Maintaining Balance as a Physician

July 10, 2009 7:43 AM

DocFilter: For those of you who are physicians and have family life, how have you achieved balance between work and family?

I am starting medical school in the fall and, though I don't have a specialty in mind at the moment, I am just curious to learn from the experiences of others in maintaining a healthy balance between work and family. I realize that the internship and residency years are difficult, but I'm interested in life after that.

I'm generally interested in the following questions:
-What specialty did you choose?
-How many hours a week do you work?
-When did you get married?
-If you have kids, when did you have them?
-Do you have any other advice on maintaining balance between work and family?

posted by sciencemandan to work & money (9 comments total)

My best friend, who has two daughters aged 8 and 2, works at the local women's prison. She really likes it, because she has regular hours, is on call only every eight weeks, and gets to see every patient for a half an hour.

She was doing a hem/onc fellowship but switched to primary care when she had her older daughter. She's since done qualifications in substance addiction and abuse, and plans to pursue that track for at least the next several years.
posted by Sidhedevil at 8:50 AM on July 10

Speaking as the grown daughter of a former surgeon and ER physician - I rarely saw my dad when I was growing up as he always seemed to work strange hours and worked most major holidays. I don't recall him coming to any of my school events. Still, he was an integral part of my growing up.

If he was home at dinnertime and I had friends over, he regaled us with unbelievable, gory, hilarious, disgusting, horrifying stories of ER patients. He showed us some of his medical books, so it wasn't unusual for us kids to spend an hour in the den poring over the nastiest looking photographs of ungodly diseases. To this day, my friends thought it was the greatest thing on earth. In high school, he brought me and another friend in to spend a couple of hours observing the ER. I saw a kid who accidentally crashed through a plate glass door and was literally shredded to pieces. I saw how kind and gentle my dad was with him and with the kid's hysterical parents.

Those with parents in the medical field also know this - you can't stay home sick from school unless you are literally bleeding out from a gaping wound or projectile vomiting chunks of bodily fluids at least an inch thick. He didn't have much patience for whining about coughing or sneezing when he saw much worse cases every day.

Since he worked most holidays, we grew up realizing that holidays were meant to be celebrated in spirit, not because it fell on a specific date. It kind of made it fun for us to be a little "different" than other families.

So I guess, from my perspective, if you are going to the medical field and will be having a family, one of the most important things to do is to involve your children in a way that will make them understand WHY you're gone so much. I love my dad so much more because of the way I saw him as a physician.
posted by HeyAllie at 9:12 AM on July 10 [5 favorites]

My dad is a neurologist. He married my mom while he was in med school, and did his residency while they had a baby (my sister) together. I came along 3 years later. I remember him being really tired and sleep deprived all the time, but I think that's par for the course. There were many times when I didn't see him growing up, but it didn't damage me or make me wonder why daddy didn't love me or anything weird like that. Kids can adapt to pretty much any situation, and he still made it to the really important stuff (little league games, etc.) and we took vacations and things like that.

From what I understand, neurology isn't the most intense of specialties, and even so it seemed pretty intense. So if balance is something you're looking for, I'd favor the less intense. That said, my dad loves his job, and now that he's one of the senior members of his practice he can make his own schedule more and more (while still working the occasional weekend of course).

Don't sweat it. There are so many awesome perks to having a physician parents (I have never had to get a real physical for sports teams!) and its easy for kids to understand why you aren't there ("Daddy's at the hospital helping sick people get better."). Oh! And he would take me with him to the hospital sometimes on half days and I got the eat in the cafeteria which at the age of 7 is the coolest thing ever!
posted by BusyBusyBusy at 9:26 AM on July 10

My husband is a pathologist, so I will answer for him. One of the big reasons he chose pathology was for the schedule - not much time on call, and a reasonably manageable workload. He's an attending now, and typically works 9ish until 6.30ish. Occasionally works evenings if he's writing papers or something. He's on call (from home) one week in eight. In those cases, he usually just gets online to look at a slide that someone at the hospital has uploaded to a microscope with camera attached.

During his residency he worked similar hours. During his first fellowship he worked at a very prestigious hospital and worked more like 8-9, but that was only one year.

We have a 10 month old daughter. Because he's a pathologist and doesn't have to round or see patients, most of his day is done on his own schedule (apart from signing out cases for a few hours). That means he has flexibility. He's always been the one to pick up our daughter from daycare if she's sick or needs something, because i worked an hour away from home. Not many specialties would allow for that sort of flexibility.
posted by gaspode at 10:21 AM on July 10

I'm the child of an ophthalmologist. He was married the year after his residency concluded and had kids 2 and 3 years after that. As a specialty, ophthalmology is fairly conducive to working reasonable hours, and I saw him a great deal when I was growing up. I'm convinced that the most important contributor to his work/life balance, however, was opening a practice in a small town of about 50,000 people. Doctors who work in larger cities or hospitals work much, much longer hours. (For much, much more money... but that's the trade-off.) Be wary of being a country doctor serving multiple rural counties, too - achieving the balance you're seeking can get tricky at both population extremes.
posted by cheapskatebay at 10:37 AM on July 10

As the daughter and sister of physicians, I'll say this: it's very important to choose your life partner carefully, and it's very important that they understand what being married to a doctor will be like. There are lots of great perks but plenty of sacrifices as well. Like others above mentioned, my father was also gone much of the time while I was growing up. He made up for it in other ways so I was ok with it, but I realize now what a big burden it put on my mom, and I see the same thing with my brother and sister-in-law. Your partner has to be very supportive and independent. My SIL has to drop off and pick up her 3 kids to/from school/daycare/after-school activities on her own, pretty much every single day, because my brother's hours are unreliable. Many, many nights she has to do dinner, baths and bedtime by herself. And many nights she goes to sleep alone, as does my mom. It can be a lonely and tiring life.

