Concierge physicians shoulder a huge amount of responsibility. They bear the burden of caring for their patients’ health, for the success of their businesses, for their employees, and for their own lives outside the practice.
Is it reasonable to expect a human being to bear that sort of weight and be okay?
Why Work-Life Balance Is Elusive for Doctors
Private physicians running thriving membership-based medical practices aren’t just unicorns; they’re purple unicorn fighter pilots. And the success of every purple unicorn fighter pilot rests on a stool of three legs.
The first leg, of course, is having a firm grasp on the practice of medicine, which is no static thing. We all know learning isn’t over just because we’ve been doing this awhile. Every hour of every day, new information is emerging that physicians need to consume, understand, consider, and apply in practical ways to patient care.
The second leg of the stool is being an entrepreneur and running a business. This is a monumental weight of ensuring profits exceed expenses, paying bills, handling human resource issues, and more. It involves learning how to be the boss, the one who manages staff issues, real estate issues, and tax issues. So while as a physician you’re working in the business, as an entrepreneur you’re also working on the business; Michael Gerber’s The E-Myth Revisited eloquently differentiates those duties and explains why ignoring them kills most small businesses.
These alone are two very full-time jobs, and there’s still one leg to go: the “life” side of “work-life balance” for doctors.
The third leg of the stool is being a good human — being humble and always striving to learn more while also taking care of your physical and mental health, being a contributing member of your community, and caring for your family.
It reminds me of the ’90s comedy “Multiplicity” with Michael Keaton. In the movie, the main character Doug can’t keep up with work and family, so he creates a clone of himself. Then the clone gets too busy, so they create a third. Eventually, there are four “Dougs” running around and still nobody’s happy.
The point is, responsibilities will always devour as much time as they can get. Without boundaries and balance, even another “you” won’t solve the problem.
Negative Results of Unhealthy Work-Life Balance for Doctors
Zig Ziglar once said, “Lack of direction, not lack of time, is the problem. We all have twenty-four hour days.” When we don’t direct our time and energy in a balanced way, we have a problem. Let’s take a look first at how this affects four major areas of physician work-life balance, followed by what to do about it.
Patient Care
Patient care is the area where physicians usually invest most of their time. It’s the practice of medicine, after all — an understandable default for doctors. Consequently, this is the area most likely to overstep its boundaries and muscle out other aspects of life and business.
If physicians spread themselves too thin in patient care, burnout isn’t far behind. Physician burnout is a major problem in medicine today, and concierge doctors can face it too; we simply must be honest about that.
Even excellent patient care still takes its toll if boundaries don’t protect a doctor’s work-life balance. Resentment can begin to creep in for anything that takes time away from patient care — like running the business that allows you to practice in the first place. Career longevity gets cut to a fraction, and eventually you can’t go on.
Business
If all your time and energy are absorbed in patient care, then you don’t have anything left to give your business. And businesses need care, too.
Part of running a business is looking beyond the day-to-day operations and thinking about strategy and long-term business development.
Managing the practice, hiring, marketing, new patient acquisition, and profitability constitute a huge job for anyone, let alone a practicing physician. Everything from growing the patient base at the outset to installing a succession plan down the road requires an investment in strategic thinking that takes time. Even office culture depends on the habits and work-life balance of the leader.
If the person steering the ship can’t pay attention to where the business is headed, sooner or later you’re going to run aground.
Family and Community
Given the demands of practicing medicine and running a business, it’s no wonder that the personal aspects of life tend to come last for too many physicians.
If you don’t intentionally budget your time and energy at the office, you end up bringing work and the stress of work home, and you can’t be present with your family and community. There’s just no gas left in the tank. With the people you care about most, you can’t be the best you.
But family and community are crucial. They’re the foundation that supports us to be really great at everything else. But if that foundation isn’t firm, strong, and well-cared for — if it’s quicksand — then everything else sinks with it.
An executive coach once told me I was great at my job, but I might be taking it too far. She was concerned that I didn’t have enough left after work to be my best self at home. I always thought, That’s who I am at work; I can’t give less 100%. But she suggested dialing it back to 70% for a week and seeing if anybody in the office noticed.
She was right. I ratcheted my effort down to 70% — and nobody said a word. Nobody even noticed.
But the change at home was huge. I had more energy and more of me available for my family. And the office was just as satisfied as it had always been.
That was a big lesson for me: Balance is possible, and I can control how much and to whom I give my finite time and energy.
Self
Self is the fourth item on the list, but it’s arguably the most essential. Unfortunately, it’s also the one that often gets cut first.
When flight attendants run through their safety instructions, they tell us to put our own oxygen mask on before we help someone else. It’s a great metaphor here. Physicians have to take care of themselves if they’re going to be able to care for everyone else.
This category is separate from family and community because it’s about caring for your physical and mental well-being. It’s about taking time to do the things that let you be your best self in all the other aspects of life and work.
Maybe this looks like setting aside time to read about parenting or business or relationships or time management. Maybe it looks like early morning meditation, perhaps related to your faith or just as a quiet time of reflection. I personally love a workout first thing in the morning, before the phone starts ringing and emails start coming in.
Determine what you need, and make an intentional move to reserve that time for yourself. Because if your self isn’t right, nothing else will be either — especially in the long term.
How to Restore a Healthy Physician Work-Life Balance
If you’re reading this post, chances are your work-life balance is skewed in favor of work at the expense of family, community, and yourself. The current will always drift in that direction. To help you row the other way, here we’re sharing what some ROAMD members are doing to stay balanced.
Follow a Passion
We’ve heard from several ROAMD members who balance the time they’re in the office by following their passions or hobbies outside of medicine and business.
For example, one member has a passion for international travel. He just loves to see this beautiful world of ours. To make it happen, he schedules it far in advance and looks forward to it. The travel then energizes him to give his best to his practice when he’s at home.
Another ROAMD physician has a passion for wine, so she decided to schedule time for classes to become a sommelier. Another doctor makes the time to do woodworking in his home, simply because he loves it.
Find your hobby — maybe even your passion — and give yourself the space and time to pursue it.
Schedule Counseling and/or Social Time
One ROAMD doctor schedules a personal visit with a mental health counselor every Friday afternoon and follows it up with an hour of social time with friends. That weekly counseling cares for his mental health, and he stays socially healthy by decompressing with a group of people he feels comfortable with. Those hours are off limits to the office.
Set Boundaries
ROAMD doctors also report setting firm boundaries in their calendars for things like morning workouts, designated lunchtimes, family functions, or kids’ sporting events. The key here is not just to schedule these activities, but to keep them sacred.
When you decide on one of these windows, make sure you set firm boundaries around it. The office should know not to schedule anything for you during those time slots.
How Are You Working Toward Work-Life Balance?
Not many people have already achieved a perfect work-life balance, especially as physicians. Most of us are works in progress.
Setting healthy boundaries and being intentional in how you budget your time and energy are two crucial components, but how you implement them looks different for everyone. That’s why we want to continue learning from one another and helping each other achieve balance in this demanding business.
What are some ways you strive for balance? How have you set healthy boundaries? What has worked, or maybe what hasn’t? We’d love to keep learning together.