual Physician Households

• 1. Set Boundaries
• 2.Talk about work for limited time or not at all
  in evenings.
• 3. Establish a time set aside to just listen for
  10-20 minutes.
• 4. Dont feel guilty about bringing some work
  home just not too much.
• 5. Decide whose career takes primary role.

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Dual Physician Households

• 6. Designate primary care giver.
• 7. Make the kids proud of profession instead of
  treating the kids as 2nd class people.
• 8. Involve kid in day whenever possible.
• 9. Work on work at home with the rest of the
  family makes the homework a family affair.
• 10. Be creative while being active in kids
  lives. Example If you cannot make the dance
  recital then videotape the dance recital and make
  it a big deal to watch it with your child later.
  Write a note before going in to work in morning.
  

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Physician Advice

• "Be very realistic about the fact that medicine
  is a difficult career. It takes a lot out of you
  emotionally. If you plan to have children it's so
  important to have a support structure. You need
  to have family support or good childcare." - Kay
  Durairaj, MD
• "Trust your instincts and feelings about your
  choices. Children come when they come and you
  have to welcome them. Don't listen to people who
  say, 'Never have children during residency.' -
  Nancy Ryan Lowitt, MD

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Final Words

• In any medical family, there's no way to get
  around the fact that being a physician is going
  to have an impact on home and family life.
  Striking the right balance can be difficult, but
  it's not impossible.

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References

• Australian Medical Workforce Advisory Committee.
  Influences on participation in the Australian
  medical workforce. AMWAC report 1998.4. Sydney
  AMWAC, 1998.
• Warde C, Allen W, Gelberg L. Physician role
  conflict and resulting career changes. Gender and
  generational differences. J Gen Intern Med 1996
  11 729-735.
• Redling, Robert, Balancing Act Drs. Mom and Dad
  Juggle Two Tough Roles, Shands Practice
  Management 2002. http//www.shands.org/professiona
  l/ppd/practice_article.asp?ID253
• Croasdale Myrle, Specialty selection Men, too,
  seek work-life balance, American Medical
  Association, American Medical News, Oct 5th 2005.
• "The Controllable Lifestyle Factor and Students'
  Attitudes about Specialty Selection," Academic
  Medicine, 1990
• Waters Mel, So many hats, so little time, Journal
  of Applied Psychology, Vol 32 1 January 2001
• Smith R. Why are doctors so unhappy? BMJ.
  200132210731074.
• Kassirer JP. Doctor discontent. N Engl J Med.
  199833915431545.
• Murray A, Montgomery JE, Chang H, Rogers WH, Inui
  T, Safran DG. Doctor discontent. A comparison of
  physician satisfaction in different delivery
  system settings, 1986 and 1997. J Gen Intern Med.
  200116452459
• CDC Divorce Statistics, 2004.

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Thank You. Questions???