And, being a doctor can be mentally and physically exhausting. We knew instantly when my dad walked in the door what kind of day he'd had. We knew how to avoid him on his bad days, and there were many of those. In that line of work, in can be very difficult to leave your job at home. Trying to help sick people who often don’t get well is a terrible thing to deal with. And it's not easy being on your feet all day long in a high-stress job. Even my brother, who is in his 30s, is tired most of the time. So, doctors are not always up to “doing their share” around the house, even when they’re home.

Of course, much of this depends on the doctor's specialty. My father is an anaesthesiologist and my brother an interventional cardiologist. Both of them do long (24-48 hour) calls once a week, and scheduled days of about 8-5 or 6 -- but those are just the regular working hours. They increase with any kind of administrative involvement. Many doctors get on the board, or are involved in the hiring process, or have to lecture, proctor exams, etc.

So what I’m saying is, all of this can take a toll on a partner. Of course it’s doable, but it’s important that they know what they’re getting into.
posted by yawper at 11:16 AM on July 10 [1 favorite]

My mom is an anesthetist(sp) and was divorced, so I was a latchkey kid. She was gone when I woke up and often worked late into the evening. But she also prepared me a full breakfast before leaving the house in the morning, and I always had the calendar in the kitchen to look at for reference. 12, 24, 16, 12, 24.

I didn't see her as much as other kids did their moms, but we still did all sorts of stuff together. It was just on the periphery of her job, which let us stay in a great house in a great neighborhood.

I always thought money made people evil and then I had a kid and I fully understood her decision.
posted by jragon at 12:26 PM on July 10

I'm a third year medical student, and I've definitely asked this question at many a panel discussion. I've also asked it from the perspective of a female who will be a dr. married to a non-physician, but wants to be the one who stays home with the future kids more than my future spouse. Also, many of my fellow students are already married and have young kids at home. So hopefully I can provide some perspective.

1. Yes, there are comfy specialties that have little call- the ones that require riidiculously high board scores like Ophtho and Derm. There are also specialties like ER where you do work a lot, but it's all shift work, so when you're off duty, you're off duty. And things like Path and non-interventional radiology don't involve that much patient-seeing, so you can be more flexible and work from home, as mentioned above.

2. That being said- There is always a way to do what you want to do. There is a female surgeon at our hospital who also seems to be a pretty involved mom. She does Plastics, a lot of breast reconstructions, because those are pre-scheduled surgeries, not a lot of emergencies, etc. So don't limit yourself- if you want to be a surgeon, be a surgeon. My gynecologist is part of a practice of probably about 12 OBs total. So while babies are born at all times of day and night and year, their call is not a big deal at all. There are ways to make it work.

3. Physicians, once they're high up enough in the ranks, work how much they want to work. Whether it's for the money or people who just LOVE what they are doing, the workaholics are at work because they want to be. If people want to spend more time with their families, they can find ways to do that. See #2

4. Honesty with your partners is key, as mentioned above. You've got to make it clear to your family that medicine does take sacrifice and time commitment, and make sure that they're on board too, or else there WILL be hurt feelings and resentment, etc. And this applies to med school as well as training afterwards. As a 3rd year, I'm probably going to be doing 80 hours a week as well. I had a 6 am to 6 pm day today and I consider myself lucky that I didn't have to pre-round and I got a full 12 hours before I have to be back at 6 am tomorrow on a Saturday. Studying for Step 1 of the USMLE I was a zombie and in the library 10 hours a day. Med school is no picnic, and while it is sometimes eased by having a partner to help, we've also had a girl in our class get divorced. Add to this that med school is SUPER expensive, and financial aid is not generous, so not only do you have no time, but you've also got more financial worries than an attending with the same hours.

5. Kids- as far as I've heard, the best policy if you want to have them in residency is to plan way in advance and not surprise people. If you're thinking about having a kid, TELL your residency program. They'll be a lot more likely to work with you and help and compromise if you give them a year and a half notice vs. 6 months to find someone to replace you. Residency programs invest money in you and get paid on the assumption that you'll be working, and if you're not there, you've lost them a lot of funding.

Anyway, this is something I'm worried about as well, but I try to stay optomistic about it. My own personal plan is to get married right after med school graduation- I kind of like the idea of moving for residency and starting a new phase of life at the same time. Kids are definitely in my plan, though who knows when, but hopefully I'll have a couple years post-residency to make some money first before I cut back on hours. Of course, I love family medicine, so the idea of being out of the hole before having children is laughable. All the best in med school- you'll need luck and patience and reminders of why you ever started on this path in the first place, but you'll survive and maybe even enjoy it sometimes.
posted by alygator at 5:09 PM on July 10

Saw this late, but, I'm an anesthesiologist, out of training, working at a large hospital. I work 65-75 hours per week, including night call in-hospital, which is somewhat better than during residency. Not married, no kids. Consider specialty choice carefully if you are looking for a normal work week.
posted by objdoc at 5:10 AM on July 13