Adapt Your Medical Career To Your Life Needs

crispydoc Uncategorized Leave a Comment

I had just turned 40, and was leading a busy life that might resonate with your own: a full-time job in community practice, marriage and fatherhood.  Since I didn’t want to take time away from my wife or kids, self-replenishing (i.e., pleasure out of proportion) pursuits suffered.  A writing group I’d started in internship began to founder because the handful of friends I’d recruited succumbed to competing time commitments. The day hikes and bird watching treks that had provided essential solitude were cut.  Kid #2 arrived and suddenly date night disappeared.  Even the sanctuary of the bathroom was violated.  My son developed the habit of assembling a puzzle on the tile floor during my wife’s morning shower, while my daughter planted herself firmly in the doorway after breakfast during what became our daily “potty talk.”

I came to the conclusion that I’d unconsciously assigned priorities according to a hierarchy I was only now recognizing:

1) work schedule
2) kids
3) wife
4) essential logistics without which household goes down in flames
5) not disappointing others
6) sleep
7) friends
8) self-replenishing (i.e., pleasure out of proportion) activities


I also came to acknowledge I’d substituted escapism for self-replenishing activities: I lost myself in reading fiction instead of  writing.  I bought stuff I did not need because consumption served to distract me from my troubling reality.

This sense of misplaced priorities was compounded by growing demands at work.  For a couple of years, our group was understaffed: one member experienced failing health, another relocated in support of a partner’s career, and several took concurrent maternity leave for a period of months.  Consequently, my original schedule (12 shifts/month) was increased (up to 15 shifts/month) for a prolonged period.  I was a zombie.  My wife grew understandably resentful of my job.  My kids began to regard me as a vaguely familiar tenant who occasionally joined them for dinner.

Thankfully, our group was able to work through the issue and eventually implement a plan to restore work-life balance. We developed what came to be known as “variable shift load,” namely the ability of each provider to decide how many target shifts worked optimally for his or her lifestyle. Since our group is productivity-based, with provider earnings based on the patient care they provide and document, earnings would be commensurate with actual work done.  To make it more appealing, we decided each member would work the same number of nights, weekends and holidays over the course of one year, so we all took equal bites of the “crap pie.”  If you wanted to work less, you were still helping your fellow group member, since the additional shifts they worked would be more desirable weekdays and day shifts.  We set a threshold number of shifts above which you retained full equity, below which you retained half equity but full voting rights, and a lower level still below which you became per diem and gave up voting rights.  We also established a ten year “tenure” period before you could avail yourself of the partial equity track.

Thus far, the experiment has been a success.  The past few months have seen me volunteering more in my kids’ classrooms than ever before; bodyboarding, hiking and kayaking on a regular basis; connecting more with interesting people in our community; reading books and blogs and re-engaging in the world of ideas; taking ownership of my family’s financial investments and future; and trying to establish my priorities for the remaining years that my kids, currently 6 and 8 years old, will presumably live under our roof.  The move to a more balanced workload has proven exciting, a bit intimidating, and completely worthwhile.  I invite you to join me in watching how this experiment unfolds.

In the meantime, my new priority list more closely resembles the following:

1) wife and kids (tied for first place)
3) work schedule
4) essential logistics without which household goes down in flames
5) activities relating to financial independence
6) self-replenishing activities
7) friends
8) sleep
9) not disappointing others

Life remains imperfect.  I continue to tinker to optimize quality of life.
How are you optimizing?

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