Hurry, Scurry, Work and Worry | Jeffrey M. Fowler, MD
Maybe I do not have the capacity or wisdom to give any other important mentoring advice to my junior colleagues, but David Cohn, MD, told me that one of the most important words of advice I gave him when he started on faculty at The Ohio State University was, “Just make sure you get a hobby.” Hopefully, I was able to offer more than that in my capacity as his Division Director. Perhaps this was one of the most important pieces of advice young Dr. Cohn received as he was fresh out of fellowship and about to embark on a successful and demanding career in gynecologic oncology.
The practice of gynecologic oncology is extremely demanding, rewarding and complex. It consumes most of our physical and mental capacity. The overwhelming majority of gynecologic oncologists are satisfied with their career choice, but the demands of the job take their toll; One third of Gyn Oncs are burned out. Indicators of psychosocial distress and poor mental well-being are alarmingly high. The wrong mix of perfectionism, self-doubt, fear of failure, compassion, loss of sense of control and exhaustion without proper support and resources leads to burnout and other problems with personal and professional well-being. The recipe for disaster is complicated. Risk factors that contribute to burnout and low career satisfaction will vary amongst individual physicians.
Work-life balance is a difficult concept in our profession; mental and physical time and effort are definitely not a 50-50 proposition. Despite finding meaning in our work and career satisfaction, it is impossible to escape the demands of our professional lives. We cannot punch out on a time clock, and it’s virtually impossible to avoid leaving work behind you when you exit the hospital. “Good” work-life balance prevents the most severe fallout that may result from our demanding careers. Surgeons who incorporate a philosophy stressing work-life balance are less likely to suffer from burnout and have a better quality of life.
An important component of work-life balance is regularly taking the time to relax. Relaxation is defined as any restorative activity associated with the key elements of enjoyment and satisfaction. It should not be an activity where the usually negative personality traits of perfectionism, obsession and extreme competitiveness are dominant, which is ot to say I don’t enjoy beating some of my colleagues in a Ping Pong match!) There is no magic formula except that the activity should be enjoyable and recharge your emotional and physical batteries.
It’s interesting that we have invested so many years into rigorous and competitive education training but we are not very disciplined about self-care. While I’m not the greatest example of work-life balance, perhaps you should have a serious talk with yourself regarding professional versus personal goals. I have learned to take regular time for family, exercise, travel, golf (enjoyable as long as I don’t expect to break 90 every outing) and fishing. It takes discipline, commitment, and advocating for oneself. You have to accept that the unique demands and responsibilities of our job will create peaks and valleys in our self-care schedule.
Harry S. Truman, may have had the most difficult combination of challenges faced by any American president in modern history. As he emerged from the shadow of Franklin Delano Roosevelt in the closing months of World War II, Truman was forced to consider these daunting issues: the use of nuclear weapons against Japan, the reconstruction of Europe (Truman Doctrine, Marshall Plan), the Berlin Airlift,a Cold War with the Soviet Union, the Korean War, and use of nuclear weapons relating to General MacArthur and McCarthyism. In spite of all this, President Truman still understood the importance of rest and diversions from work. One of his favorite quotes was from a plumbing contractor who worked at the White House.
“Every man’s a would be sportsman, in the dreams of his intent,
A potential out-of-doors man when his thoughts are pleasure bent.
But he mostly puts the idea off, for the things that must be done,
And doesn’t get his outing till his outing days are gone.
So in a hurry, scurry, worry, work, his living days are spent,
And he does his final camping in a low green tent.”
And what about Dr. Cohn? I created a monster! He went back to playing the guitar, took up the mandolin, and he is a Cross-fit training triathlete who also loves to fish. As one of my mentors would say, “Just do something!” Go get a hobby….before it’s too late.
- Rath, K. S., et al. (2015). “Burnout and associated factors among members of the Society of Gynecologic Oncology.” Am J Obstet Gynecol 213(6): 824 e821-829.
- Shanafelt, T., et al. (2006). “Shaping your career to maximize personal satisfaction in the practice of oncology.” J Clin Oncol 24(24): 4020-4026.
- Shanafelt, T. D., et al. (2012). “Avoiding burnout: the personal health habits and wellness practices of US surgeons.” Ann Surg 255(4): 625-633.
- Balch, C.M, et al. (2010). “Combating Stress and Burnout in Surgical Practice: A Review.” Advance in Surgery 44: 29-47.
Jeffrey M. Fowler, MD, is the 2016-2017 SGO President and Director of the Division of Gynecologic Oncology and professor of gynecologic oncology at The Ohio State University Wexner Medical Center.