This article is based on our observations after working a combined 25 years with neurosurgeons and candid feedback from several neurosurgeons. Thank you to those who shared their experiences.
Work life balance is one of the most discussed topics of the modern day. There are those who view it as impossible, and others who consider it critical to their individual success and to the success of their organization. Irrespective of the varying viewpoints on the subject, the first step to achieving anything is to understand it and where its value resides.
Achieving balance should not distract from building a career, but rather enhance it. Work life balance is challenging for health care providers; even more so for neurosurgeons. Neurosurgery requires manual dexterity and intense concentration when dealing with delicate parts of the nervous system. Not only must neurosurgeons be skilled in the OR, but many of them divide their time between the research lab and operating room (1). A physician in any specialty, private or academic, has to achieve some sense of work life balance in order to be successful. From the administrator’s perspective, it is critical. The financial strength of the practice is dependent upon “well-balanced,” productive surgeons who find satisfaction in what they do but also have an outlet outside of the hospital.
In our discussions with several surgeons, ranging from those just out of fellowship to emeritus status, there were surprising similarities, despite the generation gap:
- Most knew that neurosurgery would be time consuming and that work life balance would be a challenge, especially in the early part of their career.
- For those with family, a good support system is critical to being productive at work and achieving a good work life balance.
- Having an outlet away from work, although challenging at times, is critical to both professional and personal success.
- Determine Your Personal Priorities
- Track your Time
- Don’t forget your “Me Time”
- Take Care of Your Health
Sacrifices Continue to be Made for Family
Patterns appeared for those just starting their career, whether within the last couple of years or in the early 1970s, when work dominated one’s existence, and personal life came second. One junior surgeon with small children chose to work extra hours on Saturdays so he could get home on weeknights to spend 30 minutes with his kids before bedtime. Family dinners were a rarity, and his schedule did not allow much time for him to decompress. He knew this was only short-term until his practice becomes more established.
There is a similar story for a neurosurgeon who started his career in the 1970s – although a little more extreme. Being on call was required every other night. He missed the birth of his second child because he was stuck in the OR. Fortunately for most neurosurgeons, as they progress in their careers, they figure out how to achieve a balance between work and their personal life. Some undoubtedly are still working toward it, and others have regrets they could not figure it out sooner.
A Strong Support System is Vital
One reality is clear – if you are a neurosurgeon and have a family, you must have a good support system at home. Spouses of busy neurosurgeons know they may have to shoulder most of the family responsibility, at least initially. However, we observed a true appreciation and acknowledgement by the surgeons for this support system.
Being on call is uncertain and can disrupt personal life. One surgeon found that once he accepted on call duties and uncertainties as part of being a neurosurgeon, it was easier to try to achieve work life balance. Most agree that separating work and personal life is nearly impossible. As one surgeon put it, “Unfortunately patient care does not end when you walk out of the hospital. Similarly, issues at home continue throughout the day. There will always be some overlap…However, by having a strong family support structure, a balance can be achieved.”
Find What Works for You
Work life balance is not a new concept. Although it seems to be a common topic today, surprisingly, it even had a place in the 70s. Family time, sports, exercise and vacations are the most common ways that surgeons decompress or relax – this was also true nearly 50 years ago. “Instead of joining the country club, we devoted our time to our children,” admitted one of the neurosurgeons. There was consensus among the surgeons that despite the many ways to decompress, they could not be professionally successful without a happy family to go home to. Those who were once athletes found an outlet by participating in organized sports or by watching their children participate in sports. Family vacations topped most lists as a favorite way of reconnecting and spending quality time with family.
Balance or Integration?
With all the discussion and aspirations toward work life balance, one novel question today is, “Should we really be seeking a work life balance, or work life integration?” Work life balance requires some certainty of boarders or boundaries between work and personal life. Work life integration, by contrast, acknowledges that well-defined boundaries do not necessarily exist; our success at work and in our personal life might best be achieved by developing integration between the two.
Any real attempt at life balance, or better yet, “life Integration,” means giving proper attention to the things that enrich our lives, including our career, as well as family and social relationships, spirituality, health and fitness, hobbies, community service and good old fashioned R&R.
Balance/Integration Pathway
It may not be a Clinical Care Pathway, but you can consider the following a Life Balance/Integration Pathway:
Invest some time and effort on this one while really considering what is most important to you in the various aspects of your life (not just at work). Outline those items on a priorities list then determine what you need to start doing to achieve this.
Understanding your current, unbalanced life is the launching pad for your journey to a balanced or integrated one. This begins with reviewing your current 24/7 schedule. Maintain a record of how your time is spent for one week, including all work and non-work related activities. Once patterns develop, you can begin to implement changes to your schedule.
Rest and renewal are critical. Try to find at least 20 minutes of uninterrupted “me time”. Even the most successful hedge fund managers working 18-hour days have been known to schedule meditation sessions or a “centering” activity where they are alone and quiet for 20-30 minutes each day. This “me time” benefits your health, mental clarity, relationships and level of happiness.
Proper diet and exercise are critical, especially in professions that are mentally draining. Make a commitment to eating foods that will boost your energy level and keep your system running smoothly. What you eat can not only impact your short-term and long-term health, it can affect your stress levels. Exercise and physical activity are a great way to feel better, gain health benefits and have fun. As a general goal, aim for at least 30 minutes of physical activity every day.
In our discussions with neurosurgeons, we found one commonality: Although there is no argument that being a neurosurgeon is hard work, most find great satisfaction in what they do. Family is by far the number one contributor to achieving success in a surgeon’s professional and personal life. They acknowledge there are sacrifices but see the upside to them. Enjoying a commitment to the work, and the desire to have an integrated personal life, enables success and fulfillment despite the pressures and demands that come with neurosurgery.
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