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Work life balance- Is This a Myth?

Work-life balance: for many in Cardiology it’s an elusive idea. Now, our worlds of work and “life outside of work” are even more blurred among Zoom meetings and facemasks.  However, over the years, I have learned 3 important concepts (Figure 1) that has made work-life balance POSSIBLE, not just a myth.

Figure 1. Outlining the three key concepts of work-life balance.

Concept #1: Who are you outside of work?

As Cardiologists, researchers, educators, and team members we know the day, night, and weekend hours that define our careers. However, how do you describe yourself outside of work? Who are “you” after shedding the scrubs and white coat, away from the office, hospital, and lab?   Beyond Cardiology, what are your interests?  The answers to these questions help to define you and an important part of your life. When we lose our work-life balance, we are losing a part of ourselves.

To begin recapturing your interests, look at your calendar over the next month, and schedule small increments of time (just 5-10 minutes!) to reconnect with your personal interests (of course staying safely physically distant for now).  These baby steps will move you closer to capturing the “life” in work-life balance.

Concept #2: “Balance” is dynamic.

How do you define “work-life balance”? Is it an equal distribution of time? Is it a certain quantity of time for specific activities?

Work-life balance is very similar to the field of Cardiology – it is constantly changing. For most people, work-life balance will not mean that there is “equal” or balanced time between work and personal life. Especially in Cardiology, our job usually engulfs the majority of hours in a week – clinical duties, grant deadlines, presentations, emails… and the list continues.  However, for work-life balance, one of the goals is to “balance” the transition from work to “life outside of work”. This means your presence, attention, and focus should completely shift from work to your personal interests and interactions. Work-life balance is beyond physically leaving the job, but balancing the mental transition to fully shift away from work.  It will take practice to avoid checking email or mulling over work.  The amount of time between work and your personal life will remain dynamic; but the “balance” is your ability to commit your focus and attention to those precious personal moments, just as you do for work.

Concept #3:   You are Responsible for You! 

Cardiology requires you to constantly learn and practice to achieve and maintain competency. You are upholding a professional commitment. The same commitment is required to grasp work-life balance.  You have to make a personal commitment to you!!  It is not sufficient to just “wish for it”.  We cannot expect anyone else to understand our needs or create our work-life balance.

To reframe this important concept, consider your self-care and work-life balance as critical as filling your car with gas (or charging your car):  you cannot function without it!  Your personal commitment has to be as strong as your professional commitment.   No, it’s not easy, but it is possible.  Some find it helpful to be accountable to a colleague or friend, check-in regularly (set a reminder) about small steps to promote work-life balance. We understand our responsibility to patients.  Now, it’s time understand your responsibility to you!

During these uncertain times of the COVID-19 pandemic, healthcare workers are working longer hours and under even greater stress. It is normal to feel overwhelmed. Now, more than ever, it is important to find creative ways to focus on precious moments and commit to your well-being!  Below are 5 tips to stay committed to yourself and safely connect with others:

  1. Take three minutes.  Listen to your favorite song, dance while nobody’s watching, or take a few extra minutes in a hot shower. You do not need a long time to be kind to yourself.
  2. Join a Virtual group or class.  Physical distancing and long work hours can be very isolating. Take advantage of the numerous virtual options to safely connect with others who have similar interests.
  3. Share and listen.  Try moving beyond texting and talk on the phone. Commit to that moment, engage in the conversation and focus on listening.  The human connection remains very powerful to strengthen our mind and body.
  4. Protect Your Time. I know it is easier said than done. However, learning to set boundaries is critical to sustain your commitment to work and participate in the joys of life.
  5. Be Kind to Your Body. Find time to sleep, eat healthy snacks, and participate in small amounts of physical activity. Mental health and physical health are equally important.

In summary, work-life balance is a journey, not a destination.  Remember, that “balance” in work-life balance is dynamic – the amount of personal time will change, but your commitment and focus to that time should only grow.

 

About the Author:

Heather M. Johnson, MD, MMM, FAHA, FACC is a Cardiologist & Preventive Cardiologist at the Christine E. Lynn Women’s Health & Wellness Institute at Boca Raton Regional Hospital/Baptist Health South Florida.

 

“The views, opinions and positions expressed within this blog are those of the author(s) alone and do not represent those of the American Heart Association. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them. The Early Career Voice blog is not intended to provide medical advice or treatment. Only your healthcare provider can provide that. The American Heart Association recommends that you consult your healthcare provider regarding your personal health matters. If you think you are having a heart attack, stroke or another emergency, please call 911 immediately.”

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Resolutions for 2020: Optimizing my Ikigai and the pursuit of happiness

While reflecting on an extraordinarily busy yet rewarding career year of 2019, I thought of my resolutions for 2020. I’m exceptionally bad at keeping new year resolutions, so I only made one: to be happy.

The concept of Ikigai

Happiness can mean different things to different people, and each of us, particularly medical professionals, is on a personal journey. There is a cool Japanese concept that encompasses multiple spheres of happiness, called Ikigai. Meaning “a reason for being”, it is well-depicted at the intersection of a quintessential Venn diagram that is really doing the rounds on the internet.

