When recounting her HM career, Janet Nagamine, RN, MD, SFHM, often tells people she went from being the chief of everything to the chief of nothing, by choice. She can remember the whirlwind of being a quality-improvement (QI) chief, patient safety officer, risk management team member, and new mother who felt more married to her beeper than to her husband.
“I felt incredibly stressed and pulled in so many different directions,” says Dr. Nagamine, a hospitalist at Kaiser Permanente Medical Center in Santa Clara, Calif., and an SHM board member. “What really concerned me was that I was starting to feel that I wasn’t doing anything well, that I was dropping balls here and there.”
A revelation came to Dr. Nagamine at a time-management workshop. The speaker asked participants to list the three most important things in their lives, then add up the hours spent doing them.
“There was obviously a disconnect when I looked at the actual waking hours I spent with my family,” says Dr. Nagamine, who placed family at the top of her list. “That’s where I made the decision that I could always come back to doing these leadership things at a later time.”
Now pursuing an MBA, she intends to return to leadership positions to focus on QI, patient safety, and hospitalist work-life issues—for both women and men.
“Work-life balance is a key anchor for us,” says Dr. Nagamine, who helped organize a “Women in Hospital Medicine” session at HM12 last month in San Diego. “Whether you’re male or female, work-life [balance] is a challenge. We need to do better on that.”
In today’s era of ever-increasing healthcare demands, the future of hospitalist practice rests, in no small part, on the work-life satisfaction of its physicians. Recent studies suggest hospitalists are experiencing more stress and burnout now than in the past, a phenomenon HM groups would be wise to address by offering more flexible work options and workload support, regardless of gender, experts say. But individual hospitalists can mitigate strain and dissatisfaction by assessing their life and goals, and developing a work-life balance that is right for them.
“Work-life balance is really not something that is ‘a nice thing to have,’” says Iris Grimm, creator of the Atlanta-based Balanced Physician program, which helps physicians meet work, life, and leadership challenges. “It is a necessity for them if they want to sustain a long-term career.”
Defining Balance
So what causes tension between work and life outside of work? The list is long and growing.
“We still define the ideal worker as someone who starts to work in early adulthood and works full time, full force, for 40 years straight, available for overtime as needed,” says Joan Williams, distinguished professor of law, founding director of the Center of WorkLife Law at the University of California’s Hastings College of the Law in San Francisco, and author of “Unbending Gender: Why Family and Work Conflict and What To Do About It.” “That basically describes a man married to a homemaker, and that’s not who the work force is.”
In general, workplaces—including those in the hospital work environment—have been slow to adjust to the changing work force, Williams says. In time, friction arises, which leads to dissatisfied workers.