I see you, Dr. Early Career! You worked long and hard to get here. You are an attending physician! Is this what you envisioned it would be like? You want the life you pictured it to be, you want it all! To get to that place, there are 3 key secrets to protect your time. You must learn and implement these strategies to find life balance, and the harmony you desire. You CAN fit your career in alongside the other important areas of your life.

These secrets to protecting your time are not taught in medical school or residency. I didn’t learn them until mid-career, during a season of burnout in most aspects of my clinical job. As an Early Career Woman Physician, please don’t think you are alone in this season.

A 2020 JAMA Network Open article reports only 40-46% of surveyed physicians feel their work schedule leaves them enough time for personal and family life. Shanafelt and Noseworthy report poor work-life integration is a driver on the burnout-engagement spectrum, and lower work-life integration scores are associated with higher burnout.

A 2019 JAMA article states 40% of women physicians leave medicine or cut back their hours 6 years after finishing training! 

And as we currently examine “The Great Resignation” trend, a recent Mayo Clinic Proceedings article reports that 20% of physicians surveyed plan to leave medicine within the next two years, and 30% plan to cut back on their hours.

The Big Question Then Is: How Can You Get an Early Career Physician (ECP) To Turn Into a Mid Career Physician?

For physicians, Early Career is typically defined as being the ten years after training is finished. Mid Career is 11-20 years post training, and Late Career is 21 years and beyond. Simply put, to successfully get to Mid Career a doctor needs to work as a doctor, but staying in the game is the hard part.

Let me show you 3 practices that help me protect my time. These help me live a balanced life while continuing to practice clinical medicine. I know you can do it too!

1. Learn When to Say Yes and When to Say No

Early Career Physicians (ECPs), when you were doing your residency and possibly fellowship, you were establishing yourself – the same way as someone in a business or law profession. You put in long hours and received lots of supervision during this time. Your time is often at the mercy of others.

When you mature into an attending position, you get to call the shots more often. It is a time to be curious and experiment with different opportunities.

It is very important to regularly reassess how you spend your time, to see if it’s still in alignment with your ultimate goals. Building time into your day, your week, your quarter, and your year to determine what is important to you right now is crucial, to assess what is filling up your time.

A Time Commitment Is Usually More Than You Think It Will Be

You look at your schedule for the day and see patients every 15 minutes. If that is all you had to do, and you and the patients were on time, then you do not need my advice. However, charting time, in-basket answer time, form time, phone time, etc. must be figured in. Once you do that, time control starts to slip away.

I have been told over and over that X FTE is never just X FTE. Many of us are way over 1.0 FTE, including me. A one-hour presentation is not just a one-hour commitment. You have to create your idea outline, compose a PowerPoint with graphics and attributions, and practice giving the talk. Travel may be needed to give this presentation, and other things you normally do during this time have to be put off.

The rub is this: many Early Career Physicians believe if they do not volunteer or participate, they will be overlooked. But is this true?

How Do You Decide What to Say “Yes” To?

Set up a few litmus tests to determine what should make it on your calendar. Use a values compass to decide. Say yes to the things that are valuable to you.

What are your values? Have you ever sat down and reflected on your values, or is it just something you know? I encourage you to spend time actually doing this and ask yourself these questions:

• What is your ‘Why’? 
• Why do you do what you do? 
• What is important to you?

Know your ‘Why’ and be able to voice it. Be clear and be confident about your ‘Why.’ Say “No, thank you” to an offer when saying yes would be a lie. Say “Not Yet,” and ask to be considered in the future when it is better for you. Say “Yes, and…” so you can ask what additional things you will need to do this task to the best of your ability. Ask for protected time. Ask for extra compensation. Ask for extra support.

For each commitment, ask yourself: “How does this help me towards my goals and purpose?”

Lastly, Explore How You Can Balance Curiosity and Commitment

In your Early Career Physician career phase, there can be conflict because of a belief that you have to say “Yes” to everything. You feel pressure and want to show you are a motivated and engaged team player. But you cannot do it all at once. There is only one of you. Pick what you want to concentrate on now, and know you will have time to expand on your contribution and experience in the future. Remember, “Not yet,” is a valid response.

You may believe if you say “No” now, there will never be another chance. Saying “No” is better than saying “Yes” and then not being able to give it your best.

Does what you do in your day make you happy? According to Mayo Clinic research, spending 20% of your work time on what intrinsically motivates you and is meaningful to you reduces burnout, and feeds career satisfaction and happiness in your job.

2. Set Limits on Your Commitments

After you have determined what you want to say “Yes” to, how can you implement a strategy to make sure all those “Yes” answers don’t overwhelm you? You do not want to get disillusioned.

• Commit for only a set period of time. For example, sign on for 3 months or one year but not indefinitely. Do not join a project without an exit strategy in place. If you love it, you can extend your commitment, but if you do not, you can move on.
• Set time limits on how much you will spend on a particular project over a certain period. Determine and set expectations with your group.
• Have dedicated administrative time at work. I have found when I use this time for something else, I usually regret that decision.
• Know when you are available for meetings. Make it known when you can be present. Are you going to attend if it conflicts with patient care time, your lunch, or your after-work time? Know the priority hierarchy of how you want to spend your time.

3. Create Good, Realistic Habits

Start with the EMR and set up boundaries and efficiencies for charting. If you do a time audit, I bet you will find how to save time. A 2020 study reports women physicians spend 3 more weeks over a year’s time charting compared to their male colleagues!

Practice basic self-care. Take care of yourself in regard to your rest, activity, nutrition, hydration, and rejuvenation. This will give you more energy and focus to spend your time the way you want.

Cultivate your key relationships. When we are busy with work, the loved ones in our lives often get the scraps. If they are genuinely loved, you will want to spend time with them. A physician friend recently said to me there is no “work-life integration,” only “life.”  You get to decide what time you allot to the different facets of your life. These people are your support and time with them brings you joy.

Delegate when appropriate. Do not think about this as “dumping” something on someone else but as passing on an opportunity for someone else to see if it’s right for them. Also consider moving things off your plate by paying someone else to do them.

Use some of that protected time for reflection to set yourself up for your next opportunity or endeavor. As you assess how you have been spending your time, celebrate your accomplishments and keep a running list to refer back to. Update your CV. Also, use that time to make plans for the next 3 to 12 months. By doing this, you will be efficient with your time and prepared for that next “Yes.”

When you say “Yes” to the right things, using boundaries and good habits to protect your time, it’s easier to continue living the life you want as a physician.

It’s time to say “Yes” to yourself! 

Marion McCrary MD FACP is a practicing primary care general internist in North Carolina and a national board-certified health and wellness coach. She is a former Women in White Coats Writers Fellow and Podcast Co-Host. Her website is http://www.marion-wellness.com, and she can be followed on Instagram and Facebook @marionmccrarywellness and Twitter at @marionmccrarymd.

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