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Unrealistic Expectations a Big Barrier to Physician Work-Life Balance


An interesting patient-satisfaction survey comment prompts this physician to re-examine office responsibilities.

Today I was going through all of the patient comments on my patient satisfaction score. I stopped at one that was marked "negative." The patient reported that the office had an odor - like a funeral home - that they found unpleasant (although I suppose funeral homes should smell like flowers). I considered whether this is the new reality of my day-to-day professional existence - making sure the office smells acceptable to my patients (after all, my compensation is influenced by how well my patients "score" me). But with everything else I have to do, do I really have time to address the "smell" of my office? Is that realistic?

Taking on unrealistic expectations can be a major barrier to work-life balance. It's not necessarily what we have on our list each day; it's also the expectations of how we think those tasks need to be done. Some things matter a lot - like how you have certain conversations with your patients or your spouse or your kids. Some things matter far less than we assume. Part of the magic of getting balance right is correctly determining what matters and what doesn't matter that much.

There are different ways we can assume responsibility for things beyond our ability to control. The first is my personal favorite - denying that this is something beyond my control. Do this with patients who have challenges obtaining care. I agree to be the family physician/pain specialist/nephrologist/psychiatrist because my patient can't afford the time/money/inconvenience of seeing multiple specialists. While I feel like a nice person doing this, it's not the right thing for me or the patient. At home, I am slowly realizing that my children's school performance is less and less under my control. I don't have to sign agendas anymore and bright neon pieces of paper no longer come home announcing every test and project. When they fail a test or assignment, it is increasingly out of my control. I can certainly set up the expectations for success but I am less able to assure it comes about.

On other occasions I enter the fantasy world of suspended time and energy - you know, that place where I have infinite time and energy to do all things to perfection. This can mean agreeing to things I don't have the time (or enthusiasm) to do or pursuing perfect experiences when good enough is, well, good enough. I recently traveled to another state to give a lecture. I had many months to prepare and I love to give talks, so I looked to the challenge with eager anticipation. That is, until two weeks before the event when I realized that I would not be giving the most perfect lecture that's ever been given. So, instead of being satisfied with my pretty darn good talk, I obsessed about each nuance of each slide and kept improving it until the last moment. It has been aptly said that we can't enjoy what we're trying to improve.

So my challenge to my readers and to myself is to do what might already come naturally to some of you - when you see the comments about the funeral parlor odor of your office or the way the receptionist said hello, when your child brings home a less-than-stellar report card, or you're putting the finishing touches on the PTO newsletter at midnight - let it go.

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