How to achieve balance in and out of the office

Key Points

Always be a student. Medicine is a life-long commitment to learning. No urologist can be on top of his game by using only the knowledge and skills he received during training. Balance is achieved if you pursue knowledge throughout your life. Sir William Osler, one of the first professors of medicine at Johns Hopkins University, recommended to physicians and students at the end of the 19th century, "Try to get the education, if not of a scholar, at least of a gentleman. Before going to sleep, read for a half hour, and in the morning have a book open on your dressing table. You will be surprised how much can be accomplished in the course of a year."

Most state licensing boards now require that continuing medical education include regular courses in ethics. Regard this not as a burden, but as an opportunity to look at your patients and your profession from a different and balanced angle.

Take control of your finances. Most young urologists today enter practice with nearly $250,000 of debt, which will take years to pay off. However, balance comes from financial security at the end of your career, when you can practice because you truly enjoy the practice of medicine, not because you have to work. To have that security and balance, we recommend that you start the saving process early. Even in the face of daunting debt, you need to start a savings plan for your children's education and your retirement.

Learn to say "no." There is no faster road to burnout than taking on too many projects and accepting too many responsibilities. The next time you are called to join a hospital committee, become a member of a board in the community, or accept an invitation for an evening dinner, ask yourself these questions: Will the obligation enhance my career? Will the commitment take away from my time with family and friends? Will this obligation lead to imbalance in my life? If the answer is that you aren't furthering your career and/or it distracts from your family time, then turn down these requests. It is not a sin to say "no."

Set your priorities. Most urologists who have balance in their lives place, in order of importance, their religion first, their family second, and their practice third. Rabbi Harold Kushner, in When Bad Things Happen to Good People, wrote of having never met anyone on his deathbed who wished he had "spent one more day at the office." The meaning is the same if you replace the last few words of that phrase with, "saw one more patient." It is never too late to spend one more day with your spouse, your children, or your grandchildren.

Find a niche. Ross Perot described success as finding an unmet need, becoming an expert, and filling that unmet need. If you can do that, others will be knocking on your door to be your patients or to do business with you. It is amazing how successful you can be if you focus your energies on a single area of interest or expertise.

Hang out with people one generation older or younger than you. If you are a young, new urologist, then meet older, more seasoned doctors who can show you the ropes, share their valuable experiences, and give you wise counsel when you need it. If you are an older urologist, hang out with the Gen Xers. This contact with younger people can keep you current, energized, and on top of your game. In other words, balance your friendships.

Exceed patients' expectations. To truly enjoy your medical practice, it is important to not just meet patients' expectations, but to go beyond what is expected. We suggest that you adhere to the "extra mile" philosophy, which requires you to go the extra distance for your patients, exceed their expectations, and provide a little more than other doctors do. Your patients will remember you for it.

Many businesses, from office product suppliers to upscale department stores, have found that providing deluxe services to their customers ensures that those customers will keep coming back. A medical practice is no different in this respect. In today's health care market, it is very difficult to compete on price. What you can do is to make sure you're filling your appointment book. This can be accomplished by finding out what patients want and giving them more of it, and asking them what they don't want and making every effort to avoid it. It's just that simple.

Be a disciplined doer and decider, not a procrastinator. Nothing adds more anxiety to our lives than having deadlines and commitments that we have trouble meeting. If you have several projects looming, break them down into smaller projects and make a calendar to mark off their completion. That way you won't be left with a huge project with only days to complete. Discipline can bring balance to the busy professional: Clean out your inbox, fill up your outbox, complete your medical records before the delinquency notice arrives, and look for an end point to your day.

There will be a new set of mail, results, and problems tomorrow, and a clean slate creates a balanced perspective. Confront those challenging decisions. A professional who can decide in a few minutes to recommend a radical extirpative cancer operation to a relative stranger ought to be able to decide about the new 3-year lease with a few days' reflection.

Finally, have fun. The best advice to achieve balance is to take your profession seriously, but not yourself. Find ways to add a little humor to your daily activities. Start your day by listening to a CD of Jeff Foxworthy, Bill Cosby, or Abbott and Costello. A smile is the shortest distance between two people. Let us not forget that medicine is the most enjoyable profession, and it can be the most fun and rewarding, especially if we add a little humor.

Dr. Baum is a urologist in private practice in New Orleans. He is the author of Marketing Your Clinical Practice-Ethically, Effectively, and Economically.

Dr. Dowling is medical director of Urology Associates of North Texas, a 48-physician community based, single-specialty group in the Dallas-Fort Worth metroplex.