Work Life fit, create a successful partnership and career withs tips from Wonder Woman, Susan Hingle MD of ACP.
Work-Life Balance: is it a myth, or attainable if we could just find the right fit? In this episode, we chat with Dr. Susan Hingle about identifying our work-life priorities and re-evaluating these priorities throughout our lives. We strategize about achieving personal and professional goals (pro tip: stop worrying about what others think!). Dr. Hingle is Professor in the Department of Internal Medicine and Vice Chair of Education and Faculty Development and Associate Internal Medicine Residency Program Director at Southern Illinois University. She is also the Immediate Past Chair of the Board of Regents of the American College of Physicians (ACP). She has served at the ACP in a variety of ways, including as a member of the ACP Women’s Task Force. Her clinical expertise is in women’s health, health promotion, and disease prevention. Enjoy the episode!
ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST). Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at email@example.com.
Written and produced by: Nora Taranto MS4, Shreya Trivedi MD, Leah Witt MD, Sarah P. Roberts MPH.
CME Questions by: Shreya Trivedi MD
Editors: Matthew Watto MD and Chris Chiu MD
Hosts: Shreya Trivedi MD, Paul Williams MD, Leah Witt MD
Guest: Susan Hingle MD
Get with the lingo. Work-life balance implies that something will always be out of balance. Work-life integration suggests that, in an ideal world, work will integrate with your outside-of-work life (that may or may not happen). Work-life fit means that work and life expand and contract, evolving over time. At any one point in time, family might be more important, and the professional side may give a little. And then as kids grow up or as ill parents heal, the professional aspects of life may dominate. These changes are part of the excitement of life. The question is not how to attain work-life balance, but how to make your values and priorities fit with all aspects of your life.
Dr. Hingle’s moment of awakening was actually a series of moments. She’d been called the “Princess of the ACP”. When she tried to address this, she was told to drop it to avoid being “one of those women.” Then, national events raised the importance of gender equity in medicine and coincided with Dr. Hingle becoming chair of the ACP board of regents.
|“I felt this sense of responsibility and this sense of opportunity that I had a national and international platform to be able to effect change, and I decided that actually I did want to be one of ‘those women’, and am happy now to be one of ‘those women.’” – Dr. Susan Hingle
Have important discussions, with yourself, your family, and your mentors, in order to identify and make room for your life and career priorities.
Most programs aren’t explicit about family leave, but most programs will make accommodations. Medical students: look for a residency program director who is approachable when life happens (because it will), who can help with hard decisions, and takes resident well-being seriously. Figure this out by talking to residents at your interview day about the program’s culture.
Note: Among the top 10 US medical schools, the mean length of full salary supported childbearing leave is 8.6 weeks (range 6-16 weeks); 3 of 12 schools provided more than 8 weeks. There were 8 schools that allowed extensions, usually for medical reasons. The mean length of family leave was 17.9 weeks (range 2-25 weeks) with four schools providing more than 8 weeks of salary support (1 only for tenure track); however, policies varied widely between institutions. Most family leave policies had several constraints, such as restricted to “primary caregivers” who care for a child more than 50% of time, and some with ambiguous language regarding duration of leave (Riano et al JAMA 2018)
Remember Dr. Arora’s advice (Curbsiders Episode 107)? Be bold! Our hyper-planning personalities often pressure us into self-imposed timelines (e.g. marrying by 30, having a child by 35, finishing residency in 3 years, or matching into that *exact* fellowship in a *specific* location). Life is unpredictable. Make decisions that reflect your values and priorities based on today’s data. If something doesn’t feel right, reassess and be bold in making changes.
But it’s a good thing! Great things often happen unexpectedly, and shift career trajectories. Dr. Hingle has worked with the Executive Leadership in Academic Medicine program (ELAM), whose aims are to empower women to be successful in academic medicine. Through ELAM, she conducted interviews with leadership (hospital CEOs, CMOs, deans, etc.) about career paths to success.The main theme? Take advantage of unexpected opportunities.
This is tough for all of us, and women especially suffer with this challenge. Pivot your focus on how decisions will affect you, your family, and your significant others. Physicians are often focused on being team players and not imposing on others, so this mindset can be challenging.
|“It is not our job to worry about what our residency colleagues will say if we take time off to care for our ill parent, or if we have a child. It is not our job to figure out who will provide coverage if we take time off. People are, in fact, paid to deal with figuring this out (program directors, program coordinators). We need to take that out of the picture as much as possible, to assess current priorities in the moment.” – Dr. Susan Hingle
One of the most important things Dr. Hingle learned as a chief resident, when building schedules for over 100 residents, was advice from her program director: You’re never going to make everyone happy. That shouldn’t be your goal. Your job is to do your best at one particular point in time, and to be happy with that. We can’t give 100% to every aspect of our lives at all times.
|“As women in medicine, we will face self-doubt. It’s going to be hard, in part because people are going to regularly underestimate you. Do not believe them. Believe in yourself. You are valuable. You are worthy and you have this incredible opportunity to help others and to effect change.” – Dr. Susan Hingle
The guilt of going part time. Most of us are hyper-dedicated to our jobs. We spent our early adult lives training for it, after all. Many physicians (and not just women) experience guilt when grappling with how to spend more time outside of work. Unfortunately, jobs for physicians are rarely 40 hours/week. Fortunately, many jobs have the flexibility to be part-time. Women frequently make this choice for caregiving, as women are more often primary or informal caregivers for family members (2016 Caregiver stats).
