One of the most common complaints we hear about from doctors is that they never have the time they would like to have with their families. And it’s true.
I once heard someone say, “Practicing medicine is like a jealous lover. If you give it a Saturday, it will take Sunday and nights and holidays. It will take, take, take, but never give back the time it takes from you.”
Research shows that physicians in the U.S. work an average of 51.4 hours every week, which translates to working more than 10 hours each day in a traditional five-day week. Take, take, take.
Of course, most physicians’ don’t expect to work Monday to Friday from 8 am to 5 pm with a one-hour lunch break, plus the de rigueur 15-minute morning and afternoon coffee break. We’re all aware that if that’s the kind of work schedule we were looking for, none of us would have signed up to become a doctor!
But with nearly one in four (23.5%) doctors working 61-80 hours each week, it’s hard to get the quality time we want with our families.
The Idea of Work-Life Balance
The idea of a work-life balance came into play in the 1970s and 80s. Stressed Baby Boomers felt a need to balance careers, family, and other areas of their lives. Following generations have tweaked the understanding of what this idea means to align with their specific priorities.
According to Forbes, Generation X focused on the balance aspect — taking advantage of remote working trends and using PTO to focus on family and work outside the office. Now that millennials are rising through the professional ranks, Forbes reports:
“…they are more interested in finding a career path that will support their’ lifestyle,’ which in this context means their life outside of work.”
An American Medical Association survey concluded that 92% of doctors 35 or younger felt strongly that having a work-life balance was important. In addition, female physicians reported the goal of achieving this balance affected their career choices.
But as a physician, work-life balance can sometimes seem like an unattainable luxury — how can you justify taking time off when you have patients, labs, and referrals to handle? Moreover, having time off is often difficult — even if you have a day out of the office booked, you could get an urgent call about a patient, receive lab work that needs to be followed up on right away, or get called into the ER to cover a co-worker’s shift.
In medicine, anything can happen, anytime — and some doctors don’t even think a work-life balance is reasonable to work towards.
Statistics show an increase in the numbers of female physicians in the United States, with females representing 52% of medical students and 46% of residents in 2018–2019. However, research suggests that there has been little change for females regarding domestic tasks and responsibilities.
Missing important life events like birthdays, dance recitals, or soccer games is painful. More and more doctors are determined to find ways to make time for the milestone events that matter in their personal lives with their families and friends.
The Reality of Burnout
Beyond their working hours, surveyed physicians identified their demanding workload as a reason for feeling that they can’t balance their work and life priorities. Unfortunately, when you’re hardwired to be the doctor who delivers the three “A’s of physician excellence”‘ — able, affable, and available — available is often the easiest to perfect.”
Without enough time to complete it, a large workload does more than impact any attempts at a work-life balance. It’s also been identified as a key driver of burnout. And it’s no secret that the number of doctors reporting burnout has never been as high. Described as an epidemic in the U.S. healthcare system, 44% of physicians report emotional exhaustion and depersonalization at least once a week.
The World Health Organization classifies burnout as an occupational phenomenon. It is not classified as a medical condition or a psychiatric disorder but is a measure of chronic distress associated with your job.
This is especially true when your “To Do” list has gotten out of hand. It is even more true when the work piling up isn’t related to seeing patients; it’s more about heavy paperwork or administrative demands and staff meetings or training sessions.
While physicians of either gender are at substantial risk of burnout, it is more common among female physicians. They also show higher rates of depression, even suicide, than their male colleagues. In addition to their professional lives, female physicians are also more likely to take on household and childrearing responsibilities, affecting attempts to gain a work-life balance.
According to the National Library of Medicine, the three critical components of burnout are:
●Becoming easily irritable or depressed due to emotional exhaustion
●Usual empathy is replaced with cynicism, negativity, and feeling emotionally numb
●Feeling a low sense of professional and personal effectiveness
A small upside to suffering from burnout is that it doesn’t happen with the flip of a switch. Coming back from burnout and working towards a work-life balance is possible, and freeing up more time to spend with your family is attainable.
What’s Stealing Your Time?
The most significant factors in work-life balance are workload,workflow, and scheduling – the amount of work you need to do, the staff available to handle it, and the times you’re required to work.
Doctors often report that more work is added within the same time frame, making it unreasonable to accomplish. The always-present demands of paperwork — preparing or completing charts, reviewing tasks, answering emails and phone calls, etc.- go home to be done before hours, after hours, nights and weekends.
One doctor reported spending at least 75% of their day doing things that didn’t require a medical degree!
Another of the major challenges to physicians’ work-life balance is the number of hours they’re required to work – 24 hour on-call shifts are different from 9-hour workdays on a standard week, but both will take a toll on the amount of time you have to spend time with your family.
In addition to long shift times, one team member’s desperately needed vacation time often results in an increased burden on the remaining staff members. Not only does this tax the staff, but it also makes the vacationing doctor feel guilty about taking time off!
Work-related activities are another obligation that can creep into physicians’ personal time. For example, having meetings, training sessions, or other required attendance events outside of normal working hours steal time from your personal life.
So, What’s the Answer?
I’ve thoroughly painted a picture of what stands between the average doctors’ schedules and their desire to spend more time with their families. Now it’s time for some helpful suggestions on how to go about freeing up some of that time!