The concept of Ikigai

Image: Find your Ikigai. BODETREE, ADAPTED FROM FRANCESC MIRALLES

 

Fundamentally, it encompasses aligning one’s personal and career goals by combining the things one loves, is good at, what the world needs and what one is/could be paid for.1 Applied to physicians, it’s essentially the pinnacle of work-life balance.

While much is being discussed about physician wellness and work-life balance in recent times, for fellows in training and early career physicians, achieving a good work-life balance can be formidably challenging. In a formative and critical stage in your career, you want to maximize on all opportunities to learn and demonstrate competence. Given that conventional wisdom in medicine has always assumed that working harder and taking on more responsibilities is what makes one a better physician, you find yourself in a precarious position, and unable to say no, perhaps to avoid being considered “irresponsible” or “disinterested”, among others.

Thus “having it all” is way easier said than done. Thinking long and hard about this resolution, I went back to the concept of Ikigai. Seemingly, in order to discover your Ikigai, you must first find what you’re most passionate about, then find the medium through which you can express that passion.2

As cardiologists, or in fact medical professionals in general, I’d like to think that we’re already halfway there, having discovered our passion for the work we do. This got me thinking that a great part of my sense of happiness and fulfillment, my ikigai, could actually be achieved simply by getting better, more competent and efficient at my job, thus paving the way (and time) for doing the other things I also wanted to do.

While cardiology can be one of the most rewarding and emotionally fulfilling careers, it does come with significant sacrifices. In my sometimes unrealistic attempts to maintain a social life and achieve the so-called “work-life balance”, I recall doing exam revisions with my study buddy until midnight, forcibly satisfying a respectable quota of daily reading and “rewarding“ myself with a game of Settlers of Catan with my non-doctor friends late into the night, only to have to be present at rounds by eight the next morning. Especially during my initial years of training, in a pursuit to achieve work-life balance, I struggled trying to exclusively “slot out” time periods for work and leisure. As a result, my laptop became a mandatory accessory, finding a place at hangouts, parties and even vacations, where I’d squeeze in that little bit of work if I found the time.

P-squared: Matching passion with purpose

So, how do you effectively ensure time for other things in life, without compromising on expectations and quality at work? I found myself picking up handy tips from Morton T. Hansen’s fabulous book Great at Work: The hidden habits of top performers.3 One aspect that really resonated with me was the concept of P-squared, i.e. matching passion with a strong sense of purpose. He writes about how passion at work is not merely taking pleasure in the work itself, but can come from success, social interactions, learning and competence. In short, pursuing activities that are personally meaningful.

Working smarter over working harder

One way of ensuring one’s focus on meaningful activities is to prioritize and decide what work you will pour your heart and soul into.3 Naturally, each task is not guaranteed to trigger your interest to the maximum. While the “chores” that are one’s professional responsibility absolutely need to be done (and prioritized), it’s important to pick and prioritize ancillary projects, thus ensuring one’s full focus and ultimately better seeing it to fruition. Given professional hierarchy in medicine, it can sometimes be difficult to say no early on in one’s career. A piece of brilliant advice I’ve been given in such scenarios is: If it’s part of a project you happen to land but which can (and should) be done by someone else, delegate it smartly and oversee the work. The advantages are multiple: you facilitate an opportunity for someone else to gain that experience, you gain the experience of overseeing a job and most importantly, it reduces an unnecessary load on you, allowing you to make the time for the projects that matter.

Also, focusing on doing fewer things but doing them better, means that you have more time left over, which you can spend on your private life, effecting towards some degree of work-life balance.3

Share the load

A roster has a purpose and it’s important to share the load. Accepted that we all have our unique personal challenges, some more than others, I found myself chronically covering another person’s roster, stressing out and compromising on my own private time that I could very well have spent with family and friends. While mutual cooperation within a working unit is vital to good work-life balance, particularly in medicine, it should certainly not be at the expense of one’s happiness.

Take breaks

Doctor Hansen also writes about the importance of keeping one’s passion in check, and not allowing it to consume you.3 Grossly translated, it means making the time for one’s private life, be it travel, working out, reading or playing a sport. Thanks to a wonderfully supportive spouse, I might have gotten away with amalgamating work and life on most occasions, but I appreciate the necessity of making an effort to keep work passions in check, and actively make some quality time for family and friends.

“Work on how you work, not on protecting your life from work” – Morten T Hansen

All things said, I’m extremely grateful for being able to do something that I absolutely love, would hope I’m good at (!), get paid for and certainly what the world needs, neatly satisfying the central convergence of the multiple dimensions ikigai. One’s ikigai.is a deeply personal journey, and not one a mentor can spell out for you. However, actively making an effort to being efficient at work, being less stressed out and more balanced would certainly make one better at life too, translating to happier social and private lives. Achieving an Utopian level of work-life balance may not be possible, but finding happiness and fulfillment in what you do certainly is, and it’s a resolution I’m going to make an effort to keep this year. A happy new year to you all!