Female doctors spend more time with home and office housework, and feel more burnt out. A JAMA IM article from 2017, showed that women in dual-physician households with young children work 11 fewer hours per week (outside the home) compared with women without children. (Ly JAMA Oct 2017). Among young academic physicians with children, women spend 9 more hours per week on domestic activities than their male counterparts, and are more likely to take time off when a child is sick or a school is closed (Jolly Ann Intern Med 2017).
There are gendered expectations that many women feel pressured by, some of which are self-imposed (Women, Stop Volunteering for Office Housework! Salam NYT 2018). One way to address time-consuming domestic tasks is by outsourcing (e.g. Dr. Hingle outsourced housekeeping, which helped her family immensely), if such an arrangement works for you.
Don’t be afraid to seek or create flexibility in the standard structure. Limit those 6:30am and after-hours meetings. Feel comfortable leaving work when the work is at a stopping point and you need to care for your personal life. Your colleagues will be (or should be) happy you are fulfilled outside of medicine.
|“I used to come into work at 6:30 in the morning, and now I have to drop my son off at the bus. So I started suggesting 7:30 meetings. Or I used to go to a lot of after hours dinners, and now if my son has scholastic bowl and I decline one of those events, I’ve been incredibly surprised at the acceptance and flexibility of my coworkers. People will say ‘Oh, I’m sorry I forgot you have these other responsibilities, we can move that.’ People are more flexible and understanding than you would think.” – Dr. Susan Hingle
Find someone who will support you even in challenging times. You will be working hard. You will be working a lot of hours, and making compromises. Choose a partner who is proud of you and excited when you have successes, and who will be open to having discussions about priorities, as life happens.
Relationship negotiations may include shifting gender norms, for some couples. Have open and honest conversations with current (and prospective!) long-term partners about real-life challenges and the “division of labor”. This can be hard in dual professional couples, where both partners have invested a huge amount of time in their education and careers. Who does what does not have to break down along gendered lines. When parents take “non-traditional” roles, this can create unique role modeling in families (e.g. Dr. Hingle’s husband stayed at home with their kids, leading her son to to say that he wanted to be stay-at-home dad when he grows up!).
There is no “good time” to have children, just the “right” time that works for your family. In Curbsiders Episode 118, Dr. Stacy Lindau said that one of the best pieces of advice she had received was that there was no “good time”, in one’s medical career, to have children. Decide when is right for YOU. 64% of women physicians report deferring important life decisions in pursuit of medical career. 86% report waiting to have children, and 22% waiting to get married (Bering J Womens’ Health (Larchmt) 2018).
|“You need to work reflection into what you do on a regular basis so that you know your priorities in life at that moment, and can acknowledge them as they change. If you integrate reflection into your life, you will figure out when the right time is to have kids, to get married, etc.” – Dr. Susan Hingle
Redefine success at a personal level. Many of us in medicine have a drive for perfection. Humans have finite capacity, as described by Harvard Business School’s Laura Nash in her book, Just Enough. No one can give 100% to everything and if you try, you may end up unhappy or burnt out. This drive for perfection can be toxic.
Consider a Kaleidoscope. When you’re looking through a kaleidoscope, there are a multitude of colorful moving pieces. When you look in, you’re not looking for the perfect picture, you’re looking at a beautiful ever-changing picture. As you rotate the kaleidoscope, the pieces move and you discover that each new image is beautiful. Success is defining for yourself what a beautiful life looks like, from moment to moment, and not having someone else define it for you.
Listeners will gain a better understanding of the challenges faced by women in medicine.
After listening to this episode listeners will…
Dr. Hingle reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.
Leah: Money Heist on Netflix
Sue: Bohemian Rhapsody (the movie)
Paul: Flicker, a novel by Theodore Roszak
Shreya: Jiro Dreams of Sushi
Links from the show are included above.
work, life, fit, balance, integration, partner, Women in medicine, WiM, career, family, planning, caregiver, women, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student
Hingle, Susan. Guest expert. “#130 Work-Life Fit: Women In Medicine.” The Curbsiders Internal Medicine Podcast http://thecurbsiders.com. December 13, 2018. http://thecurbsiders.libsyn.com/130-work-life-fit-women-in-medicine
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