The expression “get a life” is used quite liberally today when directed at people who truly need to make something of themselves or who are too bogged down with work to stop and smell the roses. Increasingly, the latter description applies to physicians, who are taking the expression to heart and taking steps to change their work-life situations.
“That’s one of the great dilemmas in life, how much time for work and how much time for play,” explains James Reed, MD, a Springfield, Virginia-based private practice internal medicine physician for the past 17 years. “This is probably the first generation of people who have seen a lot of divorce in their lives, and it puts pressure on you to balance your home and your work life.”
That pressure is prompting physicians to seek work arrangements that more closely resemble a traditional 40-hour work week, while still allowing them to provide quality patient care.
Is it harder today?
Almost everyone has heard their parents talk about how much harder it was when they were growing up. But established physicians like Robert Schwartz, MD, who is chairman of the Department of Family Medicine and Community Health at the University of Miami Miller School of Medicine, acknowledge that today’s doctors do have it harder.
“I speak from my own experience as a physician in both practice and academia,” Schwartz explains. “If you allowed your work day to extend, you could probably work 18 or 19 hours a day. There are times when I have to consciously tell myself it’s time to stop and go home.”
Reed agrees, but he points out that physicians are not afraid of hard work. Instead, it’s the changes that have taken place in and around the work environment that are putting greater pressures on physicians and exacting a toll. “There was a time when doctors were the most respected people in town,” recalls Reed. “But there’s been a tremendous eroding of the patient-physician relationship, and the place of the physician in society. So when you hear physicians complaining, it’s not about having to work hard. It’s because what they get in return is less money, more hassle and more complaints.”
Making a change
Reed points out that very few young physicians are coming out of medical school and looking to open a traditional medical practice. Similarly, Reed says, very few graduates are going into primary care because “it’s one of the hardest jobs for the least amount of pay. There is this seed change among third- and fourth-year medical students. They like medicine, but they don’t want the lifestyle that goes with it.”
What are they doing instead? Schwartz explains that almost every one of his graduates, every year, goes into a hospitalist training environment. They’re able to work a set amount of hours, then hang up their beeper and go home. They’re also working for community health centers and clinics where they have defined hours. And when they go home, they no longer take patient calls.
But the desire for better work-life balance is not limited to young, medical school graduates. “In south Florida there are a number of middle aged and older physicians who have very good relationships with patients but have gotten fed up with the managed care scene,” says Schwartz. “Many are going into concierge situations, or incorporating themselves and doing VIP medicine. They’ve maintained their income, they’re working fewer hours, and they’re providing better care for their patients.”
Care is a driving force
Peter Hoedemaker is CEO of MD2, a concierge medicine company that now has five offices in the U.S. He has witnessed physicians’ desire for a more balanced work-life arrangement, and he emphasizes that the number one reason for the change is the desire to provide better patient care.
“The pressure cooker that physicians are under is not only burning them out—they’re not able to deliver the kind of medicine they want to deliver,” says Hoedemaker. “That’s the number one reason physicians want to make a change. They want to deliver the kind of care they dreamed of when they were in medical school. Our physicians are taking care of 50 families, whereas previously they’d been taking care of 4,500 patients. It’s what we call medicine in the ideal.”
Schwartz’ 30 years of practicing medicine have been anything but ideal. What’s the secret to balancing work-life? The veteran physician believes in communication.
“A lot of our work is confidential work, and I’m always concerned about young physicians not having the ability to find emotional release from it,” says Schwartz. “Physicians carry around a tremendous emotional burden, and it’s critically important for them to find appropriate communication release for that. Exercise is very important. And I love to go out to dinner with friends, sit around, and have a bottle of wine and talk.”
Ed Rabinowitz is a veteran healthcare reporter and writer. He welcomes comments at firstname.lastname@example.org.