 

References

  1. Garcia H, Miralles F. Ikigai: The Japanese Secret to a long and happy life. New York: Penguin Books; 2016.
  2. Myers C. How To Find Your Ikigai And Transform Your Outlook On Life And Business. Feb 23, 2018. https://www.forbes.com/sites/chrismyers/2018/02/23/how-to-find-your-ikigai-and-transform-your-outlook-on-life-and-business/#6e99332a2ed4
  3. Hansen MT. Great at Work: The Hidden Habits of Top Performers. New York: Simon and Schuster paperbacks; 2018.

 

The views, opinions and positions expressed within this blog are those of the author(s) alone and do not represent those of the American Heart Association. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them. The Early Career Voice blog is not intended to provide medical advice or treatment. Only your healthcare provider can provide that. The American Heart Association recommends that you consult your healthcare provider regarding your personal health matters. If you think you are having a heart attack, stroke or another emergency, please call 911 immediately.

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What Are Your Thoughts on Work-Life Balance/Imbalance in Science and Medicine?

My blog post this month is meant to be a starting point for discussion. There are a plethora of articles and blog posts on work-life balance/imbalance in medicine and science (and many other professions). Some articles and blog posts even discuss that it is not possible to have work-life balance in medicine/science/academia1-3. As the winter holiday season comes to an end and a new year and decade starts, I find myself reassessing my personal and professional goals and resolutions for this upcoming year and decade. On my list is “continuing to work on work-life balance.” My blog is meant to stimulate discussion and solicit advice from those of you in science and medicine on potential tips to improve work-life balance. Figuring out how to balance the personal and professional aspects of our lives throughout a long and arduous career can be a formidable process.

Some people have voiced concerns about the recommendations often told to trainees and early career physicians/scientists to maintain work-life balance and wellness in order to prevent burnout: get adequate sleep, eat well, exercise, meditate, pet dogs, wake up earlier to plan your day, travel, read nonmedical/nonscience books, continue your hobbies, find good mentors, and spend time with family and friends all while providing good clinical care and/or doing good research. How are there enough hours in a day to do all of this?

An article in The Atlantic published last year entitled “Give Up on Work-Life Balance”4 discusses a recommendation from Brad Stulberg, author of The Passion Paradox, of not thinking of work-life balance as dividing hours within a day for personal and work activities. Alternatively, consider balance in terms of “seasons.” For example, one “season” could be a few years where the majority of the time is focused on one’s training/career and another “season”, possibly during a time when one has young children, where focus is on spending time with family. One of my mentors who has young children says that when he goes home, he prioritizes spending time with family and tries not to do any work until he and his wife go to bed. Some people have noted that they dislike the term work-life balance since it implies that there is a scale where one side is competing against the other. Instead, “integrating” work and personal lives is encouraged. Unfortunately, careers in science and/or medicine do not always allow for easy integration of work and personal lives, but system changes can occur to allow for better integration of work and personal life. For example, I applaud the efforts of one of my co-AHA early career bloggers, Dr. Nosheen Reza (@noshreza), in assisting with establishing a culture and creating tangible changes to support breastfeeding cardiology fellows5. Another AHA early career blogger, Dr. Renee Bullock-Palmer (@RBP0612) wrote a blog post last year discussing tips for integrating motherhood and a career as a female cardiologist (https://earlycareervoice.professional.heart.org/balancing-versus-integration-of-motherhood-and-your-career-as-a-female-cardiologist/).

Many established researchers and clinicians have recently told me that they regret not spending more time with their families. This same sentiment has been echoed by many clinicians/researchers on Twitter over the holiday season. While it is not always possible to spend every holiday with loved ones, especially while in training, allotting some protected time to spend with loved ones is important for maintaining wellness.

Establishing work-life balance is a constant evolving process dependent on the stage of our careers and personal lives and is a very individualized process. As mentioned before, I hope that we can have a further discussion on work-life balance and that you will share some tips on ways to improve work-life balance. I wish all of you a happy, healthy, and productive new year!

 

  1. Lazzari, Elisa. To be a top performer you need to be happy – something academics tend to forget. Naturejobs Blog. 13 Jun 2016. http://blogs.nature.com/naturejobs/2016/06/13/can-scientists-really-have-worklife-balance/.
  2. Powell, K. Young, talented and fed-up: scientists tell their stories. Nature538, 446–449 (2016).
  3. Is Work-Life Balance for Physicians a Unicorn? com. 3 Jan 2018. https://www.kevinmd.com/blog/2018/01/work-life-balance-physicians-unicorn.html
  4. Khazan, Olga. Give Up on Work-Life Balance. The Atlantic. Atlantic Media Company. 30 May 2019. https://www.theatlantic.com/health/archive/2019/05/work-life-balance/590662/.
  5. Kay J, Reza N and Silvestry FE. Establishing and Expecting a Culture of Support for Breastfeeding Cardiology Fellows. JACC: Case Reports. 2019;1:680-683.

The views, opinions and positions expressed within this blog are those of the author(s) alone and do not represent those of the American Heart Association. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them. The Early Career Voice blog is not intended to provide medical advice or treatment. Only your healthcare provider can provide that. The American Heart Association recommends that you consult your healthcare provider regarding your personal health matters. If you think you are having a heart attack, stroke or another emergency, please call 911 immediately.