Balancing Act

A good friend of mine, who’s a family practice APP, recently asked me about work-life balance. She’s an experienced and skilled clinician, a leader in her workplace, and a consummate professional. She’s also a mother with two young children, one of whom is still an infant. Since coming back from maternity leave, she’s been struggling to figure out how to make good on all her responsibilities: to her family, to her patients, to her co-workers, and to herself. Oh, and also she’d like to sleep sometimes.

I had no real answer for her. Medicine is broken--and primary care doubly so. The amount of care we expect our providers to deliver, and the documentation they need to do, and the performance metrics they’re supposed to meet, and the prescriptions they need to fill, and the lab results they’re supposed to review--there literally isn’t enough time in a day to do it all, even if they lived at the clinic and slept on a cot in the storage room. If we continue to ask them to do this job, sooner or later they’re going to refuse. What will we do then?

Medicine needs a system-wide overhaul. We need high-functioning teams of providers and support staff practicing smart, proactive, comprehensive primary care, and we need a system that supports and rewards them for doing it. Without that, we’re heading for a cliff, and we’re running out of time to turn the wheel. 

When you’re carrying a piano on each shoulder while riding a unicycle, the appropriate question isn’t: “How do I find balance?”  It’s: “What the f*#%k are we doing?”