Work-life balance is a huge topic in leadership circles these days. There’s been a strong reaction against the old “work till you drop” mentality, where your job was your life and things like health, family, and personal fulfillment received marginal attention at best. And while most of us would agree that a fuller life is a worthy goal to pursue, something else must also be said: medicine is hard. It’s demanding. It’s never going to be easy. If you’re looking for a career where you reliably get five hours of “me time” each night before bed, medicine probably isn’t it. As leaders in the medical field, we must not shy away from the fact that medicine asks a lot of its practitioners. Rather, we must strive to equip our people for the challenge.
I’ll state for the record: I work hard. And I like it. I get tremendous satisfaction from doing challenging, difficult surgical procedures and doing them well. I view medicine as a calling, and I’m not ashamed to say that my job receives the better part of me. I also treasure other aspects of my life, such as family and friends. But I knew from the outset of my career that medicine would dominate my life and attention. And I agreed to that condition going in.
Expectations Matter
That’s not to say doctors should endure unreasonable demands or oppressive work conditions. If you read this blog or my book All Physicians Lead, you know I’m a champion of workspaces that are caring, respectful, and psychologically safe. But that doesn’t mean we should soften the requirements. Medicine is hard, and its practitioners must be fully up to the challenge.
Some of today’s job dissatisfaction among doctors seems to stem from a mismatch between expectations and reality. If you come into medicine thinking you’re going to work a regular, nine-to-five, no-nights, no-weekends, four-day-a-week job, you’re in for a shock. That’s not the job, regardless of which specialty you practice. The learning process alone—the initial schooling and the ongoing effort to stay current—is extremely taxing and time-consuming. You can’t do that to the degree necessary and still have five hours of free time every night.
People acknowledge that medicine is challenging, but they often have no idea how demanding and personally taxing it can be. There’s no real way to prepare for it. You can read about it, you can watch movies about it (usually inaccurate), or you can even shadow other doctors for hundreds of hours. But until you’re in it, until you’re the one holding a patient’s life in your hands—you cannot know how stressful it is.
That’s why I urge my healthcare colleagues to go back to saying, “This is really hard work.”
Mastery is a Must
There’s a lot of talk these days about restoring the “joy in medicine.” Being a physician can and should be joyful, whenever possible, but it will never be easy. This is a profession where people’s lives are in your hands, where you are entrusted with people’s deepest secrets, where you touch people in intimate ways no one else is permitted to. You must work very hard to earn such trust. And so, we must be clear with people entering the field that they are signing up for something hard, and we shouldn’t make it less challenging. If we did, then doctors wouldn’t spend as much time learning. They wouldn’t do the work necessary to achieve mastery. And that’s what our patients deserve: mastery. Not adequacy. Mastery.
Mastery is not achieved by doing easy things. Mastery is achieved by doing hard work.
The practice of medicine is not for everyone. It’s for a particular type of person with a particular mindset. We do no one any favors by pretending it’s just another nine-to-five source of income. Its practitioners must be fully cognizant of its unique demands and stresses. Of course, medicine also has unique rewards. When I see a child whose life I saved in the OR graduate from college or start a family, all that hard work seems like a tiny price to have paid.