Finding Time Away From Your Practice
Around 30 minutes before I was leaving today, I e-mailed my husband to let him know I would bring home my extra lunch for dinner. (I overbooked and had two lunches.) Things didn't workout the way I had planned. I called him at home, two and a half hours later, to see if he had eaten. His reply, amid chewing was - “yes.” I arrived home 20 minutes later and was greeted by my oldest son. We shared the leftover lunch and started talking about what I could write for this article. He wondered if I had addressed the topic of work-life balance ... not a bad idea.
Finding the balance between work and life can be extremely difficult. When you open your own health care business, it can be nearly impossible. I opened a primary care clinic. One of the biggest needs in health care today is access to primary services. Lack of PCP services results in overuse of the emergency rooms or urgent care centers, fragmented care from constant retail clinic use and poor case management or monitoring of chronic conditions. Poor utilization of health care services contributes to the high cost of health care today. How do you balance being there for your patients and taking care of yourself (and family)? How do you do it when you are the primary clinician and owner? The quick answer would be to hire more staff, but how do you pay for them?
When I decided to try opening my clinic, I had a great job. I worked three days a week (Tues, Wed,and Thurs), had call only when someone was out of town or sick, had my own patient panel and was paid very well. Many of my colleagues wondered why I left my position. (My reasons were discussed in an earlier article). In the beginning I used my two days off during the week to plan and prepare for the opening of the clinic. I was able to be home when my family was home, continue to participate in my community activities and still feel like I was moving forward on the clinic opening.
Once the clinic opened, all my time was spent at work. Our model as a full-service primary care pediatric and family clinic meant that we needed to be available extended hours and on weekends. My original partner had a young child and felt she could not spend as much time in the clinic as was necessary. Someone needed to be there when patients needed to be seen. At the time my oldest son was in college and the younger two were in high school, so I told myself it was fine, the kids didn't need me to be around “as much.” My husband filled the gaps with the boys and kept quiet about my obsession. (Bless his heart!)
Last year (2007) was the first year I took an actual vacation from the clinic. There were times when I would be “out of the office” but never without contact. I have a picture that I keep on my wall of me talking on my cell while cruising around asthma camp on a golf cart. You can bet I was talking to someone at the office. Leaving the area and going to a place where there was no phone or cell service was very difficult for me. I admit I like to know what is going on at all times, but I have worked hard to keep from becoming a control freak. I am making progress...
That vacation was the first time my husband and I ever went to the BWCA alone. I love the BWCA (BoundaryWaters Canoe Area Wilderness in Minnesota). I introduced my family to its majesty when the boys were in elementary and middle schools. My husband has gone every year since, but I am always too busy with work.
There were a number of factors that motivated me to take that vacation. I had finally found a potential partner who had the same passion and drive as me, I had another clinician who wanted to see the clinic succeed and was comfortable making decisions when I was gone, and I had excellent support staff to keep things running smoothly. Short of a natural disaster, I felt the place could hold its own for a week or so. It was risky taking vacation during summer break –typically a busy time in pediatrics - but we picked a week that was historically slow in patient visits.
I was a nervous wreck, but I learned one very important lesson: The world continued to revolve while I was gone. The people I chose and the systems we created, kept things going when Iwas gone. I also learned that I was missed by my family the past 5 years. My husband kindly told me that I was obsessed and that I was beginning to show the stress. He didn't say how I showed the stress, but I felt the gray hair and wrinkles might have been a clue.
It wasn't until this year that I have felt I did not need to be involved in the business every waking minute. I have even started to take one day off during the middle of the week to get a few things done before the holidays. It took my partner to point out that I was going to burn out and be of no value to the business or myself.
Slowly I have moved some of the administrative and clinical responsibilities to other members of my staff. It is hard to keep myself from watching over their shoulders – this is my baby. Well, babies need to grow up. It has taken over 6 years for me to feel this comfortable. The clinic is still running in the red more than the black, we still have many battles to fight with insurance, legislation, competition and the like, but I have come to a place where I know I am better at my job if Ihave a break from it. My husband has remarked how much more relaxed I seem, and my kids are asking if the business is going well because they see me more often.
Keeping life and work apart is very, very difficult. As my partner says, your work is your life when you are the owner. Take heart in the knowledge that you have set up good systems and have surrounded yourself with good people who can keep things going when you need a break. Your emotional health is projected onto your staff and your patients. It is very easy to get caught up in the business of doing business and forget that you are in this to care for others – don’t forget to include yourself.
Now, if I could take my own advice!