Voices: How much is too much? | Linda R. Duska, MD, MPH

How much is too much? | Linda R. Duska, MD, MPH

I have a habit of over-committing at work. I thrive on new opportunities, love learning new things, and appreciate being asked to lead or contribute. And like many of us, I was raised in an environment in which hard work and over-extension were most valued. I have always wanted to be that person who agrees to add another patient to an already over-full clinic, performs the most surgeries, enrolls the most patients onto clinical trials. Competitive much?

Linda Duska, MD, MPH

I have a habit of over-committing at work. I thrive on new opportunities, love learning new things, and appreciate being asked to lead or contribute. And like many of us, I was raised in an environment in which hard work and over-extension were most valued. I have always wanted to be that person who agrees to add another patient to an already over-full clinic, performs the most surgeries, enrolls the most patients onto clinical trials. Competitive much?

But in all seriousness, in our profession as gynecologic oncologists we are often valued by these metrics, if not in others’ minds then in our own. It is weak to say no, to finish the OR at 4:00 p.m., to have a light clinic. But more than that–I don’t want to turn down opportunities because then people will stop asking me, or stop thinking of me when a new position is available.

A few years ago I had a fabulous opportunity to join the Dean’s office. This position opened up many new doors and possibilities for me in my career. But I made an almost fatal mistake: in my first year in this new (50% effort) position, I tried to keep everything I already had, including maintaining my practice at the same volume. At the end of that first year, I knew I was failing at my new position, in addition to not being the best wife, mother, fellowship director, or let’s face it, person. And I had to give something up if I wanted to keep the position and make a difference at my school.

At some point it all becomes overwhelming. There is just too much to do and not enough time to take a breath. So what is the solution?

Clearly I don’t know, because as I write this, I am wondering how I managed to volunteer to write this blog when I have so many other things I need to do. And yet, it is an important message. None of us can do everything well, and also take care of ourselves. When I’m stressed and pulled in too many different directions, I am not the nicest person to those who are most important to me. And when I can’t do my very best with every task, I am disappointed in myself, and promise myself that I won’t overcommit again. And then I do (of course).

For me, the solution definitely involves prioritizing what is important, learning when and how to say no, and graciously passing opportunities to others. Fellowship Director was a mid-career goal and a job that I loved and was passionate about. It was very hard to give up, but after nine years it was time. I passed that role on to a very competent and wonderful colleague who is already doing a great job, and now I’m thriving in my Dean’s position. I’m not always successful at balancing my commitments though, and each phase of my career has brought new challenges. I’m still working on it.

Linda R. Duska, MD, MPH, is a Professor of Obstetrics and Gynecology in the University of Virginia Health System in Charlottesville, VA.

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