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Join Sarah Samaan, a retired cardiologist and a Master Certified Physician Development Coach. We’ll delve into the complex world of work-life balance for physicians, exploring the difference between work-life balance and integration, drawing insights from art theory, and uncovering practical strategies for achieving harmony in their demanding careers.

Sarah Samaan is a retired cardiologist and a Master Certified Physician Development Coach. She can be reached at Mindful Physician Coaching and LinkedIn. She is the author of DASH Diet for Dummies.

She discusses the KevinMD article, “Using the language of art to create work-life balance.”

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast, and get CME for this episode by clicking on the CME link in the show notes. Today we welcome back Sarah Samaan. She’s a retired cardiologist and a Master Certified Physician Development Coach. Today’s KevinMD article is titled “Using the language of art to create work-life balance.” Sarah, it’s great seeing you again.

Sarah Samaan: Oh, thank you so much. Thank you for inviting me back.

Kevin Pho: So to hear Sarah’s story, since she’s been on multiple times, go to KevinMD.com/podcast. In the upper right-hand corner there’s a search icon, and you can search for Sarah’s name to hear her story. But today, let’s jump right into your most recent article, “Using the language of art to create work-life balance.” How did this article come together?

Sarah Samaan: Yes. As a physician coach, one of the most common reasons people seek me out is to find work-life balance, so I started investigating it a little further, because it’s such a common question. It turns out that in 2022, 85 percent of new physicians coming out of residency programs cited work-life balance as their number one concern, and that’s up from 63 percent in 2018. So it’s an increasingly important factor for physicians determining what kind of job they want to take. And what’s interesting is that we might think it’s something more related to women and family, but as it turns out, amongst millennials, work-life balance is equally important for men and women.

Kevin Pho: So when people say work-life balance, that could mean a lot of different things to different people. As a physician coach, when people ask you about work-life balance, how do you define it for them? What does it mean to you?

Sarah Samaan: Right, that’s a really good question, because work-life balance can mean very different things to different people, and it can be different at different stages of our lives. Work-life balance is really a matter of finding personal harmony between your work life and your personal life, and the personal life is however you define it for yourself.

Kevin Pho: So you bring in the language of art theory as it relates to work-life balance. As it relates to art, talk about that concept of balance.

Sarah Samaan: Right, so I’ll just give a little background. I retired from my job as a cardiologist. I practiced cardiology for nearly 30 years and retired in early 2022, and one of the reasons was that I wanted to pursue other life passions, and being in practice was just not going to allow me to pursue those passions with the intensity I really wanted to devote to them. So right now I’m in the process of obtaining a Bachelor of Fine Arts degree, and I’ve been exposed to a lot of great information and background on art theory. One of the things I started to realize in my work as a physician coach was that I could really apply what I was learning from art theory to my coaching.

So when we think about balance in art, there are four different ways of looking at it. There is symmetric balance, which is what we traditionally think of as balance. You can think of a balancing scale, or a perfectly balanced piece of art such as architecture; the Taj Mahal is a great example of symmetrical balance. Then there’s asymmetric balance, and that’s often the more interesting kind of balance, where the elements don’t completely line up. There may be a larger element balanced by smaller elements, or it may be a matter of colors balancing out, with a brighter color set against darker, smaller elements. Then there’s radial balance, where you have a central focal point with smaller radiating pieces, so you could think of the rays of the sun. And finally we have crystallographic balance, and probably the most concrete way of thinking about that is an empty chessboard, where every piece is equal.

Kevin Pho: All right, so we have these four types of balance in art theory. How can you relate these concepts to balance in a physician’s life?

Sarah Samaan: Right. When we think of symmetric balance in terms of a physician’s life, it’s really not very practical. There may be some cases where work and life can balance out completely, but really that’s not the way balance usually works. Partly that’s because when we think about work and life, we’re not just thinking about two completely different things. We’re thinking about work, and we’re thinking about our personal life, our health, our hobbies and the interests that we have. So work and life are not necessarily equal things, because life can be so complex.

So when I think about developing balance as a physician, asymmetric balance feels like the most reasonable way, and really the most creative way, to develop our own personal balance. In asymmetric balance, the perception of weight is balanced, so there’s harmony, and that’s what we’re searching for when we’re trying to achieve a sense of work-life balance, but the pieces are not equal. In fact, asymmetric balance falls apart when the pieces are too equal. It’s much more interesting and cohesive when the pieces are different. Usually we’ve got a dominant element, and other components play a supportive or balancing role, and often you’ll have two or three supporting elements that balance out the larger element. And often in asymmetric balance, ideally, there will be some type of tension that makes it an interesting piece of work, and the image thereby feels complete.

Kevin Pho: Now give us a case study, a story or an example of a physician’s life. It could be hypothetical, it could be an amalgamation from your coaching, where we can apply this concept of asymmetric balance. What would that look like?

Sarah Samaan: Right, well, first of all, just to step back a bit, balance can change over time, and there are different times in the life of a physician when balance is going to look different. For example, somebody who’s in their residency program may be feeling overwhelmed with work, and yet that’s a time of life when the balance is clearly asymmetric, and the larger element is most likely going to be that residency program: learning, growing and acquiring the skills you’re going to need to move forward. So at that point in life, sometimes you do have to accept that this balance, this tension, might not be comfortable. But if you can look at it this way and realize that we’re dealing with movable elements, it can give you more of a sense of ease, knowing, OK, this is the balance I’m experiencing right now, with this large piece of my medical practice. Someone who’s just starting out in practice may have the same sense of an overwhelmingly large piece, but this is not something that’s always going to stay this way.

