Finding Personal Time in the Business of Saving Lives

July 10, 2008— -- Dr. Brian Bethea has to stay up all night again.

But after attending to patients in their hospital beds, his thoughts turn to tucking in his little girl at home. "Got a big game tomorrow right? I'll be there," Bethea says on the phone to his daughter while sitting in his empty office. "You've got to keep your emotions in control. I love you too. Get in bed!"

The scene of fathers parenting over the phone in between meetings and making promises to be home even when they're not sure they can be kept takes place across America every day.

Bethea knows it all too well and had a particularly hard time striking the work-life balance while he was training to be a heart and lung surgeon at Johns Hopkins. Bethea — who finished his residency in June and has since found a way to make more time for his family — was stretched thin back then.

During that period, Bethea tried to share house duties with his wife, a physician assistant, such as taking their daughters, ages 11, 10 and 7, to sports practices all while working a 100-hour week. But he just wasn't able to do it all.

"You've got to put the patients first, so it makes everything else — your family, yourself, everything — by definition, second. It's unpredictable; we don't have a start and stop point to every day," Bethea said.

Saving Lives, Searching for Personal Time

"What is happening is almost a perfect storm of factors — we're seeing so many more dads taking a more active parenting role because wives are also in the workplace," said Susan Seitel, president of WFC Resources, an organization that helps train companies on work-life balance issues. "June Cleaver is dead."

Another factor in that perfect storm, Seitel noted, is the current recessionary economy combined with a skilled-employee shortage, particularly in health care.

The result is even a profession like medicine, which is traditionally defined by long hours, is waking up to the fact that the profession must adapt to both women and men demanding more of a work-life balance.

When Your Career Takes a Toll on Your Personal Life

Emotional strain, depression and burnout are the fears of many people like Bethea, who are in high-powered careers. They also may discover work can be hazardous to their relationships.

Things reached its roughest point for Bethea when the lack of consistent time with his family started taking a toll on his home life.

"On top of working [you're] trying to maintain a little bit of self-preservation," he said. "The initial downfall is the relationship between the husband and the wife — it gets neglected. And once you start neglecting it, it becomes very easy to value it less."

Partly as a result of this lack of time, Bethea's wife contacted her lawyer. Bethea then moved into a separate apartment, and it seemed like their 12-year marriage was on its way to being over.

Employers Take Notice

Traditional roles in more traditional times aren't cutting it anymore — if employers want to be competitive and attract employees, said Phil Miller, vice president of Merritt Hawkins & Associates, a national physician recruiting firm.

In the firm's 2006 survey of final-year medical residents and what they look for in a job, lifestyle ranked the highest. It also found that 63 percent ranked the "availability of free time" as a significant concern in their first job, up from 13 percent several years earlier.

"The questions they are most concerned with are, 'What's my call schedule going to look like? How much vacation? When do I get home?' The preference is for a set schedule," Miller said of both the female and male clients for whom he negotiates.

"Today's employees don't subscribe to the idea that doctors need to be around 24 hours a day. They've seen the damage that's been done to their older colleagues and don't really want that for themselves," Miller said. "They want balance, to see their daughter's piano recitals, watch their kids grow up, and keep marriages intact."

Giving Doctors Breathing Room

But can this be applied even to the business of saving lives? There doesn't seem to be much of a choice. Miller cites a doctor shortage that is only going to get worse. The number of doctors graduating from training programs have remained the same since the 1980s, even as older doctors are retiring and the population in need of good health care continues to grow.

Today the law limits doctors in residency to 80 work hours a week — a transition which Bethea just missed — and now there also is a movement to possibly shorten the amount of years involved in training a doctor.

Bethea spent nine years in cardiothoracic training in addition to four years of medical school. He says a shorter program may help attract more quality residents to the profession, but he admits it's still in question just how to do that and ensure they are adequately trained.

Increasingly, hospitals and medical groups are trying to accommodate younger doctors with part-time and flexible work schedules. Doctors are also sharing their practices with other doctors with whom they can split the work week. Miller believes these changes are good for patients in the long run. "You want a well-adjusted work force taking care of you," he said.

In the end, working fathers may find they have more issues in common with working mothers than they thought.

Saving a Marriage

Through hard work at the relationship and couples counseling, Bethea was able to save his marriage. The fact that he completed his residency and found a new job also helped. Bethea now works as an associate professor and attending physician in Dallas. Fortunately, his wife also found a job in the same cardiothoracic department.

"I think the easiest thing to do is probably go your separate ways, to throw in the towel. ... [But] when you put the focus back on each other ... it makes the relationship grow again instead of being stagnant," Bethea said.

Scott Haltzman, psychiatrist and author of the book "The Secrets of Happily Married Men," advises men to "make marriage your job — define what your job roles are and meet the challenges like you do at work."

Bethea said he is much happier now. He and his wife are able to work together every day and talk over lunch. They continue to work at making their children's activities a huge part of their lives.

"It's a matter of setting priorities," Seitel noted. She says setting boundaries are important for everyone, regardless of the industry in which one works.

"How and when are you going to be using your BlackBerry? Are you going to be text-messaging at dinner? You have to make up your mind and make the decision and decide how you will be available in emergencies," she said.

"And if, as a family, you decide it's not worth it to be working those long hours, then you have to talk about what kind of changes you are willing to make financially," Haltzman said. "In those circumstances, you have to sit down and negotiate with your partner what that acceptable level is."