Relationships are crucial to the effective and safe practice of medicine. When disrupted, they can cause problems for us and our patients.
One thing I am sure you have noticed is that when things are out of balance, relationships tend to suffer. This includes relationships at home, with your patients, with colleagues, and with your staff. When we are busy and overwhelmed, it is easy to fall into unintentional conflict. This can include becoming impatient with an elderly or slower patient when you are overscheduled and running behind, getting angry at a perceived patient "turf war," failing to consider your partner's needs when making plans, or not being available mentally when your kids need help with homework.
Often when these conflicts erupt, we become overly focused on the content of the event. We may bemoan how our schedule is never right, or characterize physicians of a certain specialty as being lazy or indifferent or prone to "dumping" their patients, or we may accuse our family members of expecting too much from us. However, the subject of these episodes is often not the main issue. Instead, we lose our resilience and our ability to step back and consider the situation with less emotion. When balance is out of whack, our objectivity suffers.
It is so easy to pick apart these difficult days in an effort to prevent them from reoccurring. However, it is usually not as simple as making sure Mrs. Jones is always given an extra-long appointment or hiring a different medical assistant. We should look at these challenges and squabbles as indicators that our balance is off and seek to correct that first. This may include temporary measures such as getting a good night sleep or planning your next vacation. It also may include longer-term fixes such as adjusting your work schedule or critically evaluating how close you are to burnout.
Much like many of the diseases we treat, burnout or work-life imbalance tends to manifest early warnings signs and symptoms. When you become argumentative with a colleague or are no longer able to summon compassion for your patients, these are obvious signs of an underlying problem, but tend to occur late in the game. It is ideal to find those symptoms earlier when the course can be more easily changed.
Sometimes we are not the ones who are facing imbalance but are on the receiving end of someone else's frustration or difficult day. When we see colleagues struggling, it can be important to remember to not personalize everything directed your way, and to watch for signs that your colleague is having internal problems that they are projecting onto external issues.
Relationships are crucial to the effective and safe practice of medicine. When disrupted, they can cause problems for us and our patients. When we see relationships falter, it is important to consider why this may be occurring - whether we are the giver or the receiver of poor behavior or impatience.