On the other hand, to create balance, we do need to have those other pieces. So if you can think of it that way as well, with this large, busy, growing part of the practice, but still maintaining and nurturing the smaller elements, family, relationships, hobbies, then over the long term that’s going to give you more options for moving those elements around and changing the weight of the different elements.

And I do want to say, just backing up a little bit again, that it is important that you maintain a balance in some way or another, and that’s not only for your own personal benefit. We know that patient care can actually be enhanced when people have a greater work-life balance. There was a study out of Duke that found that patient care actually improved when physicians and other members of the health care team had a greater sense of work-life balance.

Kevin Pho: Give us a sense of what kinds of physicians come to you for coaching, and maybe give us, I don’t want to say a typical physician, but some examples of how physicians today can have their lives out of balance. What are some examples you’re hearing through your coaching experience?

Sarah Samaan: Yeah, so again, I find a lot of people come to me with concerns about work-life balance, and I think part of that has to do with the disconnect between the physician and the management of the practice. In years past, when physicians owned their own practices, they were able to create that balance for themselves. At certain stages of life the practice might have required, or been more motivated by, the development of a larger patient population, for example, or the growth of certain skills and the importance of the physician reaching out to grow their practice more rapidly. Now those decisions are not necessarily made by the physicians. Physicians are often feeling overwhelmed and feeling as if their lives are being dictated by external forces, and that’s not always the case. Often the people who come to me are the ones dealing with this sense of unease and imbalance, and perhaps the people in their own private practices, or working within systems that allow more flexibility, are not necessarily seeking out coaching. But often people come to a coach for help finding their own direction and creating their own goals.

I think it’s important to realize that when you are in a situation where your own personal growth and personal balance are not being honored, there are other opportunities. Sometimes the right answer is getting out of the situation you’re in, but sometimes the right answer is being empowered to negotiate and to learn what you can say no to, and perhaps even to experiment with what you can say no to. Where can you find more ease? Where can you find more balance? Sometimes that also means giving up your perfectionism. Sometimes it may mean that a physician who has taken on a lot of roles outside of patient care needs to learn to say no. Some people are involved in a lot of committees, for example, and sometimes it’s hard to say no. You may feel that you’re needed, or you may feel that your future might depend on saying yes to everything you’re offered. But sometimes when you take on those roles, you’re saying no to something that might be even more important to you.

So when you take on a new role or a new project or a new committee, it’s important to realize that anything you say yes to means you have to say no to something else. Creating that awareness, and being more intentional and more mindful about the choices that we make in one sector of our life, can affect all the other aspects of life as well, and create a balance that may or may not feel harmonious. Getting that balance back to what’s appropriate for you as an individual may take some work, some contemplation and some time, but in order to have a practice that’s resilient and able to sustain you, it’s important that you develop and understand your own balance.

Kevin Pho: One thing you said resonated with me: that sometimes physicians need to let go of, for instance, their perfectionism, or accept that their notes aren’t as perfect or as comprehensive as they’d like. So that means that to achieve balance, physicians can’t rely on the environment to change; sometimes they themselves have to change to achieve the balance they want. Is that right?

Sarah Samaan: That’s exactly right, that’s exactly right. I think it’s really important to be realistic with yourself about what you can do, and to know that it doesn’t have to be all or nothing, and also to know that when you say no to something, it doesn’t mean never. Maybe there’s something you’re really interested in, but right now you just can’t take it on. You can say no now and still leave the door open for possibilities.

I think it’s also important, when physicians are feeling overwhelmed and feeling as if their lives are out of balance, to again turn to the idea of giving up perfectionism. Allow yourself to be a beginner in something else. Allow yourself to develop hobbies or interests that you don’t have expertise in, and just give yourself 10 or 15 minutes every day. You’ll find that over time, if you find something that’s important to you, that resonates with you, your ability to devote time to it may actually grow.

Now, we haven’t mentioned the issue of family life, and that’s something that obviously you don’t always have control over. Again, when we look at where the balance lies, at certain times in your life that family element is going to require more dedicated time and more dedicated energy. So for each physician, it’s going to be important to be able to step back and try to look at things objectively. Sometimes that can be helped by working with a coach. Sometimes just being able to sit down and give yourself time to mindfully work through where you are now, where you want to be and what the steps are to get there may be all that it takes.

Kevin Pho: We’re talking to Sarah Samaan. She’s a retired cardiologist and a Master Certified Physician Development Coach. We’re talking about her KevinMD article, “Using the language of art to create work-life balance.” Sarah, tell us some of the take-home messages that you would like to leave with the KevinMD audience.

Sarah Samaan: Yeah, so I think, first of all, thinking about balance as something that doesn’t have to be perfect, and that will change over time, is an important way to conceptualize your own personal balance, along with understanding that what’s right for you may not be the same as what’s right for somebody else. Define where you are in your practice trajectory, and know that things are not always going to stay the same. If you’re not satisfied or comfortable with your balance, that doesn’t mean it’s wrong, but think about how you’re spending your time and learn to say no when you need to. Understand that saying no can elevate your life, give you more joy and allow more space for the other elements of your life to move in.

Thinking about delegation can help a lot when you’re thinking about saying no, giving up your perfectionism and being realistic about what you can do. Ask for help when you need it, whether that’s somebody to help at home, a scribe at work or a coach to help you work through the questions you have about how your life is going and what trajectory you want to pursue. And then just think about how you’re using your time in other ways. Are there places where you can take time that isn’t suiting your values and isn’t resonating with you, and use it in a way that might be more harmonious and more joy-fulfilling?

Kevin Pho: Sarah, thank you so much for sharing your time and insight, and thanks again for coming back on the show.

Sarah Samaan: Thank you so much for having me. I really enjoyed meeting with you.