Even the Hortons, who have no children yet, have shaped their careers to fit their future family. Miranda Horton says she truly wanted to be an internist, but she also chose it because “it’s a good choice for making a two-doctor family work.” Indeed, she works Monday through Friday, and does no admitting. Kyle Horton, although currently a hospitalist, plans to specialize in endocrinology, which Miranda Horton likes because call will be rare or nonexistent.

Try to stay flexible and open-minded with your work arrangements. Eighty percent of the nonphysician spouses in one-physician couples also work. Certainly, their careers matter, too. The more you two can work as a team in support of common familial goals, rather than two people on parallel career tracks, the better.

So no, being a medical family is not easy. You might miss seeing your son finally score his first soccer goal, or your husband graduate with his MBA. Every time something like that happens, you’ll probably feel guilty. Who wouldn’t? But rest assured, if you’re doing all you can to be mindfully present when you’re with your children and spouse, they’ll know it.

“If I mention that Mom won’t be here for dinner, there’s moaning and groaning, but we deal,” says Gertler. And it’s OK, he says. “[Doctors] should know that even though their hours or specialty can put a burden on the family, we admire and support the work that they do. They’re being a part of the family and the community in the best way they can.”

Elaine Hale concurs. “You actually admire that about your spouse, that he puts other people first, including [before] himself,” she says. Maintaining this perspective has everything to do with home life staying sweet.

The Alliance: Just What the Doctor’s Spouse Ordered The Second Law of Thermodynamics says that anything left unattended will naturally fall apart. Human relationships are no exception. Work, work, work = “Hello, divorce.” What a potentially untenable quandary for the nonphysician in a relationship: She knows you have to work long, often unpredictable hours. He accepts you’ll be forgoing a certain, undetermined number of family events. Knows and accepts, yes. But living with it can still wear on your sweetie. Imagine the guilt your better half could be enduring, unable to squelch the resentment that you had to leave your anniversary dinner because some stranger had the bad manners to go into labor right then. It’s a silent, lonely battle, accepting this part of being a physician-spouse versus the natural human need to feel like you’re “Number One” with your life partner — at least sometimes. Enter the Alliance. The “PTA” of the medical world, the Alliance is a national organization of 22,000 fellow physician-spouses who “get” what it’s like dealing with a malpractice lawsuit or a terrible call schedule, says Dianne Fenyk, president of the AMA Alliance (www.AMAAlliance.org). “I find that no matter where I go, a county or a state or even in Chicago where our headquarters are, you see the love and support of a family. It’s an extended family, but most of us have gone through medical school with our spouses, the years of training, starting out with nothing. We all need to talk, and we don’t have to explain.” Moving to a new area can be particularly isolating for a physician family. “As soon as we know someone’s coming, we will connect the ‘movee’ to that community, like a Welcome Wagon. They’ll find out about the school, the libraries, churches, whatever they need,” says Fenyk. “We try to make them feel that this is where they want to be.” The organization is split into state and county chapters. Not every state has a chapter. Fenyk is working hard to change that, though she admits that some state medical societies “won’t give the Alliance the time of day. … They regard the Alliance as fluff. They don’t see the value.” If your own state lacks a chapter and you think your spouse would benefit, perhaps you could advise the leadership of your state medical association about the utility of such a group in keeping physicians happy. But the group is more than just a coffee klatch for physicians’ spouses. It is also a vehicle for several advocacy programs, including Screen Out!, which aims to get smoking out of youth-rated movies, and Stop America’s Violence Everywhere (SAVE), a domestic abuse awareness effort. Advocacy occurs locally as well. The Florida Medical Society Alliance assists the society with various legislative issues by calling and educating legislators on important healthcare issues. It also works with kids and addresses community issues, through programs such as “Hands are not for Hitting.” It even offers practice-management workshops during annual conferences, as many physicians’ spouses help run their practices. “Anything that relates to the health of our local community,” says Elaine Hale, president of the Florida Medical Society Alliance. Of course, just like the PTA, “we’re not always advocates; sometimes we’re just social,” says Fenyk, although she admits that changes in gender roles over the past half-century have presented a new challenge — getting male nonphysician spouses to join. “We do have some exceptional men who will take on leadership roles,” says Fenyk. “Mostly, they’ll help out with a project, but they’re not good at socializing over tea.” Encourage your spouse to look into joining the local Alliance. “It gives a great opportunity to socialize with our friends and do something worthwhile,” says Fenyk. “You can make a big difference in your community and hang with your friends.”

Shirley Grace, senior writer for Physicians Practice, holds an MA in nonfiction writing from The Johns Hopkins University. Her articles have appeared in numerous publications, including The Washington Post and Notre Dame Business magazine. She can be reached at sgrace@physicianspractice.com.

This article originally appeared in the February 2008 issue of Physicians Practice.