Balancing the many roles in the physician’s profession


How Doctors Manage Business, Patient Care, and Set Boundaries to Help Curb Stress

Saying “no” to unwanted stresses is an important part of balancing your physician duties with home life. Just ask family practitioner Dr. Joseph Ghaly.He limits night and weekend duty, freeing him to spend more quality time with his family.
Dr. Dean Shull, president of the Polk County Medical Association, said “no” to his psychiatric practice after 40 years. He now works about three or four months out of the year as a locum tenens, a temporary doctor. Dr. Duane Gainsburg,a neurosurgeon, works about ten days every month as a locum tenens.
Dr. Cynthia Enlow,a pediatrician,carves out a two-hour lunch break whenever she can, enabling her to go home for lunch, nap, and make plans for later in the day. She used to eat lunch at her desk, but she discovered nurses and patients would come in with questions “just because you’re there and it’s easy.” Even shutting the door is helpful, but living three miles from her office lets her go home for lunch. “I take naps,” she acknowledges. “When you’re little you avoid taking naps. When you get to be an adult you really appreciate them.”Every doctor’s solution is a bit different, but each sets his or her own boundaries to avoid work overload.
As a solo practitioner of a family practice, Dr. Ghaly finds he has more freedom to align his work with personal priorities. “We’re in a very good place now,” says Dr. Ghaly, who usually spends weekends with his family while hospitalists care for his patients. “It’s certainly a process. You continue to balance and improve that balance as you go.”
Out of a desire to give back, he volunteers twice a month on Sundays at a health clinic. He acknowledges you have to make balance a priority. “In the past I wasn’t so good at that,” he concedes. “I had to rearrange my schedule.”
As president and owner of St. Luke’s Regional Health Care Center in Lakeland, Dr. Ghaly makes it a priority to take off half a day a week for administrative matters. “We try to have dinner together at the table every night,” he adds.
Dr. Ghaly enjoys being able to access medical records at home or while on vacation. When he’s away, he might spend 15 to 20 minutes a day addressing concerns.
He includes his family when he attends Continuing Medical Education conferences, so it becomes a getaway of sorts. And because his wife Lisa is a pharmacist, she accompanies him to dinners and lectures. In addition to working as a clinical research manager for Merck, she manages his office practice, complementing his efforts. “We make a rule to take one to two big trips [a year],” he points out.
Vacations are important to tap into your spiritual energies, says Dr. Shull,an elder in the First Presbyterian Church of Winter Haven. “It offers us an opportunity to get quiet, to go somewhere where it’s possible to be — not to think, but just feel it,” he explains.“If a person takes time to be, it is like finding a source of a never ending spring of what you need.” As a locum tenens, he is holding the place for another psychiatrist, all the while freeing himself from the obligation to pay medical malpractice insurance and run the business side of his practice.“I wanted to work, but not full time anymore,”says the 74-year-oldphysician.“When you’re through, you’re through. It’s a good, clean way of working.”
He calls the shots: He loves to explore the area where he’s at, visit the local Rotary Club, and give his patients the time they need.“I’m not a robot,” he adds. “I’m going to see patients the way I see them. The first day [of my assignment] I ran 1 1/2 hours over.”
Dr. Gainsburg, a 74-year-oldBoca Raton resident who travels out of state to work,tells a similar story. “It works perfectly,” he says of beinga locum tenens.“I […] decide how much I’m going to work, where I’m going to work.” But he doesn’t turn it into a working vacation. “I’m really there to be a full time doctor. They expect it,” he says. “When I’m not a doctor, then I’m home. The two lives don’t conflict and compete with each other.”When he’s working he’s on call 24 hours a day. “I’m used to it. I was 24/7 in my solo practice,” he says.
Dr. Gainsburg closed his practice eight years ago after testing the temp arrangement for a weekend, and then a full week. He recommends being a locum tenens to senior physicians and others “fed up with the hassle” who want to supplement their income.It’s also a good idea for new physicians looking for their preferred venue, he advises.As a locum tenens, he acts like a business partner stepping in as a substitute while the regular doctor is off. “I’m not there to take work away from the full time people,” he clarifies.
As a critical care physician, and associate director of Medical Intensive Care at Orlando Health Physician Group,Dr. Kerlan Wolsey is on the other end of the spectrum. He relies on locum tenens from Weatherby Healthcare headquartered in Fort Lauderdale for backup on occasion. “There’s a universal shortage of critical care physicians,” says Dr. Wolsey. “It helps to have a day off to recover, to decompress. […] Everybody has a honey do list they have to go through.”
Being part of a firm, Lakeland’s Clark & Daughtrey Medical Group, gives Dr. Enlow the benefit of backup from fellow staff members. But as a pediatrician, the arrangement does require some flexibility. She tries to schedule personal and family activities when she is not on call. “Whoever is on call covers the clinic that whole weekend,” she explains. “With four of us, it’s one weekend a month that we’re tied down.”
Dr. Enlow, whose children were 12 and 14 when she began working at Clark and Daughtrey 14 years ago, found it best to have a routine and make herself stick to it. In general, she prefers being active to sitting around with the stress of knowing someone may call with an emergency. “These days most seem to be managed over the phone,” she says. While she enjoys the ease of checking medical records at home, she advises, “You can’t let yourself get caught up in checking things that don’t really need to be checked.”

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