7 gastroenterologists share the secret to a healthy work-life balance

The population is aging, regulatory requirements are increasing and reimbursement pressure persists. Physicians are busier than ever. Here, seven

gastroenterologists share how they balance successful professional and personal lives.

Ask a Gastroenterologist is a weekly series of questions posed to GI physicians around the country on business and clinical issues affecting the field of gastroenterology. We invite all gastroenterologists to submit responses.

Next week's question: What should younger GI physicians look for in a mentor?

Please submit responses to Carrie Pallardy at cpallardy@beckershealthcare.com by Wednesday, April 29, at 5 p.m. CST.

Mazen Alsatie, MD, St. Vincent Medical Group (Indianapolis): Physicians in general have gotten used to having intense workdays with tight schedules and multiple responsibilities. We, wrongfully, also think of ourselves as superheroes with very thick skins thus believing nothing can get to us. Isn't that a recipe for burnout? Yes, it is.

When you leave work with overwhelming stress, frustrations, dissatisfaction and burnout, the odds are these will follow you home and insert themselves into your personal life. Having a balanced and healthy work-life relationship starts by making sure you have control over your stress at work and not the other way around. How to do that?

1. Look at your schedule daily and study it. Is it going to be ok? Anything wrong with it based on your prior experiences? If so, alter the future ones. It is probably too late to alter this one. I consider every day of work as a road trip and I like to plan it well. Think about your day and you objectives and how to achieve them.

2. Reward yourself periodically and put it into your schedule if you can. That might be a lunch with a spouse or a friend every now and then. 

3.  Do not let yourself get too hungry. Yes, many of us lecture others and our patients about eating habits and health but we forget ourselves. In my experience, if you plan for lunch as you plan for other things, the odds are you will eat healthier food (maybe from home), and eat less amounts of it and not too fast. I try not to let my adrenaline go through the roof while trying to keep my blood sugar up when I'm scrambling to finish up with one more case.

4. Where do you fit exercise in your life? Crucial points that are frequently overlooked by gastroenterologists: we do need to maintain our muscle mass, keep a healthy posture and watch for repetitive trauma. As you get older, the muscle mass magically decreases while the fat around the waist increases. The best way to lower your stress level is by routine exercise.

5. Do not forget to relax a little during the work day. It might be in the physicians' lounge in the hospital or your office.

6. Build downtime into your schedule. Do not over schedule yourself to do errands during down time. If you do, the odds are you put your brain in the hurry up mode to get done and go back to work, leading to increase of stress hormones.

Larry Good, MD, FACG, founder, CEO Good Pharmaceutical Development, CEO, Compassionate Care Center of New York:Maintaining a healthy life-work balance is a challenge. Medicine is a consuming career. Varying one’s professional interest helps. Prioritizing family, friends and exercise habits is often difficult. Developing new career paths, I have found, leads to more enthusiasm, energy and opportunity for growth. That perspective leads to contentment and better life-work balance.

Sameer Islam, MD, MBA, Southwest Gastroenterology (Lubbock, Texas):

1. Focus on your family when you are at home. Unless I am on call, I turn my phone off and leave my pager in my car when I come home. I dedicate that time at home ONLY to my family and nothing else. Work will always be there, but the time for my family and kids will not be. When I am at home, that is only home time. Once my kids go to bed, that is when I will finish up some work if I need to.

2. Have activities outside of work. It is important to have a life outside of work. Develop a hobby, workout, read a book; do something to engage other parts of your mind. I work out every day, no matter what. It is my way of relaxing and keeping a balance. On days when I don't exercise, I can tell I am more on edge and am not able to engage fully in anything I do.

3. If married, set aside a weekly date night. My wife and I are both physicians and we have three young children. We are pulled in many directions with work, family obligations, recitals, dance practices, etc. But no matter what, we always schedule a weekday night as our date night. We go to dinner, see a movie or go get dessert. Even if it is only 30 minutes, we spend that time with each other. We pick a weeknight on purpose (as opposed to Friday or a weekend) because the wait times are usually very small. I look forward to this every week, and it helps keep me balanced.

These are some of the ways in which I try to maintain a work-life balance. Though I may not be able to do all of these consistently, I know that when I can do them, my day is much better.

Julie C. Servoss, MD, MPH, Medical Director, EMA Gastroenterology: Life is a never-ending juggle, but as a physician and mother it's vital to ensure I devote enough attention to both my professional and personal obligations. It would be next to impossible to do so without efficiency and good communications in both the workplace and at home. My spouse and I are both physicians, and we have active children. So we're all quite busy, but we support each other and always want the kids to know they're our priority.

