Communication, flexibility, understanding key to making dual-HM marriages work
by Gretchen Henkel
During their residency at Beth Israel Deaconess Medical Center in Boston, hospitalist Margaret Fang, MD, MPH, FHM, and her friends often talked about who they might want to marry: someone completely outside of the medical field? A violinist, perhaps? But when she interviewed for a faculty position at the University of California at San Francisco (UCSF), she met hospitalist Bradley Sharpe, MD, SFHM, then the chief resident in the Department of Medicine.
They married in 2010 and currently work as associate professors in the Department of Medicine at UCSF Medical Center—Margaret as a clinician-investigator and Brad as a clinician-educator and administrator. “I find that [being married to a hospitalist] makes many aspects of communication easier because you have a shared language,” she says.
A common language, a partner who “gets it” if you’re on service 16 days straight, a shared passion for the hospitalist movement: These are the advantages of being married to a fellow hospitalist, say five dual hospitalist couples.
“It is wonderful having a partner who understands where I’m coming from if I do have a rough day,” says Elizabeth “Liz” Gundersen, MD, FHM, who in 2004 tied the knot with hospitalist Jasen Gundersen, MD, MBA, CPE, SFHM.
Heather Wark, MD, who is married to SHM cofounder Win Whitcomb, MD, MHM, seconds that notion. “You don’t have to start from the beginning with anything,” says Dr. Wark, who works as a hospitalist (SNFist), at Farren Care Center, a skilled nursing facility in Turners Falls, Mass. “You can just launch right into whatever the crisis of the day is, and your partner completely understands.”
By and large, the advantages of marrying someone in the same profession outweigh the disadvantages, as a survey of female family physicians recently showed.1 But with those advantages come challenges. Among them:
Threading through these issues requires transparent communication, flexibility, and mutual respect, according to these couples.
Liz Gundersen recently resigned her position as associate chief of the Division of Hospital Medicine at the University of Massachusetts (UMass) Medical School in Worcester, Mass. The reason? Jasen accepted a new job. As many hospitalists before them have done, the Gundersens pulled up roots and moved across the country, as Jasen started his new job as chief medical officer with TeamHealth Hospital Medicine in Fort Lauderdale, Fla.
“It was a pretty stressful job change,” Jasen says. Following the job offer from TeamHealth, the Gundersens spent “a couple of months” weighing all of their options. “My taking the job was a great promotion for me,” he says, “but Liz also had the opportunity for a great promotion at UMass. In the end, the decision came down to the fact that it was a great opportunity for me and a great opportunity for us, as a couple, to do something new. And I think we weathered it pretty well.”
Liz, who is in the midst of securing her credentials to work in Florida, agrees. She is continuing to work with UMass long-distance, completing the physician schedule and training the new scheduler.
Dr. Whitcomb, who is medical director of healthcare quality at Baystate Medical Center in Springfield, Mass., and Dr. Wark married 15 years ago and have worked to configure their relationship to accommodate both career and family. “For most of our relationship,” she explains, “I’ve had a part-time job that has stayed steady.”
Dr. Wark’s professional flexibility allows her to function as a full-time mother to their two children, Maela, 13, and Nicholas, 10. “Although my career has been very successful, Win has been more the one who has undergone career changes and advancements,” she says. “My staying steady has allowed that space in our relationship.”
Drs. Fang and Sharpe haven’t had to cross the bridge of different job offerings yet. But Dr. Sharpe asserts that he’s a firm believer that there should be no difference in how their careers are valued. The couple has an ongoing “transparent conversation,” adds Dr. Fang, about what’s important to each of them and the relative impact of future opportunities. In addition, her job as a researcher is somewhat portable, so the chances of simultaneous job offers might increase. For now, though, they are happily committed to UCSF and love the city of San Francisco.
Madhavi Dandu, MD, MPH, assistant clinical professor and associate director of Pathways to Discovery in Global Health at UCSF, and her husband, Nima Afshar, MD, an ED/hospitalist at UCSF and at the Veterans Affairs Medical Center in San Francisco, have been lucky, she says, because “we were both drawn to medicine for similar reasons.” Together since their second year of medical school, they also both wanted, early on, to pursue careers in academic medicine. “We definitely went through some difficult times, but mostly, we were on the same page,” Dr. Dandu says.
When it came time to apply to a match program for residency, they both applied to UCSF, where they successfully completed their residencies and began their academic careers. They made a conscious decision to wait to have children until their training was finished.
Still, in the first year or so after their daughter’s birth in 2008, Dr. Dandu felt the pull between career and parenthood. “As a physician, you’re driven to make sure you’re not dropping the ball on anything, and there were many weekends that I was away from my daughter,” she says.
A supportive family helped with a flexible childcare arrangement, but this past year, Dr. Dandu decided to scale back her work schedule to 80% of regular shifts in order to spend more time with her daughter. Now, she says, “It’s pretty rare” that she will alter a commitment with her daughter for last-minute calls from work.
