Hard work. Long hours. Stress. That's what it means to be a physician. And a parent.

As more women enter medicine each year, balancing the demands of two demanding jobs (women physicians still shoulder 80 percent of domestic duties) has become an important issue. To be sure, male physicians as well are tending toward more active roles as parents than in generations past.

Those in the know — both physician-parents and industry experts — agree that some keys to meeting the demands 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; and
• creating outside support systems.

But perhaps the most important thing to learn about balancing the demands of being a parent and a physician is that there's no secret to success waiting to be uncovered.

"I wish I had some pearls to say this is how I do it, but to be honest there is no big secret to share," says Frank Kane, a New Jersey family physician. Kane, a father of two, leads a 16-physician practice and volunteers for state and national specialty organizations, but makes sure he has time to coach youth sports teams and attend school events.

"There is no five-step plan; it just takes hard work," agrees Wayne M. Sotile, a clinical psychologist in Winston-Salem, N.C.

"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," says Sotile, who has studied more than 1,000 marriages in which one or both spouses are physicians.

Define your values

Lisa Corum, a Fort Mill, S.C., family physician who works part-time, says her approach to handling both jobs was to decide what she wanted to get out of being a physician.

Before she joined her current practice as a part-time employee, Corum told the five physicians who own the practice that her priority was to have sufficient time to care for her two-year-old son, even if that meant delaying the opportunity to get on the practice partner track.

"I was moving to an area where I didn't have any family support and my husband travels a lot for his work, so I told my new colleagues before I was hired that I could not work full-time and could not take call. That was the condition I set," she says.

Corum says that physicians who want to handle more than a minimal share of child-rearing duties should first ask themselves:

• Is my spouse also working?
• What are my daycare options?
• Do I have family members who can help with childcare?
• How much do I need to earn to pay my bills?

"You have to be honest to yourself about what you are capable of doing within the boundaries of your life situation and say to your partners at home and at work, 'This is what I'm capable of doing and doing well,'" she says.

Even with her current arrangement for 25-hour workweeks, Corum still puts in full days now and then when other physicians travel, take vacation, or are ill. Like other physician-parents, Corum finds that balancing work and family life is not an exact science.

"For a physician to lead the totally balanced life is just a myth; it's a hard job," says Sotile, who has co-authored several books with his wife, Mary, including The Medical Marriage and The Resilient Physician. "Work in medicine always was and always will be extraordinarily demanding," he adds.

Sotile notes that finding more time for children is not exclusively an issue for women physicians. He finds many older male physicians looking for more time to enjoy their grandchildren or their children from a second marriage. "They figure they blew it and missed those precious years the first time around and they are not going to let a second chance slip by," he says.

Make choices, plan ahead