Lessons Learned in Work-Life Balance

By: Erin McAdams, MD

Work-life balance is hard and that’s true for so many career options both in and out of the medical field. The topic is something that you consider as you choose a career path. It’s something that you struggle to achieve and maintain as you train for your job, and as I have found out over the past eight months, something that you have to invest energy into after finishing training and finally starting your career.

I went to DePauw University for my undergrad, followed by a master’s program through Purdue, and then ultimately completed my medical school training at Indiana University before moving to Utah for my Family Medicine Residency training. I finished residency in the summer of 2018 and have since been on faculty with the University of Utah Family Medicine Department since then. During these many, many years of studying and training, I have learned to work hard, but also try to prioritize things that I am passionate about outside of schooling and medicine. I haven’t always done this as well as I’d like, and I still have a lot I can learn about work-life balance, but I’d like to share that I truly believe this is something that is possible, and something we can all work towards.

Working as a primary care provider offers many positive experiences and is rewarding in many ways; this work can also be as demanding of your time and energy as you allow it to be. The patient messaging, phone calls, prescription refills, and paperwork that needs to be completed won’t stop accumulating simply because your clinic day is over. And if you work on faculty, you have additional responsibilities of teaching and training, attending meetings, and academic pursuits of increasing or creating knowledge and improving clinic processes. I love my job and am grateful to be where I am, but these things add up in terms of time demands and strain. Outside of my job, I am active in my church, I’m married, I help lead annual medical service trips internationally, and I like to enjoy the outdoors through sports and other activities (I’m training for a half Ironman right now!). (I don’t have kids at this point, so I can only imagine the difficulty in balancing similar things for other primary care providers who do!) What I’m trying to say is, most of us have many demands on our time and energy both in and outside of work, and to help do each of those things well, we have to attempt to learn how to balance them.

There are a few helpful things I have learned along the way that make the balance between career demands and the rest of life more manageable. One is that it is okay to say NO. In fact, it is probably healthier than always saying yes. When you have a new opportunity or new ask of you, weigh the pros and cons of the ask. Is this something that you feel particularly skilled at or is it an idea that sounds more draining than rejuvenating? Is this something that moves you in the direction of where you’d see yourself in 10 years or is it something that takes you off the track you envisioned for yourself? Is this something that you are truly the best person to be doing or are you just conveniently available for the person asking to approach… because they need SOMEbody to do the role, but not necessarily you. There are times to say yes when you would be pushing yourself beyond what you know, to grow in new areas, to take a chance on a new opportunity, or to just help out a friend or colleague. But it is more than okay to say no.

Another thing that has been helpful, particularly within the clinic setting to maximize the work I do while at work, is to create a clinic flow for myself that helps me stay off the EMR while I’m at home. I pre-chart for clinic encounters, and with rare exception, I close the chart for the patient I am seeing before I enter the next patient room.  I use a few minutes here and there between clinic visits to review and manage various EMR tasks or paperwork. If I have 2 to 3 minutes before the next patient will be ready or arrive, I can review prescription refills, or release a few normal results to patients for myself or other providers who are on vacation. If I have 5 to 10 minutes prior to the next patient, I may be able to call a patient about abnormal results and manage the next steps. My goal by the time I finish seeing my last patient of the day is to have an EMR inbox that has no new results, patient calls, MyChart messages, or medication requests that I have not seen and attempted to manage. There are exceptions for sure, but I’d say 90%+ of the time this is done and I can leave work following my last patient appointment. Sure, all of this takes effort, and it requires more mental energy to actively manage tasks throughout the day and between patient visits, but to me the value added in this effort is invaluable. I do not chart from home (or after clinic at all), and I can allow my time away from work to be filled with things that refresh me in a way that makes me happy to come back to work the next day.

I think we all could learn from one another ways to improve our work-life balance. We can also help create a culture for our colleagues, and particularly for our residents in training, that emphasizes the importance of this. We can aim to model behavior that reflects how important this balance truly is.

Erin McAdams, MD, is an Assistant Professor (Clinical) in the Division of Family Medicine in the Department of Family and Preventive Medicine at the University of Utah in Salt Lake City, UT.

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