Background

The Webster’s dictionary defines balance as the “condition in which different elements are in equal or correct proportions” and describes the act of balancing as that of “remaining in a steady position without falling”; “establishing equal or appropriate proportions of elements”.  Ironically, balance is also defined as “an amount left over.”    Experience demonstrates that our internal perceptions of balance do not always correlate to what others perceive.  As an example, we might hear friends or relatives exclaim, “I don’t know how you balance it all!” all the while knowing that our lives are anything but balanced. Similarly, we are at risk of presuming colleagues have achieved a balance that eludes us, something that can lead to frustration and self-doubt.

Many who pursue a career in medicine do so as a result of their core values of service, dedication, excellence, self-sacrifice, and compassion.  While each of these values is noble, consistent adherence to them, without taking time and using strategies for self-care can become exhausting, eliminate the joy of work, and result in one’s role as a physician feeling like an act of self-deprivation that leads to burnout¹.  Such burnout has significant implications for physician well-being, patient satisfaction, and perhaps most importantly, patient safety².  Developing the requisite skills for physician resilience offers an important strategy to prevent or mitigate such burnout.

Thus, as it pertains to physician resiliency, balancing work and life can be thought of as the following:  establishing appropriate proportions of work-life elements according to each person’s values and needs.   As Dr. Drummond points out, work-life balance is not a “problem” as it does not have a simple, one-step solution; rather, it is a dilemma that must be attended to actively and regularly in order for each of us to establish and maintain our own “appropriate” life proportions³.

References:

1. Nedrwo A, Steckler NA, Harman J. Physician resilience and burnout:  can you make the switch?  FP Mgmnt, 2013.
2. Haas JS et al. Is the professional satisfaction of general internists associated with patient satisfaction?  J Gen Intern Med, 2000.
3. Drummond D. FP Mgmnt, 2016.

Assignment

1. Describe a situation at work in which you experienced stress or burnout. Analyze the root cause of your feelings, considering your previous experiences in similar situations throughout your life and your personal context .
   1. To what degree was lack of “balance” in your life involved?
   2. What did you learn from this experience regarding your personal priorities and their alignment with your situation at the time?
   3. If your personal priorities and reality were in discord, which situational aspects (if any) can be adjusted and in what areas do you need to modify your personal expectations or how you handle your priorities?
2. Consider what you value most both in work and in your personal life by completing the following exercise:
   1. On a sheet of paper, create three columns, and label them “Most Important”, “Moderately Important” and “Least Important”. Under each column, list corresponding activities/values. Examples may include money, physical space, travel, time alone, achievement, recognition, time with your friends/family/children, power or authority, flexibility, security, among many others).
   2. Now, look at your list. Which of the items in your “most important” list need more time or attention in your life?  Which of the items in your “least important” list are currently present in your life and could potentially be sacrificed to make room for some of the more important activities or values?
3. Because our lives are often unbalanced, and time is at a premium, it is critical that we intentionally organize our time and energy to nurture those values or activities that are most important to us. This can help prevent us from being swept along in the current of everyday life spending time and energy on those things we value least at the expense of things we value most.  With this in mind:
   1. Come to the small group with one strategy/action that will help you to bring more “balance” into your life right now.
   2. Identify who will support you in working towards the balance you want.
   3. Identify your biggest obstacles and how to overcome them.