It comes down to three activities:
1.Be clear about what you want
2.Take inventory of your time
3.Cut out what doesn’t work for you
1. Be Clear About What You Want
Michelangelo famously said:
“The greater danger for most of us lies not in setting our aim too high and falling short, but in setting our aim too low, and achieving our mark.”
Until you are clear about your personal life goals, it’s very difficult to develop a strategy to achieve them. When it comes to managing your time, this is especially true. Rather than simply saying you want more time with your family, be specific about what kind of time and when.
That’s not to say that specificity is like having a genie grant your wishes but being vague certainly doesn’t get the job done! And just because you can’t make every change at once doesn’t mean you can’t work towards your end goal.
Physician Making Specific Goals
Below are some questions to ask yourself to help clarify your personal goals. Different seasons of your life will provoke different answers. When you’ve just (and finally) finished med school, a high priority may be to clear up as much of your student debt as possible. When you want to start a family, priorities will naturally shift and become more about having extra time.
The natural first question is:
●What’s my current priority? Having time or making money?
If your answer is making money, I’ll deal with that in a future post! But, if your answer is having time, here are some more questions to ask yourself:
●What’s currently causing me stress or unhappiness?
●How is that affecting my work and personal life?
●What am I prioritizing? What am I losing out on?
2. Take Inventory of Your Time
Our work administrators, and patients (and our families), may track our time for their own needs, but it often doesn’t occur to us to take this same crucial step. In any budget process, it is crucial to determine where our resources are spent to create a realistic and achievable budget in the future.
The first step in gathering this information is to log your time for a week or more. Consider using an Excel or Google Sheets spreadsheet to monitor where and how you spend your time for a week.
Once you’ve filled out a week’s worth of activities, divide your notes between work and personal. It’s as important to take an inventory of how you spend your personal time as it is how you spend your work time.
Now comes the fun part. Perhaps. For some of you. Build categories that can group together similar activities. For instance, when it comes to work categories, they may look something like these:
●Direct patient care: clinic, operating, rounding
●Clerical tasks: paperwork, phone calls, emails
●Administrative tasks: staff meetings, hospital committees
●Academic work: teaching, reading, lectures, continuing medical education
●Societal activities: committees, conference calls
Also, make sure to look at how much time “away” from work you are still working: checking on patients by phone, email, or computer, doing academic or administrative work at home. It is essential that you be honest in your assessment of your time.
Do the same for your personal time:
●Sleeping (most of us don’t get enough)
●Home care: cooking, grocery shopping, cleaning, dog walking, running errands
●Child care: chauffeuring, sports activities, extra-curricular activities
●“Down” time: reading, journaling, tv, and other screen time
Once you have completed this day-to-day analysis, start to map out your time annually. Dig into how many days you give to clinic time, operating, and administration. Do you use all of your vacation days, CME days? How are you using them?
Sometimes, it is enlightening just to realize where the time you’re spending is well spent and where you’re wasting it. A surprising amount of time gets used between activities and is unaccounted for. Being aware of this and making the time more useable may help improve your time budget, even before implementing any changes.
3. Cut Out What Doesn’t Work For You
Now that you have your detailed (and honest) inventory of how you spend your time, you’ll probably see that you’re doing work of one kind or another that doesn’t let you spend more time with your family.
Sometimes it is clear as day which activity doesn’t help achieve your goals, and sometimes it’s a little more elusive. Two questions I always ask myself when it comes to cutting out what doesn’t work for me are:
●Does this serve me?
●Can I delegate it?
These two questions cut right to the heart of my priorities and, whether I like it or not, reveal activities that I may need to cut out or delegate. If you’re like the rest of the human race, you may be surprised to find how much time you spend on activities that kill time but don’t align with your purpose. Streaming seasons on Netflix comes to mind.
The time we spend on some activities needs to be cut down, if not cut out. However, there are more activities that can’t be eliminated but may not need to be done by you. And this is where delegation comes in.
For many of us, by the time we reach an age where spending time with our family outstrips our paycheck to paycheck lifestyle, investing some of our resources into delegating activities that can be done by someone other than us is a wonderful investment.
Getting help with personal chores like cleaning, shopping, food prep, and many other things is one of the quickest ways to reclaim more time for the important things in life.
That help doesn’t need to be limited to our personal lives. Perhaps hiring a medical records clerk, lab tech, or someone who can do our data entry would also be appropriate to buy back time. Spending money to buy time can be one of the most significant ways to free up your schedule.
Along the way, I’ve also come to realize that letting go of the notion that my life should be Instagrammable is another way to free up time. I’ve learned to let go of the spirit of competition that started when I worked hard to get good grades for college, better grades for medical school, and competed for the residency and subspecialty I wanted.
I can now say “no” when I need to and say “yes” to what truly matters to me and my family. I can take care of myself in ways that truly nourish me, and I’m grateful every day for the life I have.
“Be stubborn about your goals and flexible about your methods.” – William A Donohue
Managing Interpersonal Conflict
If you’d like to learn the secrets that led me to this place in my life, I’d be more than happy to talk with you. I started EntreMD to share with doctors how to build a profitable business, so they can live life and practice medicine on their own terms. So send me an email, and I’ll be sure to respond!