Wallin' and Weavin'

Quality of life. Now there's a hot topic. It seems that everyone under the age of 45 with a marketable skill is looking for it. And every head hunter, real estate agent, and chamber of commerce claims they know where to find it. But, quality of life isn't something to market or buy. Nor is it something that's going to fall into our laps just because we behave well and have nice hair.

Quality of life is something we have to build for ourselves. And it must begin with a plan—one that is realistic, matches our capabilities and personalities, and is reasonably achievable in the current economy. It must be adjustable because stuff happens; every plan A should include at least options B and C.

It must be built from quality materials that include a vocation that satisfies our need to be productive and contribute to a cause outside of ourselves. Choosing a position primarily because it offers more free time runs the risk of our accepting unfulfilling hours of drudgery with our eyes glued to our watch and calendar. Location can be very important but without a supportive partner and/or a comfortable collection of friends, anywhere can lose its charm. The right job in the right place surrounded by the right people still can't guarantee a good quality of life because being a physician comes with stressors that can erode even the most artfully constructed life. Having watched scores of physicians and myself struggle to maintain balance in their lives, it appears that the ability to compartmentalize one's life is a critical skill.

If Robert Frost was correct about good fences and good neighbors, then the physician who can build good walls between his professional and personal lives is more likely to be living a good quality life. It takes practice for a compassionate doctor to successfully leave patients' problems in the office at the end of a long day. But it must be done. It means learning how to minimize our errors of omission so that we can sleep at night knowing we have dotted all of the i's and crossed all of the of t's. If we want to live in the community where we practice, it will mean learning how to politely deflect the occasional impertinent questions in the grocery store checkout line. At times we must adopt two personas, one for the office and one for the outside world.

Although I suspect that most practice consultants today will agree with me that compartmentalization is a strategy to aim for, it hasn't always been the model for physicians. I recently read about the death of Dr. Martin F. Randolph, a 92-year-old pediatrician who practiced in Danbury, Conn., from 1948 to 1997 (“With the Death of a Physician, An Era Fades” by Peter Applebome, The New York Times, March 25, 2010). That's 50 years of pediatric practice, folks! His office was in his home. His wife worked with him as a nurse. He saw patients at all hours including weekends. He was the school system's first physician, and he was often seen bicycling around town. I think it would be safe to say that Dr. Randolph didn't build many walls between his private and professional lives. Instead, he chose to be a weaver and wove his pediatric practice into the fabric of his life. It would seem that he did a damn good job of it. And, I'll bet you he was pretty happy with the quality of life he achieved.

Quality of life. Now there's a hot topic. It seems that everyone under the age of 45 with a marketable skill is looking for it. And every head hunter, real estate agent, and chamber of commerce claims they know where to find it. But, quality of life isn't something to market or buy. Nor is it something that's going to fall into our laps just because we behave well and have nice hair.

Quality of life is something we have to build for ourselves. And it must begin with a plan—one that is realistic, matches our capabilities and personalities, and is reasonably achievable in the current economy. It must be adjustable because stuff happens; every plan A should include at least options B and C.

It must be built from quality materials that include a vocation that satisfies our need to be productive and contribute to a cause outside of ourselves. Choosing a position primarily because it offers more free time runs the risk of our accepting unfulfilling hours of drudgery with our eyes glued to our watch and calendar. Location can be very important but without a supportive partner and/or a comfortable collection of friends, anywhere can lose its charm. The right job in the right place surrounded by the right people still can't guarantee a good quality of life because being a physician comes with stressors that can erode even the most artfully constructed life. Having watched scores of physicians and myself struggle to maintain balance in their lives, it appears that the ability to compartmentalize one's life is a critical skill.

If Robert Frost was correct about good fences and good neighbors, then the physician who can build good walls between his professional and personal lives is more likely to be living a good quality life. It takes practice for a compassionate doctor to successfully leave patients' problems in the office at the end of a long day. But it must be done. It means learning how to minimize our errors of omission so that we can sleep at night knowing we have dotted all of the i's and crossed all of the of t's. If we want to live in the community where we practice, it will mean learning how to politely deflect the occasional impertinent questions in the grocery store checkout line. At times we must adopt two personas, one for the office and one for the outside world.

Although I suspect that most practice consultants today will agree with me that compartmentalization is a strategy to aim for, it hasn't always been the model for physicians. I recently read about the death of Dr. Martin F. Randolph, a 92-year-old pediatrician who practiced in Danbury, Conn., from 1948 to 1997 (“With the Death of a Physician, An Era Fades” by Peter Applebome, The New York Times, March 25, 2010). That's 50 years of pediatric practice, folks! His office was in his home. His wife worked with him as a nurse. He saw patients at all hours including weekends. He was the school system's first physician, and he was often seen bicycling around town. I think it would be safe to say that Dr. Randolph didn't build many walls between his private and professional lives. Instead, he chose to be a weaver and wove his pediatric practice into the fabric of his life. It would seem that he did a damn good job of it. And, I'll bet you he was pretty happy with the quality of life he achieved.

Quality of life. Now there's a hot topic. It seems that everyone under the age of 45 with a marketable skill is looking for it. And every head hunter, real estate agent, and chamber of commerce claims they know where to find it. But, quality of life isn't something to market or buy. Nor is it something that's going to fall into our laps just because we behave well and have nice hair.

Quality of life is something we have to build for ourselves. And it must begin with a plan—one that is realistic, matches our capabilities and personalities, and is reasonably achievable in the current economy. It must be adjustable because stuff happens; every plan A should include at least options B and C.

It must be built from quality materials that include a vocation that satisfies our need to be productive and contribute to a cause outside of ourselves. Choosing a position primarily because it offers more free time runs the risk of our accepting unfulfilling hours of drudgery with our eyes glued to our watch and calendar. Location can be very important but without a supportive partner and/or a comfortable collection of friends, anywhere can lose its charm. The right job in the right place surrounded by the right people still can't guarantee a good quality of life because being a physician comes with stressors that can erode even the most artfully constructed life. Having watched scores of physicians and myself struggle to maintain balance in their lives, it appears that the ability to compartmentalize one's life is a critical skill.

If Robert Frost was correct about good fences and good neighbors, then the physician who can build good walls between his professional and personal lives is more likely to be living a good quality life. It takes practice for a compassionate doctor to successfully leave patients' problems in the office at the end of a long day. But it must be done. It means learning how to minimize our errors of omission so that we can sleep at night knowing we have dotted all of the i's and crossed all of the of t's. If we want to live in the community where we practice, it will mean learning how to politely deflect the occasional impertinent questions in the grocery store checkout line. At times we must adopt two personas, one for the office and one for the outside world.

Although I suspect that most practice consultants today will agree with me that compartmentalization is a strategy to aim for, it hasn't always been the model for physicians. I recently read about the death of Dr. Martin F. Randolph, a 92-year-old pediatrician who practiced in Danbury, Conn., from 1948 to 1997 (“With the Death of a Physician, An Era Fades” by Peter Applebome, The New York Times, March 25, 2010). That's 50 years of pediatric practice, folks! His office was in his home. His wife worked with him as a nurse. He saw patients at all hours including weekends. He was the school system's first physician, and he was often seen bicycling around town. I think it would be safe to say that Dr. Randolph didn't build many walls between his private and professional lives. Instead, he chose to be a weaver and wove his pediatric practice into the fabric of his life. It would seem that he did a damn good job of it. And, I'll bet you he was pretty happy with the quality of life he achieved.