At work, I must be efficient. I cannot afford to bring my professional work home because once I leave work, my favorite job begins - being a mother/driver/multi-tasker extraordinaire. I only want to do physician related tasks once to save time. For example, my EMR system, EMA Gastroenterology, helps reduce the time physicians need to take for recording and coding. I only enter patient information once - on an iPad and at the point of care. I don't have to worry about finishing my notes and workflow at home after my kids go to sleep.  EMA allows me to be successful at both my jobs - providing excellent patient care and being a present and engaged mother.

Michael F. Sheffield, MD, The Oregon Clinic (Tualatin): There are two things that I think contribute to a healthy work-life balance. The first is making sure that when you are off, you are off. I don't usually do work on my days or time off so that when I am home, I have not brought work or my attention to work home with me. I typically turn off work email when I am on vacation. One of the things that allows me to do that is a great practice with partners I trust implicitly. Patients are well taken care of despite me not being there.

The second part to a healthy work-life balance is the fact I love to be home. My wife and I have fun together; we love to be together doing anything so when I am home it is easier to concentrate on home rather than work. We also communicate well about a lot of things which then gives me another perspective about things at work and how they affect me. Medicine is difficult enough without that balance but with the right work-life balance it becomes that much more enjoyable.

Pankaj Vashi, MD, Lead National Medical Director, National Clinical Director of Gastroenterology/Nutrition, Metabolic Support and Gastroenterology, Cancer Treatment Centers of America at Midwestern Regional Medical Center (Zion, Ill.): Work-life balance is a necessary component to living a healthy and fulfilling life, no matter your line of work. For those of us who have chosen to work in healthcare, I feel it is especially important to maintain that equilibrium. Specifically relating to the field of gastroenterology, which is a very demanding, procedure oriented field, having a clear mind and rejuvenated spirit is vital.

As care providers, we tend to put the needs of our patients ahead of our own. This type of dedication to patient care can make achieving a healthy balance a tricky endeavor. On busy days, working 12 to 14 hours is not unheard of, especially if you work in a single physician clinic.  One tactic that I find helps keep balance is being able to anticipate the week's schedule and the overall growth of the practice. If you see a regular increase in the number of patients you are seeing week to week, month to month, looking to bring on another physician, whether permanent or temporarily, may help take some of the pressure off of you. By sharing the patient load with another physician, you remain more alert and rested, which has a positive impact on your patients. For this very reason, many gastroenterologists have started recruiting midlevel practitioners who can help with non-procedure related patient care.

When I was in private practice, another way I was able to maintain a manageable work-life balance was by limiting the number of new patients I accepted in my practice. As much as I wanted to provide care to everyone in need, there is a breaking point that directly affects work-life balance. There is a bit of an inner struggle on knowing what that number is; however, when I relate it back to being there for my family and friends, it’s not a difficult decision. Being there to enjoy my son's volleyball games and daughter's dance recitals is important to me. Life moves fast; in the blink of an eye the kids are grown and out of the house. I made the conscious decision to be present during their childhood.

At Cancer Treatment Centers of America at Midwestern Regional Medical Center (Midwestern), I work directly with a fellow gastroenterologist and a full care team that respects the relationship between work-life balance. The team works together to meet and exceed patients' care needs, while keeping a close eye on the needs of their fellow care team members. In keeping with the idea of work life balance, there are times while in the workplace when a care provider needs to reconnect. Holistic nurses at CTCA at Midwestern created Renewal Rooms, which are safe spaces where providers go to reconnect the mind and body. The spaces support the importance of taking time for oneself to be able to be present in the moment with patients and other team members. Through the use of these healing spaces, the benefits of self-care and positive emotional health are discovered.
My advice to all the future gastroenterologists would be to work hard at providing the care your patients desire, but don't let the profession be what defines you. Balance is the key to life.

Gareth Weiner, MD, president, Rocky Mountain Gastroenterology (Denver, Colo.): The secret to maintaining a healthy work-life balance is to make sure you enjoy your job. I still enjoy going to work every day, even after 21 years of being a gastroenterologist in the same city and with the same practice. I also make sure to take time off to be with my family and have an active life outside of work, including exercise, golf, skiing, travel and enjoying the outdoor life in Colorado.  Being President of Rocky Mountain Gastroenterology has increased my responsibilities (while still maintaining a complete clinical practice), but it is still very important to be actively involved in my practice which is still 100 percent owned by myself and my 25 partners.

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