Losing our self-identity in medicine is an often overlooked consequence of human nature. The expectation is that being a physician means everything outside of our work is to be sacrificed.
Why is that?
In this post by The Physician Philosopher, he talks about the difficulties of choosing between work and life, but also the reward you will feel when you adopt a “Hell Yes!” policy.
It seems like natural human tendency to explain ourselves. When we are late to a meeting, we come up with an excuse in case anyone asks. When our kid starts throwing a temper tantrum at the store, people stare at us expecting an apology. In the same way, when we decide that there are things outside of medicine that are more important to us than the job – an explanation seems required. That’s until you adopt a “Hell Yes” policy.
I am here to say I am done playing this game.
And, as you’ll see, I don’t think you should keep playing either.
Losing Our Self-Identity
I’ve been on several podcasts recently. One of the themes that keeps presenting itself is how we define our self-identity when we earn a paycheck as physicians.
How do you define who you are? If you aren’t sure, a great way to figure this out is to see what you say when someone asks you to “tell me a little bit about yourself. Who are you?”
Self Identity in Medicine
One of the most meaningful posts on this site remains my post on losing our self-identity.
For those that don’t feel like clicking the link, here is my typical answer when I am asked to “tell me a little bit about yourself”.
“Well, I am a God-fearing husband and father of three. I am an author, inventor, teacher, blogger, and golf-playing craft beer lover. I also happen to be a physician who practices anesthesia.”
This might seem trite, but answering questions about my identity in this way serves two purposes.
First, I am speaking truth into my own life. It is a reminder of who I am and why I am here on this earth. As life gets busy, sometimes we forget what’s truly important. I am a physician, but that is not what defines me. Reminding myself of that is important.
Second, it is imperative to me that my readers, which include medical students and residents, see that you can be good at your job as a physician and have other priorities in this life. Being a physician does not have to be an all-consuming act despite what other generations would have you believe.
Competing Priorities Leads to Burnout
Unfortunately, our priorities that define our identity can often be at odds with each other. We can’t always be the greatest doctor, spouse, and parent.
When my wife started full-time in July – for the first time – I was forced to choose between my priorities. My job as a dad tripled while my work requirements at the hospital remained at 1.3 FTE (130% of a full-time schedule). This doesn’t even include my research and education efforts.
All of a sudden, there simply weren’t enough hours in the days or weeks to accomplish everything that I had planned. Apparently, having a voracious appetite for setting and achieving goals has its limits.
With a realization that my time was limited, I couldn’t waste another second on things that didn’t matter to me. It really brought everything into perspective.
Honestly, it also completely burned me out. Given that I’ve been writing about physician burnout for a year, the irony was not lost on me, but it was happening whether I wanted it to or not.
This led my wife and I to have a lot of conversations about what mattered most to us, which can be easily accomplished using the Three Kinder Questions.
If we were suddenly living the ideal life, what would that look like? If we knew our days on this earth were numbered, what would that change?
There were a lot of common threads throughout these talks. For example, we wanted to be at all of our kids’ extracurricular and school events. We also wanted to travel, spend time with family and friends, and pursue our passions.
As these talks progressed, I started to notice that none of my goals involved increasing my number of publications to get more notoriety, staying later at work, or whether I’ll ever make full professor in academics.
Does that make me a bad doctor or academician? No. I still hold to some of these goals, but they are just lower on the priority list than they used to be. And, that’s okay.
The Generational Gap
When I started saying “no” to new committee opportunities and commitments, I often felt like people were staring at me. The squeaky wheel might get the grease, but it also seems to get a lot of attention from a certain crowd.
You know what I am talking about. The people who say things like “being a doctor is a noble calling that requires sacrifice!” Or maybe you’ve heard people say something like “suck it up, you’re a doctor.” This is the same group that says doctors shouldn’t retire early.
The expectation here is that being a physician is who we are, and that it is an all-consuming calling that requires everything else to be sacrificed at the altar of being a dedicated (i.e. non-complaining) physician.
These conversations remind me that there continues to be a generational gapbetween those who identify with a Generation X mentality and the millennial physicians who are coming into the fold.
The Generation X thought process demands that we put our hands to the plow, put our head down, and push until someone tells us to stop or the job is done. If we do stop before the job is done, and our hands aren’t bloody, we are clearly not dedicated to the cause.
The millennial mindset asks why the plow is shaped the way that it is, if we can get the job done more efficiently using a different method, and if we can make the process better for everyone involved.
These questions lead to a uniform response: Don’t you dare ask questions, young millennial! You haven’t had enough trips around the sun. There is a reason we are the way that we are!
Take Home: The “Hell Yes” Policy
My point is this. Many doctors (young and old) are tired of having to choose between work and life. If they can’t have both work and life, many of them are choosing the latter.
It is not my job to explain to others that being a husband and father matters more to me than my job. It is also not my job to care what others think about that.
I simply don’t have enough time in my life to accomplish everything. This has resulted in a “Hell yes” policy where I only say yes to things that I can’t refuse.
Otherwise, I risk burning out completely or missing out on the people and things that matter most to me in this life.
We should all refuse to lose our identity in our jobs. And when others call us on it, remember that it is not our responsibility to explain ourselves. It’s okay to care more about things outside of medicine.
And, if something doesn’t make you say, “Hell Yes!” then you should probably just say, “no.”
Have you ever had to choose between work and life? How did your colleagues handle that? What advice would you give to others who are struggling with this balance? Leave a comment.