Your practice likely consumes most of your daily energy, but don't forget to save something for your family, too. A medical marriage often includes two busy professionals, and compromise is key.
Your spouse puts up with the long hours and short temper your stressful practice tends to create, but you know it's taking a toll on the marriage. How can you support your partner's career and interests and still keep up with your own?
High divorce rates prove this is no easy task, particularly as medical marriages often today include two busy professionals. But there are small, consistent ways to shore up your relationship even with a demanding work schedule.
Shortly after getting married about five years ago, Sharon and Yusuf "JP" Saleeby relocated to tiny Bennettsville, S.C. (population: 9,425) for JP to take a job as medical director of the local hospital's emergency department.
They live less than two miles from the ER, JP's parents are in a nearby town, and his children from a previous marriage live within a decent drive.
For Sharon, though, the move hasn't been as kind. She's still commuting to her job as a pediatric respiratory therapist in Charleston, a three-hour drive, so she's splitting an apartment with her adult son and crashes there when she needs to.
Even worse than the commute, she says, has been the shock of the rural lifestyle. Even a discount department store is an hour away by car, and the area feels depressing because of high unemployment and poor schools, she says.
"Rural healthcare is fine if you're from a rural area, but if you're not used to the lifestyle I wouldn't recommend it," she says.
How does the couple cope?
"JP's has been very supportive, and when I've had enough we take mini-vacations to just get away," Sharon says. "That's been the lifesaver. Even a day or two away makes a big difference. You get very disconnected if one spouse is very happy in the environment and the other is unhappy."
Also making a difference: Her husband backs her decision to continue working in another city, which she wanted to do to maintain her seniority and her standing in the state retirement system.
Busy physicians can often vastly improve their relationships, and by extension their own mental health, by taking small steps to show their spouses they value them, says Wayne Sotile, PhD, a clinical psychologist and author of The Medical Marriage.
And that starts with taking stock of your own attitudes about your spouse's career or other interests, he says.
"Don't fall prey to the notion that it costs more money for your spouse to work than it's worth," he says. Meaningful work, paid or unpaid, is a key component of fulfillment, so nix the snide comments about low pay or job status.
Instead, Sotile says, focus on what kind of impact the work is having on your spouse, he says.
"You want to get across the notion that you're curious about how the day's events impacted your spouse's sense of self, whether the day was spent changing diapers or trading stocks," he says.
What about over-sharing your own work baggage? That's a problem, too, but not talking about it can be just as isolating.
"One predictor of marriage failure is never talking about work," he says. "Just don't focus constantly on the minute frustrations. Instead of talking about how many procedures you did, explain how the work is affecting you."
Depending on your practice environment, there may be ways to get some outside help.
The AMA Alliance (www.amaalliance.org) offers social networking and other support for physician spouses and families, and some group practices, particularly in rural areas, are making proactive efforts to support spouses.
Dr. Edward Krall, a psychiatrist at the Marshfield Clinic in rural Wisconsin, started a physician spouse group there several years ago. The informal group, known as The Network, hosts lunches and welcome events for spouses of prospective and incoming physicians at the clinic and some social events for existing physicians.
"The clinic had hired a New York marketing firm to do some research around our brand, and part of that was a survey of recent job candidates to find a profile of what types of spouses would be happy here," he says. "It found the Marshfield spouse drives an SUV, not a BMW, drinks Gatorade, not a Manhattan, and values family activities over ample shopping."
The findings drew a few smirks, he admits, but also rang pretty true. Some departments within the roughly 700-physician organization had been doing an excellent job of recruiting and retaining physician families that would be happy in the area, but it wasn't a universal priority, Krall says.
"We know that if the family isn't happy, the physician isn't happy, so we felt we needed to address that more directly," he says. Krall and the clinic also host lectures and workshops for physicians and their families on work/life balance, workplace stress, and other personal issues. "All of the data suggest that a supportive spouse is key to a physician's success."
If your group doesn't have a formal spouse program, a good place to start is simply hosting a social gathering with spouses. Today's busy lifestyles have put a damper on socializing at work, but a little effort here can help the whole group deepen their commitment to each other.
Think your practice is too important to spend time fretting over this? That's precisely the point, Krall says.
"You can get away with putting off paying attention to this for a little while, but you're going to pay the piper eventually," he says. "A lot of physicians feel stressed because they think their family just wants them home more, but studies actually have shown they just want you in a better mood when you do come home. If the dog runs away and the kids go in the other room when you walk in the door, that's a bad sign."
For Michael McLaughlin, the lack of control over his schedule and the impact on his family life was part of what drove him out of his practice as a hand surgeon and into a business startup about 10 years ago. He is founder of Peloton Advantage, a medical communications company in Parsippany, N.J.
"I was the only hand surgeon in my group, so I'd end up getting a lot of calls even on my 'off' nights," he says. "You try to set up vacations and they fall through. Now if there's extra work I can work it around coaching soccer and getting to school events."
Even before he left practice, however, McLaughlin says he tried make sure his wife, Kristin, always knew he longed to be home.
"Sometimes physicians really have more control over their schedule than they realize," he says. "Everyone's afraid that if they start to cut back then referral sources will decrease, however I think the first thing anybody should do is to take a look at their practice, piece by piece, and evaluate what's in their control to make better and what is not. There may be certain types of patients you decide you'll refer out to colleagues. Most of these decisions decrease your income - the golden handcuffs - but if you evaluate it and decide it's not worth the money, it might be the right move."
Janet Kidd Stewart is married to a pediatric intensivist at the Marshfield Clinic and is a member of the clinic's spouse group mentioned in the article. She also contributes personal finance articles for Physicians Practice and writes a syndicated retirement column for the Chicago Tribune and other Tribune newspapers. She holds bachelor's and master's degrees in journalism from Northwestern University. She can be reached at [email protected]physicianspractice.com.
This article originally appeared in the July/August 2011 issue of Physicians Practice.