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Posted February 15, 2016

Women in medicine and leadership: Work life blend and preventing and healing burnout

By Barbara Roehl, MD, MBA

The research and literature on physician burnout is staggering. Not only are physicians burning out at rapid rates, data also shows physicians are working longer hours than in the past. Adults employed full time in the U.S. report working an average of 47 hours per week (Gallup Work and Education Poll, 2014). Most physicians work between 40 and 60 hours per week, but nearly one-quarter of physicians work between 61 and 80 hours per week (2014 Work/Life Profiles of Todays Physicians, AMA Insurance).

Women who are physicians or hold leadership positions are found to work even longer hours. Between work and home, women physicians worked 22 hours more per week than men physicians (Woodward et al 1996). Whether you are a leader at work or a leader in your home, balancing professional and personal life requires us to develop priorities and maximize our time to truly be effective.

Frankly, there have been moments in my life when the easier choice would have been to leave the workforce. However my work gives me a sense of meaning and purpose that I’d be hard pressed to give up. And my mother, who did opt out, not without some regrets, has kept whispering in my ear, “don’t quit, don’t quit”.

Having choices can be difficult and, at times, it’s been my own decision that’s prevented a leadership step. For example, I had my first child at the end of internship and was able to complete residency at 80% time, but for an extended six months. This was important to me personally and yet a tough thing to ask for professionally. However I knew it was the right choice for me at the time so I asked and it was granted.

Despite what could have been perceived as not being “all in”, instead I was asked to be chief resident. I ended up declining the offer (with much angst) because I didn’t think I could do a good job on the 80% schedule, which I didn’t want to give up. To my surprise, in the same year, I was granted the honor of Resident of the Year for the state of New Jersey in Family Medicine. I realized that I really wasn’t penalized for doing what I needed in the context of my life at the time.

I believe we need fundamental shifts in our work culture, to create a great place for everyone to work, including women. We need to have more women in leadership positions to make this culture change possible. Here I’ve included some tips that I have found helpful at managing work and home.

Set personal and professional goals and priorities. I’m pretty good at personal priorities but haven’t been as good at setting goals for myself. If you don’t already have defined goals, I recommend a 5 year, 1 year and a 90-day plan. Put reminders on your calendar quarterly to see how you’re tracking toward your goals, and to see if changes are needed.

Give before you get. Don’t expect anyone to “hand it to you on a silver platter”. We have to earn our privileges, regardless if we’re male or female. Work hard, exceed expectations, bring solutions to problems and strive to be a model employee.

Be visible. Get on the right committees, which can also mean excusing yourself from the wrong ones. Choose mentors that are male and female to expand your learning. Get out of your comfort zone at meetings by sitting next to someone you don’t know or someone influential. And speak up! Share your knowledge and expertise, even if it feels self-promotional at times.

Convey confidence. How often have you quietly listened while someone says exactly what you were thinking? When you have something worthwhile to say, say it with confidence. It has taken concerted effort for me to be vocal in meetings. I prefer one on one or small group, and often get consensus prior to large meetings. Don’t sell yourself short by not speaking up, or being too self-deprecating when you do.

Seek out and find the help you need. Don’t be afraid to ask for help. Prior to working with an organization that offered a structured evaluation, I brought my own. I wanted the direct feedback on my performance. Also, identify and ask for training opportunities. Look to your medical societies, peers, and even your own organization to strengthen your skillsets.

Let go of guilt. You DO do enough - both at work and at home. Give yourself permission to delegate. Let your mom pick up the kids, or a nanny help with homework. Leave at 5 o’clock. Hard work and long hours are important, but not the only driver. Don’t let yourself get sucked into that mentality. Also don’t forget that you have PEP – potential earning power. I dollarize my time. Given my hourly rate, is it worth spending extra to have someone else do the laundry or yard work?

My final tip is to make your job work for you. I have at times reduced my hours to part-time. I’ve asked to buy myself out of weekend call so I could spend more time with my family. I’ve negotiated contracts to have optional leave without pay for the month of August every year. Don’t be afraid to ask for what you need. You may be shocked by the answer. Lastly, seek out a work environment that’s supportive. I’m fortunate to work with a faculty group, of both men and women, who intentionally sought to create a culture where we help each other. It makes a big difference.

REFERENCES

  1. Women in Medicine: Career and Life Management. Marjorie Bowman, Erica Frank, Deborah Allen, Deborah O’Neil. Springer – Verlag, New York. 2002.
  2. Lean In: Women, Work, and the Will to Lead. Sheryl Sandberg. Alfred A. Knopf, NY. 2013.
  3. Unfinished Business: Women, Men, Work, Family. Anne-Marie Slaughter. Random House, NY. 2015.
  4. On Being a Doctor, Balancing Family and Career: Advice from the Trenches. Molly Carnes, Annals of Internal Medicine October 1996. Volume 125, Issue 7, pages 618-620.
  5. Women Rising: The Unseen Barriers. Herminia Ibarra, Robin Ely, and Deborah Kolb. Harvard Business Review, September 2013, pages 61-66.
  6. Why Ambition Isn’t Working for Women. Kristin van Ogtrop. Time September 28, 2015, pages 53-56.

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