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Balancing Act

From: The Hospitalist, May 2007

Avoid burnout in the future: consider work-life-self balance now

by Jane Jerrard

When you start work as a hospitalist, you’ll tend to immerse yourself in your new job. But you should also strive to maintain a work-life balance from the start, to guard against eventual burnout.

“It’s really work-family-self balance, because of the importance of self-care,” says Maureen Murray of Maureen Murray Associates in Pittsburgh, who provides professional training in stress management and work-life balance. “Self-care is more than just running or dieting—it’s the foundation of a balanced life.”

TIPS for type -a personalities

Many—if not most—physicians are Type-A personalities: overachievers who aren’t interested in slowing down.

“Type As tend to act and think quickly,” says Murray. “They commonly get a high degree of satisfaction from activity.” But these types still need to rest their minds and bodies, though they don’t always realize it.

“I recommend that they literally make a decision to rest,” says Murray. Her advice:

Take a walk in nature instead of going for a run;
Have an unhurried conversation with a friend; or
Read one chapter of a book that has nothing to do with your work.

“Type As don’t need this as much as other people,” explains Murray. “A half-hour [of these activities] might be restful; an hour would be ideal.”

How do you know if you need physical or mental rest? “When you find that you’re stressed more than usual,” says Murray. “Maybe you’re more irritable. You might also feel more fatigued or have trouble sleeping.”—JJ

Areas of Self-Care

“If you don’t put yourself first, you won’t be very effective at caring for others,” says Murray. Her training program categorizes self-care into four areas:

Physical: What keeps me healthy? “Most people already know the answer to this,” says Murray. “Some form of regular activity, eating reasonably well, and getting some rest.” Mental: What energizes my mind? The answer is “something different,” according to Murray.

Read a book or see a movie;
Try a new cuisine; or
Go out with friends who aren’t in the medical profession.

Emotional: What gives me contentment and joy? “This can be spending quality time with loved ones and friends because friends are often the first to fall through the cracks when we get busy,” says Murray. “The answer might also be a hobby that puts you ‘in the zone.’”

Spiritual: What feeds my spirit? This will be different for different people: attend church; take a walk in nature; meditate or pray; or read something inspirational.

The Eight-Step Program

Here are eight things you can do—starting now—to ensure a healthy balance in your career:

Select the best job for you. Keep your work-life-self balance in mind during the job search, particularly when it comes to comparing schedules, time off, benefits.
Consider location. If you have a family, or plan to have children soon, “choose a workplace that’s near your extended family,” advises Murray.
Find someone who’s doing it right. “After you start, look around and find role models who seem to be balancing their lives pretty well,” says Murray. “Look for the physician who’s not stressed, who’s juggling a family and work. Then ask them how they do it so well. Having a role model like this is really important.”
Talk about work. “There’s a temptation to isolate yourself and work really long hours,” warns Murray. “Grab a cup of coffee with a colleague or go for a walk with a friend.”
Be aware of stress. “You need to feel you’re in control of something—so control your reaction to stress,” says Murray. “Read about stress, but let go of the idea that coping with it is out of your hands.”
Plan ahead. Have a contingency plan for things that need to be done. “Ask yourself, ‘What’s my backup plan for childcare … and what’s my backup to the backup?’ ” says Murray. When you plan ahead, you can avoid stressful situations.
Laugh. “Laughter releases endorphins, which make you feel good,” Murray points out. “Seek the company of those you laugh with. And when you have options for what to watch on TV or on DVD, always choose the comedy.”
State your needs. “People need to communicate their needs about life balance,” Murray stresses. “This can be very difficult to do, whether it’s to your partner or your boss. State what you need in a positive way. ”

Be vigilant in maintaining a healthy work-life-self balance, with an emphasis on self, and your hospitalist career should be a happy one. TH

advice from a hospitalist mother

Jeanne M. Farnan, MD, hospitalist scholar, The University of Chicago Hospitals, Section, General Internal Medicine, has strong feelings about combining a medical career with having a family. She was pregnant during her residency, and now has a toddler as well as a teenage stepson.

“We feel that in order to become a successful physician, we have to delay family and other things that are important to us,” says Dr. Farnan. “Discontent is part of medical training. Residents [and new physicians] feel that they’ve put off their lives and waited for marriage and kids.”

Dr. Farnan believes the workplace will change to accommodate physicians, including hospitalists, who want more time for their young families. “Women are a major force in medicine now,” she says. “Employers will be faced with making changes for them. Good doctors should be good parents.”

Her advice for balancing work with family:

“I maximize my time at work,” Dr. Farnan says. “I’ve learned to strategize to get some downtime.”
“I delegate everything,” she says. “Every single person in medicine is type A to the extreme—we feel we need control over everything. You need to let go of that.” Hire someone to clean your house, do your errands, … whatever tasks don’t add to your quality of life or family time.
“You have to lower your standards,” she advises. “I don’t live in a Pottery Barn catalog and I never will.”
“You also need a really supportive spouse who can pick up the slack when necessary and who understands the demands on your time,” she says.—JJ

This copy is for your personal, noncommercial use only. No part of this article can be reproduced without the written permission of the publisher. Order presentation-ready copies for distribution to your colleagues, clients, or customers by contacting our reprints department at reprints@wiley.com. Copyright © 2009 Society of Hospital Medicine, administered by John Wiley & Sons Inc.

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