Even if they work in the same division, dual-hospitalist couples say they thrive when they also have independent career interests. David O. Meltzer, MD, PhD, FHM, chief of the Division of Hospital Medicine at the University of Chicago’s Department of Medicine and director of the Center for Health and the Social Sciences in Chicago, and his wife, Vineet Arora, MD, MPP, SFHM, assistant dean of Pritzker School of Medicine in Chicago and associate program director of the internal-medicine residency program, pursue independent spheres in addition to occasional collaborations as hospitalist-researchers.
They recently were on clinical service together during a blizzard. “We also co-mentor several trainees,” Dr. Arora says, “which is actually really fun. For example, I can refer trainees to David if they’re interested in economics, and if someone has a quality/safety interest, he could refer that person to me” (see “Keys to Thriving as a Dual-Hospitalist Couple,” above).
The Gundersens’ professional interests forked when Jasen found his niche in administrative work and started to pursue an MBA in 2007. Meanwhile, Liz was finding her own niche doing quality improvement (QI) and became one of the physician quality officers at UMass Memorial.
Drs. Fang and Sharpe have experienced similar career divisions with their hospitalist roots. Dr. Sharpe is focused on medical education, while Dr. Fang’s focus predominantly is clinical research. “Between the two of us, we capture many of the elements of academic hospitalist practice,” she says. “I think having our diverse interests gives us a lot of knowledge and expertise about our respective fields. I’m able to learn a lot about how the hospital works and about clinical teaching from Brad, and, hopefully, he can come to me for research advice.”
Drs. Dandu and Afshar have branched out, too. He completed additional residency training in emergency medicine and she acquired an MPH at the University of California at Berkeley. Subsequently, she became associate director of Pathways to Discovery in Global Health, the global health elective program for medical students.
“If you follow your passion in your career, that will allow you to bring a happier individual to your relationship,” Dr. Whitcomb adds.
Communication is a major factor when dual-hospitalist couples plan and execute their weekly schedules. “We try to have an organizing conversation at the end of each weekend,” says Dr. Wark, who also is the keeper of the family calendar and “the glue” that keeps her family of four on track.
Marriage and family therapist Catherine Hastings, PhD, who practices in Lancaster, Pa., says it’s important for dual-hospitalist couples to remember that the relationship needs attention, just as physician careers do.
“It’s very easy to talk about your job when you are in the same profession, but you can easily get consumed by that and let your personal relationships take a back seat,” Dr. Hastings explains. “Couples may look upon conversation about work as ‘brainstorming’ or problem-solving together, but that can also take over.” Hospitalist couples need to be aware that they should plan to be a couple as rigorously as they plan for their jobs, she adds.
Dr. Meltzer doesn’t think that he and his wife consciously delineate between work and personal conversation. “We certainly talk about things that don’t involve work, but we do not say, ‘We will absolutely not talk about work,’ ” he says. “That’s like saying there is not an elephant in the room.”
It didn’t bother the Gundersens that their work came home to a certain extent, says Liz. Even so, to avoid the temptation to “try and churn through all of our work over dinner,” she began scheduling meetings through Jasen’s secretary to discuss work issues.
“When we’re working, we’re doing so full-on,” Jasen says. “But then, we are definitely known for taking recovery time,” which includes skiing vacations and spending weekends on their boat in order to recharge.
Drs. Meltzer and Arora have traveled extensively together for both work and fun. On a trip last year, they traveled to China to a medical school partnered with their own to give talks. They even lengthened their stay to visit the Great Wall of China and toured Beijing and Shanghai.
Dr. Fang considers her husband the “uber-scheduler” in their relationship. “We very consciously build quality time with each other into our schedules,” she says. Without children, for the moment, they also have the free time to grab dinner spontaneously.
Time together as a couple is a scarcer commodity when a dual-hospitalist couple has children. With a pair of pre-teens who are involved in competitive swimming, Drs. Wark and Whitcomb have a two-hour block of time they need plan into their schedule three to four evenings a week.
“We’ve got a built-in babysitter called the YMCA swim team,” Dr. Wark jokes. They also run together several times a week, an activity they use to reconnect. “You have to figure out ways to grow together, to develop and have interests and activities that are specific to the relationship and not related to the kids,” Dr. Whitcomb says. “And if you don’t grow together, you’ll grow apart.”
Drs. Dandu and Afshar, who married in 2003, are just beginning to reacquaint themselves with their adult social lives, she says, now that their daughter is two and a half. “Sometimes we make time to have ‘date night,’ but sometimes it’s just us getting together with our adult friends,” she says.
With or without children, dual-hospitalist couples’ passion for their profession is intertwined with their successful marriages. “Being a physician,” Jasen Gundersen says, “is not just a vocation; it’s part of who you are.”
Dr. Dandu describes it this way: “Our life at home and our life at work are very melded.”
Like Dr. Wang, Dr. Dandu had contemplated a long-term relationship with someone who wasn’t in medicine. But being married to a physician-hospitalist, she says, “turned out to be great for me, because I have someone I can really talk to about everything.” TH
Gretchen Henkel is a freelance writer based in California.
The Hospitalist newsmagazine reports on issues and trends in hospital medicine. The Hospitalist reaches more than 25,000 hospitalists, physician assistants, nurse practitioners, residents, and medical administrators interested in the practice and business of hospital medicine.