Choices Can Easily Overwhelm You at Home, at Your Medical Practice

September 10, 2013

Meet one of the biggest challenges to work-life balance as a physician - the complexity of narrowing down the multitude of choices we face every day.

I was talking to my kids the other night about my exposure to fruits and veggies growing up. In the summer, my mom bought strawberries (a special treat), melon, pears, peaches, plums, and nectarines. In the winter, we had apples, oranges, and bananas.  Our vegetable options consisted of the basics - beans, broccoli, carrots, cauliflower, tomatoes, spinach, and iceberg lettuce. My kids were incredulous. No asparagus, artichokes, Asian pears, star fruit, kohlrabi, kale, or apricots? They also have exposure to things like pluots (a cross between a plum and an apricot) and other exotic combinations.

It’s not only in our kitchen that variety abounds. When we go out for pizza, we not only have the old standby choices of pepperoni, olives, sausage, and green peppers, but we have all kinds of different combinations - taco pizza, Greek salad pizza, shrimp and pineapple pizza, etc. The complexity around us is staggering. The number of choices and quantity to data we need to process even at the grocery store can be overwhelming.

I don’t think this helps with balance. We’re starting back to school this month. We have to make all kinds of decisions and scheduling plans in order to fit in swim lessons, pottery class, baton class, tennis lessons, piano, and so on. I remember my mom hustling to get everyone to after-school activities but that was before traveling sports teams started at age eight.

We have the option to ignore the multitude of choices at home. We can stick with our list at the grocery store, but there remains a niggling doubt that you may be bypassing the best option - the one with the lowest calories and highest anti-oxidant count - in favor of something not quite as good. Likewise, you want to make sure your kids are on the best team or in the best class, even if you have to drive a few towns over to get them there.

When I started family medicine, I did full-spectrum care: OB, inpatient adult and peds, nursery care, nursing home, and even home visits. Since then, I’ve slowly scaled things back and now am almost exclusively an outpatient doctor. The whole landscape of medicine has changed in the short decade plus since I’ve graduated residency. The rise of the hospitalist movement altered the landscape of hospital medicine making it no longer sufficient to round once a day and review everything from the past 24 hours. Instead, things are happening constantly and hospital-based physicians can respond more quickly than a doctor remotely located, checking results and speaking with consultants between clinic patients or over the lunch hour.

I’m glad to live in a world where we have many different types of insulin, exotic fruits, and vegetables available year-round, and amazing opportunities for our kids to explore. The secret to balance - at work and at home - is to be selective about those choices and realize at the outset that you can’t do it all, be it all, or choose it all.