Is work-life balance for physicians a unicorn?

This discussion is something I’ve tossed around in my head for awhile.  As I have gone back and forth on the topic, I decided to debate myself while I answer the question:

Is work-life balance a real thing?  If so, what is it and can it be achieved, specifically in a demanding field such as medicine that often expects your job to be your life?

In this corner: Cynical Rogue Dad

Of course, it’s a myth.  As a physician, you must immerse yourself and give yourself to medicine in order to be a good doctor.  If your focus shifts from medicine, you will either hurt your patient or hurt your career.

Let me tell you a story.

When my wife was pregnant with Rogue Two, I was a new faculty member at my university.  I was facing an important grant deadline.  Applying for this grant was important enough to my boss(es) that applying for it was even written into my new faculty contract — we stipulated reduced clinical time to work on the grant.

My wife went into labor two weeks before it was due (the contract was signed months before she was pregnant).  The night she began having contractions, I was up late working on a draft of the grant to circulate to my mentoring group.

Her labor took a long time to progress with Rogue One, so when she came downstairs having contractions, and I was working, she told me to finish the draft of my grant and then we would go to the hospital.

I finished the draft of the grant, emailed it, and we went to the hospital.  She had a healthy baby boy.

The grant was still not finished, so I spent a good chunk of my “paternity leave” finishing and submitting the grant.  I stayed up late writing the grant (and helping with our son).  Rogue Two was even readmitted to the hospital for jaundice and phototherapy during this time.

I was exhausted in every possible way, but I submitted the grant on time.

Medicine is an increasingly complex field, and it’s become ever harder to have the knowledge base to provide up-to-date medical care, let alone the ability to conduct research at a high level.

Not only are physicians increasingly expected to know and apply a firehose of evidence, but the surgeons/proceduralists must continuously advance and refine their skills.

When you are a full-time physician, married with kids, what does balance mean?  When you leave work, your life belongs to your spouse and kids.

The bosses don’t want balance — they want productive workers. Anything they toss our way for “balance” is really a crumb to keep us from quitting.

There is no such thing as balance.  Just priorities, shifting moment to moment, with a constantly rearranging hierarchy.

In this corner: Zen Rogue Dad

That’s depressing.  No wonder you are a cynic.

I should remind you — that grant you applied for when Rogue Two was born?  You didn’t get it.  Also, you weren’t exactly doing a great job of parenting either.

Yes, it is all about priorities.  However, if your priorities are out of whack, then you clearly can have an imbalance.  If an imbalance can exist, then balance must be achievable as well.

Let me tell you a story.

Last year, my wife was pregnant with Rogue Three.  I was taking the board exam for a new specialty (clinical informatics) — I had to study for it on my own. I didn’t do a fellowship or a masters program to prepare — it was almost all self-study. The exam was notoriously hard — more difficult than any of the regular medical board exams.

My wife went into labor a couple of weeks before the exam.  When it was time to go the hospital, we didn’t delay so I could study.

We had a healthy baby boy.

Yes, I studied at home on paternity leave.  A few hours a day, when nothing else was going on.  I did not stay up late to study, because we were being kept up enough by three Rogue children.

That exam?  I passed, despite sleep deprivation and only having a fraction of the time to study compared to what I would have done in the past.

This blog?  It’s something I started despite having three kids, and a full-time job, and a working spouse.  It’s been a source of enjoyment and something I can spend time on when I’m tired.  It provides me a boost of mental energy even when I’m tired.

While I often am up late because of an ER shift, that’s about the only time I’m being productive (for my “day” job) after 10 p.m.  Working on grants, emails, papers, etc. late every night is something I can do (and am still guilty of on occasion), but rarely to good effect.

While I strive to be good at my job, there is not only a point of diminishing returns; there is a point of negative returns.

While there it seems like there is always another birthday party or another kids soccer practice, those truly are finite.  Rogue Three is very different than his brothers, but the only way to appreciate it is to see him.

And I don’t know about your bosses, but the good ones really do care about their employees being satisfied with life outside of work. Even the cynical bosses should know that keeping workers content will save money by reducing turnover and increasing productivity.

Unfortunately not every job is a good one, and not every boss is either.  Why do you think so many people are trying to reach FIRE — financial independence/retire early?  They feel imbalanced.  Even many people who enjoy their jobs have decided they want more than to achieve the next work objective.  They’ve assigned “priorities” that are important to them, and that means working in the way they want to work and for the goals that are meaningful to them.

“Rogue Dad, MD” is a physician who blogs at his self-titled site, Rogue Dad, M.D.

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