Say No to Yes

October 1, 2011

Are you always saying yes to every request? Here’s how to find the fine point between professional obligations and personal priorities.

Family physician Jennifer Frank strives to maintain a work-life balance for the benefit of her four children by finding serenity in daily tasks and remembering the importance of delegating, outsourcing, and recharging.

"To capture the idea that medicine will always take everything you give it and more, one of my colleagues used to say 'medicine is a jealous mistress,'" Frank explains. After nine years of practicing medicine she has learned, "If you are waiting for the day to be done or for your job to be finished to take a break, you will never leave. So, there has to be a conscious decision to disengage from your medical role because there is no natural break."

Frank, who currently practices at Theda Care Physicians in Neenah, Wis., says one of the poignant work-life balance lessons she espouses is the understanding that physicians are not indispensible. This understanding has helped her create boundaries between her professional duties and her family life.

"When I used to teach residents, I told them, 'If you got hit by a bus, your patients would survive and their needs would be taken care of.' Sometimes in medicine there is the sense that we are the hero and that our patients need us. There is also a need for physicians to learn that it's okay to end your day, go home, and take care of your family," explains Frank, who also blogs on work-life issues for Physicians Practice's website.

She emphasizes that reciprocity is key when working to implement work-life balance strategies. Frank takes a team approach to coordinating schedules, notifies colleagues about schedule changes in advance, and works to accommodate colleagues' scheduling needs as well as her own. "This creates an atmosphere of collaboration and cooperation," she says.

Finding balance at work

After eight years teaching residents and seven years of working first in private practice then in urgent care, Roohi Desai says she has recently accepted a new position in family medicine that will provide her with a comfortable work-life balance.

Desai says the symptoms of imbalance can serve as catalyst for positive change. "I always felt like I needed to be home when I was at work or at work when I was home," Desai, who currently practices in St. Louis, explains. Facing competing priorities, Desai chose to try working part time.

"I always feel more comfortable when I have some semblance of control, and that is when I made the decision to work part time because I have time for family and time for myself so that when I am at work, I am ready to be at work," she says.

Desai says her journey toward balance required an exploration of personal and professional priorities. "I recommend sitting down with your spouse to prioritize your goals. What is going to matter to you most 20 years from now? Then look back and try to set your life goals accordingly," she suggests.

As the mother of two teenagers, right now Desai's priority is family time. "I have four more years before both my kids are in college, and I still have another 20 years of professional life left. I can always change career paths and change my work hours after they are in college," she says.

For Desai, who has worked part time since she completed her residency, missed career opportunities did not present a challenge. "I guess you don't miss what you never had and I began as I meant to proceed, so there never has been a decrease in income or other benefits to deal with," Desai explains.

She says she is fortunate to have worked with supportive bosses and colleagues over the years - some who made similar work-life balance choices - and has not dealt with pressure to work "more than [she] was comfortable with."

Practical solutions

Personal organizer Nadine Levy sums up how to prioritize family time and maximize on-the-job efficiency, without sacrificing patient care, in three words: priorities, boundaries, and systems. The owner of Management 180° Organizing, located in Calabasas, Calif., Levy says physicians should "define what 'enough' means to you."

"It is important to identify your goals and objectives, benchmarks, and milestones for success rather than concerning oneself with others' measures of success," she says. "Take the time to think about and document your core values as an individual, a professional, and as a family member, [then] set your priorities based upon these core values."

When advising clients, Levy said taking the time to set up systems at home and at the office is worth the effort. "It is a bit time consuming … but you will reap the benefits for years to come," she explains. "Document what you do, when you do it, and how you do it in order to maintain quality and consistency. Develop and record 'best practices' and incorporate them into your practices' protocols, systems, and procedures," she says.

Letting go of guilt

Levy emphasizes the importance of setting appropriate boundaries. She advises physicians to "take charge of your life by creating a definable boundary between work time and home/family time. ...You are the one who decides when your work day starts and when it ends, which translates into turning off your cell phone, laptop, PDA, etc. when your work day is over and on the weekends. This will allow you to be fully present with your family."

Desai emphasizes that competing priorities are "just a part of life" and feeling guilty won't change the demands on your time. For her, the keys are maintaining a proper work-life balance, evaluating yourself to better understand what is and is not working, and most importantly and most simply, to "choose the best path for you."

To achieve balance in her roles as physician and as a mother, Frank relies on a tip from Tony Schwartz's "The Power of Full Engagement" - creating a personal vision statement for work and another for who she wants to be at home. She keeps her "work vision statement" on the visor of her car and reads it on the way to work as a way to clear her mind and focus on patient care. Then, on the way home, she reads her vision statement for herself as a mother and wife. This helps Frank to leave the workday behind and more seamlessly shift from her role as a physician, to her role as a mother with a focus on family goals.

Finding balance at home

Frank has just begun to outsource at home by hiring a housekeeper, which has created more time for family activities. When it comes to delegating, Frank says her children - ages 2, 5, 7, and 8 - each have assigned, age-appropriate chores. She and her husband also emphasize that "when the family is preparing to go out and do something fun, everyone plays a role in making that happen."

"Battling the guilt that many mothers or fathers probably feel about not being at home or not being at work requires accepting it is a fact of life and moving on rather than thinking, 'Okay, I can't feel any guilt in order to take some time for myself,'" Frank says.

Desai said 15 years after completing her residency, being "content" is the key to "doing a better job both personally and professionally."

Creating space for self-acceptance and letting go of perfectionism is one way Desai has learned to focus on her long-term goals. "At work, things have to be just right, but at home I don't go crazy because there is a laundry basket sitting in the middle of the room; you kind of have to learn to let things like that go."

Kate DeBevois is a Philadelphia-based freelance writer. She has written for several healthcare and business publications. She can be reached at editor@physicianspractice.com.