Lecture delivered in API CME in jan 2013

1. Wor k Life balance in
Medical pr actice
Vijay sardana
MD , DM ( Neurology)
Professor & Head, Deptt. of Neurology,
Chairman Medical Education Unit
Government Medical college
kota

2. Doctor : Facts
 One of the every three dissatisfied due to lack of
time for themselves or their families
 Average life 10 year less
 Depression 4 times higher than general
population
 8.6% higher risk of emotional exhaustion, 10%
higher risk of burnout
 US- Physician suicide 3 time than general
population
 10% - Develop drug addiction

3. Job satisfaction among Doctors
 69.5% –satisfied (AIIMS)
 Medical doctor in Armed Force – 40%
Choudhary et al MIAFI 2004;60:329-32
Madan N. job satisfaction among doctor in a Tertiary Care Hospital jk science:2008,10(2)81-83

4. work life balance: Issues
 Managing burn out
 Time management
 Managing marriage and family
 When to retire?

5. Manage boredom & burnout

6. Stages of career
Medical student
Resident
Doctor- professional work
Boredom by 40-50 years
? What to do next

7. Burnout
 Work/family/ community/ self
work – more than 60%
self _ less than 10%
 Lossof Physical, Emotional & Mental
Energy

9. Burnout : Symptoms
 Behavioral – Angry/Depressed, poor
concentration,
 Chronically late or psychologically
absent, work avoidance
 Excessive drinking/Drugs
 Tiredness, lethargy, sleep disorders

10. Burnout – Things to do
 Learn to take care of yourself
– learn to rest
- learn to Exercise
 Learn to say No
 Have fulfilling life outside of clinic - develop your
hobbies & activities
 Learn to cut routine work
 Develop strong support system

11. Exercise has life transforming benefits

12. Regular exercise: benefits
 Improves cardio vascular fitness
 Improves mood
 Reduces stress
 Loses fat, not lean muscle
 Decrease back & joint pain
 Decrease loss of bone density
 Decrease chol., HT, insulin sensitivity,
incidence & mortality from CAD, risk of
colonic cancer

13. Ultradian performance rhythm

15. Time management science

16. Time as a Commodity
 most precious thing we have
 ultimately the most valuable resource
 Time cannot be stored up for later use

17. Very Busy ?
 Just because you are busy does not mean that
you are productive
 Differentiate between
– Effectiveness -- doing the right things
– Efficiency -- doing the right things correctly

18. Spent Time Matrix
stephen covey’s matrix
Urgent Not Urgent
Q1 MANAGE Q2 FOCUS
Crisis Preparation/planning
Important Medical emergencies Prevention
Pressing problems Values clarification
Deadline-driven projects Exercise
Last-minute exam preparations Relationship-building
True recreation/relaxation
Q3 AVOID Q4 AVOID
Not Interruptions, some calls
Some mail & reports
Junk mail
Some phone message
Important Some meetings
Many “pressing” matters
Time wasters
Viewing mindless TV shows
Many popular activities
18

19. Quadrant 1
 Being in Quadrant 1 brings
– Stress
– Burnout
– Crises management
– Focus on the immediate

20. Quadrant 3
 Being in Quadrant 3 brings
– Short term focus
– Crises management
– Low value on goal

21. Characteristics of a Quadrant 2 Person
--Coherence
– Balance
– Focus
– An ability to get on with people
– Flexibility
– Portability

22. Time saving techniques
 Control paperwork – action/ file / throw
 Delegate your job
 Learn to say no
 Analyze what we do
-need to do it?
- can someone else do it?
- any quicker/ easier way to do

23. Physicians: problematic spouse?

24. Mar riages
 Perfectionism,compulsiveness &
wor kholism – good doctor but
problematic spouse
 Many mar ried to Profession – no time
to cultivate intimacy with spouse

25. Issues Threatening marriage
 Money & Financial arguments
 Infidelity
 Boredom
 Career crisis
 Empty nest syndrome
 Retirement.

26. Mar ria ges
 Spend time together
 Respect each other
 Have fun together
 Treat your spouse as your most
impor tant VIP patient
-- A loved spouse is also
loving spouse

27. Parenting and medicine
 Pressure
of balancing family and work
commitment enormous
 Notspending enough time/ daily inattention over
the years detrimental to parent child relationship
 High expectations

28. children and medicine
A meal together ever yday
 Fun together once a week
 One holiday ever y year together
 Make sure children meet grand
parents, relatives periodically
 attend famil y functions/ mar riages
 Help children honor family tradition,

29. Retirement : final career
Think of Retiring when you feel time is right

30. Preparing to Retire
 What would you do if you didn’t have to work for
living
 Where do you want to live
 How will you use your time so that you remain
productive & inspired
 Want to be close to children or away
 What role the family will play
 Arrangement for possible decline in health

31. Retirement
 Don’t retire unless you have enough financial
security
 Studies-Retirement has Predominantly positive
impact on emotional state – less demand of
practice, more time for travel, pleasurable
activities
 25% depression
 30% feel retirement years better
 1st year difficult later integration / adjustment
takes place

32. Retirement
 Keep alive what matters to you
 Explore you hobbies
 Explore your spirituality
 Serve other selflessly-do
charity work/volunteer work
 Physical activity/light exercise

33. Take Home
 Enjoy being a Doctor. Focus on sunny side
of it
 Effective time management is key to work
life balance
 Work short of causing burnout and know
when to retire
 Evolve as a comprehensive human being
with physician incorporated

34. T hanks