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    No balance without boundaries for physicians

    My first experience with finding balance came when I was fresh out of residency. Having just joined a private obstetrics practice, I was so excited to finally make money and enjoy a lot more free time than in the prior four years. It did not take long to realize that I had significantly overestimated the amount of free time I was going to have. I had scheduled a tennis lesson for Friday evening, which gave me plenty of time to finish office hours, sign out and get there on time.


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    But things don’t always go as planned. My office ran way over, and the last patient was more complicated than I had originally thought, so I ended up racing to my lesson and still got there half an hour late. Maybe the week had been worse than normal, or maybe I just got caught up in the moment, but when I actually got onto the court, all I could do was sit down on the bench and cry. Cry over the complete lack of control I had over my own schedule and essentially my life.

    It wasn’t supposed to be like that after residency. I had paid my dues. My tennis instructor listened patiently, then looked at me and said, “The problem is, your life has no boundaries, and if you have no boundaries you can’t possibly have balance.”

    I thought about his words long after leaving my defunct tennis lesson-turned-therapy session, and realized that he was exactly right. So much so, that it has been one of the most profound pieces of insight I have ever received. 

     Now you may ask why I found such a seemingly simple piece of advice to be so profound. Because that one answer, wasn’t just one answer. It led to a cascade of many other answers that helped me reevaluate and rebalance my life at that time, and many other times throughout my career and life when balance escaped me.

    So what was it about boundaries that was so important to finding balance? The most important thing I figured out wasn’t about establishing boundaries. It was the realization that sometimes in our profession there just weren’t any boundaries between work and home. One often bled into the other.


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    The nature of the job dictated that no matter how hard I tried, there were days that office hours would run late, and others when dates or events would be cut short or ruined by an emergency. Coming to grips with, and accepting that was monumental for me because I had fought against that so hard. But the reality was, that was part of being a good, caring doctor. It was part of the job; a job I loved, and indeed had signed up for.  

    Once I accepted that, it was up to me to create the boundaries I wanted and needed for balance. How much time off and me-time did I need to rest and rejuvenate? What did that ‘R-and-R’ look like, and was my schedule and the hours I worked conducive to that? Nobody could answer those questions but me. 

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