I glanced at my timepiece: 10:30 p.m. Almost done. My last patient note was signed, all my assigned electrocardiogram and transthoracic echocardiograms had been interpreted. Then I remembered. I had an ill patient on the cardiology floor. Perhaps, it wouldn’t hurt to swing by the inpatient ward, talk to the nurse and review the patient’s telemetry one more time. As I climbed up the stairway to the cardiology unit, I rationalized that it’d only take five minutes and then I’d go home. As I reviewed the patient’s telemonitor, a floor nurse called out to me in surprise: “Doctor, what are you still doing here? Go home.” I realized the nurse was right. It was time to go home.

As I drove home, I reflected on my frequent late nights at work, and realized that I’d inadvertently allowed the balance of my life to shift heavily towards the workplace. As a friend remarked to me, I was practically living in the hospital.

Work-life balance is an interminable topic among physicians. It describes the employee’s perception of the equilibrium between personal and work life.¹ Work-life balance affects physician satisfaction with their quality of life, affects the quality of patient care and patient satisfaction, and ultimately affects physician burnout, physician turnover intention and physician migration from one clinical practice to another, which impacts patient access to care.^2,3

There probably isn’t a “one-size-fits-all” approach to the topic of work-life balance. Regardless of gender or social status, we all need to listen to our inner compass and recognize when the needle persistently swings disproportionately towards work and considerably away from our concept of life-outside-of-work.

Although ‘work’ may have a universal/clear definition, the definition of ‘life’ may vary from physician to physician. Personal and family circumstances vary over the years and affects demands on time as well as preferred ratio for work and life balance. Several studies suggest that men are usually more satisfied than women with work-life balance.^2-5

Consequently, there probably isn’t a “one-size-fits-all” approach to the topic of work-life balance. Regardless of gender or social status, we all need to listen to our inner compass and recognize when the needle persistently swings disproportionately towards work and considerably away from our concept of life-outside-of-work.

For the Early Career physician, maintaining work-life balance can be tricky due to the transitions within this phase in the career cycle. The Early Career physician is faced with the challenges inherent with starting a new job and building a viable clinical and/or academic practice and potentially the stressors involved with relocating self and family to a new city. Here are some tips to help maintain a healthy work-life balance.

• Set boundaries. Define your work-life boundaries and as much as possible adhere to them. Your colleagues will follow your lead and respect your boundaries. Creativity may be required on your part to ensure maintaining these boundaries. For instance, you might establish a set time early in the morning for research writing (work) and a set time for dinner with your family (life).
• Set goals. Define your career and nonwork/life goals. This will help you track your progress in both these spheres and ensure that you are devoting adequate time to both.
• Learn to say “no.” Don’t feel obliged to accept every offer or ancillary responsibility at work. Assess whether the offer helps you to meet your goals. Be mindful of your current position with the work-life pendulum. Before saying yes to additional responsibilities, respectfully request time to reflect. During the first few months post-graduation, this might help prevent burnout during the transition from trainee to attending physician. Mistakes happen — if you’ve taken on more responsibility than you can handle, keep the communication channels open.
• Delegate. Discuss options for delegation in the workplace and at home. Use your work team to delegate responsibilities as appropriate. Carefully consider professional assistance with life outside of work — nannies, housecleaning services, online shopping and delivery services.
• Redefine your work schedule. In certain circumstances, a flexible work schedule may be an attractive option for the physician while maintaining full-time employee status.⁶ Speak with your colleagues and hospital administration regarding potential options for flexibility in your work schedule.⁴ Alternatively, a part-time work schedule may be considered.
• Make time for life. Think of your cardiology career not as a sprint, but a marathon. Train/work hard, but pace yourself. Take scheduled breaks such as vacation and regularly engage in nonwork related activities to rejuvenate yourself. Network with others within and outside work.

Occasionally, the pendulum may temporarily swing heavily towards work or life. This can occur during a job/project deadline or major life event. It’s okay to live in those moments, with a plan to restore the work-life equilibrium once the event is over. Life is a journey. Embrace the moments. Live life to its fullest. Our service to our patients and our profession is enhanced when we take time to look after ourselves.

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References

1. Kansas Workforce Initiative Evidence Review. Work-Family Conflict and Family-Work Conflict. Available here . Accessed April 9, 2018.
2. Dyrbye LN, Varkey P, Boone SL, et al. Mayo Clin Proc 2013;88:1358-67.
3. Lu Y, Hu XM, Huang XL, et al. BMJ Open 2017;7:e014894.
4. Shanafelt TD, Noseworthy JH. Mayo Clin Proc 2017;92:129-46.
5. Lachish S, Svirko E, Goldacre MJ, Lambert T. Hum Resour Health 2016;14:62.
6. Treister-Goltzman Y, Peleg R. Isr Med Assoc J 2016;18:261-6.

Keywords: ACC Publications, Cardiology Magazine, Workplace, Personal Satisfaction, Burnout, Professional, Hospital Administration, Creativity, Patient Satisfaction, Inpatients, Work-Life Balance, Goals, Quality of Life, Physicians, Personnel Turnover, Perception, Research, Patient Care, Telemetry, Writing, Electrocardiography

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