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Physicians share how they manage work-life balance while having a meaningful career in medicine.
Katy Brodski-Quigley, MD, worked in a mid-sized family medicine practice for a few years after medical school. Then she set up a private practice. In both situations, she was unhappy with the work-life balance. “I felt like I was always on call and the paperwork was piling up,” she recalls. “It kept eating into my life.”
To earn more income as her practice grew, Brodski-Quigley started to work shifts at an urgent care center. She found she liked working in a setting where more tasks were supported by medical assistants, and her schedule was more consistent. She now works full time in an urgent care center in Waltham, Mass. “I think I am in a much better place now financially and sanity-wise, and I am a better physician because I like going to work. During the last month of my primary care career, I dreaded going to work.”
Brodski-Quigley’s experience points to a trend in which an increasing number of physicians who are working more than 40 hours per week either make changes to their practice or find new jobs to avoid burnout and gain more control over their careers.
In the 9th annual Physicians Practice Great American Physician Survey, about 66 percent of respondents said they worked more than 40 hours most weeks. Not surprisingly, 29 percent said the main reason they would prefer to work somewhere else is to work better hours or achieve greater work-life balance. Also, 63 percent of respondents agreed they don’t have as much time for their personal life as they think they should have.
Burnout is a dilemma you must address with a strategy and a coordinated set of actions, says Dike Drummond, MD, author of Stop Physician Burnout and CEO of TheHappyMD.com, an online source of tools and coaching resources. “When you are really burned out, all you have in mind is escape,” he says. Some doctors leap into a new situation and realize their new situation is even worse. “They jumped from the frying pan into the fire,” he adds. Drummond says during individual coaching sessions, he tries to help physicians focus less on what they don’t like about their current situation and more on what they envision their ideal working situation to be and work toward that goal.
Physicians Practice spoke with physicians who made career changes or changes in their practice to regain a better work-life balance. Here are some ways physicians can gain more autonomy and reduce stress as owners or employed physicians.
Eva Martin, MD, is an obstetrician gynecologist in Dublin, Ga. She has owned her own solo practice and worked in large health systems, such as the Veterans Administration (VA). She says the work at the VA was rewarding but also taxing in many ways because of the large bureaucracy. A few years ago, she decided to make a change and work three days per week in rural clinics for the Georgia Department of Public Health.
She says working in two rural clinics is gratifying. Her team was able to start a prenatal clinic for indigent care in one county, and they started offering care for transgender patients in another. She ends up driving long distances to the rural clinics-up to four hours per day round-trip. Martin says she enjoys driving on back roads and see feels productive because she listens to audiobooks or continuing education material.
Although she does not earn as much as she used to, Martin says she is much happier. “The staff is very dedicated to taking care of patients, and the patients we see are very thankful to be taken care of,” she says. “You feel appreciated.”
Kerry Swindle, MD, a family medicine physician in Tucson, Ariz., believes she has found the right balance by practicing independently but in a physician cooperative. Arizona Community Physicians has its own imaging centers, lab, and helps with group billing and purchasing. The 54 practices in its membership can set their own schedules. “We have doctors who work 12 to 14 hours per day seeing 60 patients, while I will see 10 to 20,” Swindle says. “I can leave when I want and take as much time off as I want. I am not beholden to an owner. I took two weeks off last year to go to New Zealand.” She isn’t set to a schedule, but there is a catch: she doesn’t get paid when she doesn’t work.
Swindle sees electronic health record (EHR) documentation as one of the biggest contributors to the time burden physicians experience. She’s not a technophobe, but she made a conscious decision to avoid EHRs. Others in her co-op started deploying EHRs 15 years ago, but even when federal incentives became available, she wasn’t interested. “I didn’t care how much the government was going to give me to defray costs, I just didn’t want that hassle,” she says.
Drummond says dissatisfaction with the EHR is a common complaint, but he advises doctors to try to stop hating the EHR because it’s not going away. “Being a hater drives avoidance behavior, which messes you up,” he explains.
Ed Marut, MD, a reproductive endocrinologist with Fertility Centers of Illinois in the Chicago area, says as he nears retirement, he has gained more control over his schedule. “I am at a point where I am not going to begin too early or extend my day too late. I allow the day to go with the flow,” he says. “You don’t get points for coming early or staying late unless you are being productive.”
One thing that has made life easier, he says, is that his practice works with a management group that handles business aspects such as purchasing, employment, and malpractice insurance. “I don’t need to worry about anything but patient care,” Marut says. Working with a management group is a cost, but he thinks it can be a worthwhile one. He sees physicians who focus on their earnings to the detriment of their health or family life. “Some doctors are unwilling to do anything that takes one extra dollar out of their pockets, when in the long run they are probably hurting themselves because they are losing the most important part of their life.” He’s proud of the fact that he never missed a game when his son played football at Miami University in Oxford, Ohio, a five-hour drive from home.
Erinn Harris, MD, is an internal medicine doctor in Tyrone, Ga. who has worked in several settings including private practice, academic medicine, and as a hospitalist in the Atlanta area. In 2014, she felt burned out enough to consider leaving the practice of medicine altogether. Then she discovered the direct primary care movement and decided to give it a try. Four years later, she is glad she did.
She makes less money than she made as an employee. She had to moonlight at hospitals on the weekends in the beginning but has been able to cut back as the practice has grown. The payoff has been the freedom to focus on patient care. Harris feels like she has more control over how much time she spends with each patient. “Patients are not used to you spending 30 minutes to an hour with them. All that time spent is not in a waiting room with a television, but actually face to face with me. That is the most rewarding part.”
Going out on your own may be the answer, but Drummond often reminds physicians that with autonomy comes responsibility. “There is nothing in my experience as a coach that suggests that if you own your own practice, it makes things easier,” he says. “Every job adds additional stresses to the practice of medicine, which is stressful all by itself. But if you own your own practice and can make decisions and execute on them the same day, it gives you a level of flexibility.”
David Raths is a Philadelphia-based freelance writer focused on healthcare and technology.