Rethinking time management: Finding balance in a physician’s life [PODCAST]

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Family physician Laura Suttin discusses her KevinMD article, “An argument against time management.” In this episode, Laura explores the pressures physicians face in trying to adhere to strict time management practices, which often lead to feelings of inadequacy and burnout. She shares her personal struggles with balancing work and personal life, highlighting the importance of aligning one’s energy with natural rhythms rather than rigid schedules. Laura emphasizes the value of authenticity, self-awareness, and embracing the ebb and flow of daily life to reduce stress and enhance both personal and professional fulfillment. She offers actionable strategies for physicians to move away from traditional time management techniques and towards a more energy-focused approach, fostering a healthier and more balanced lifestyle.

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today, we welcome back Laura Suttin. She’s a family physician, and today’s KevinMD article is “An argument against time management.” Laura, welcome back to the show.

Laura Suttin: Thanks for having me. It’s good to be here.

Kevin Pho: All right, so tell us what this KevinMD article is about.

Laura Suttin: So I wrote this article when the area where I live, South Texas, was experiencing a deep freeze. We lost power for several days, and I really noticed how much of my energy first was depleted during that time and how much of our natural rhythms we really have to honor.

And just since I wrote that article, I’ve had so many other examples come up. But really, we have to make sure that we are working with our bodies and not against our bodies, listening to our body when we need rest, maybe when we need to try to find some more energy. It was really just the first example for me that when we talk about managing our time, it’s not so much about managing our time but managing our energy. Honoring those ebbs and flows has been really, really important for me.

Kevin Pho: So this happened a few years ago with that deep freeze in Texas. So exactly how did that affect you, and how did that interfere with your normal workflow and your normal energy flow as a physician?

Laura Suttin: Yeah, so I will say that we were lucky enough that everybody in my immediate family was fine, and I know not everybody was as lucky. But we didn’t have power for three days, and I lived in a drafty old house. It was very cold. We didn’t have hot water, and therefore we didn’t have internet. Work came to a halt. My daughter is a teenager; school came to a halt. We’re very limited on what we were able to do.

And so when we don’t have those things, it just becomes a matter of, “OK, well, I can read a book, but I can only do that until sunset.” And in February, sunset’s kind of early. So you really kind of go into this mode of, “OK, noticing how my body feels, noticing the bodily sensations,” and having to honor that.

I noticed that I needed so much more sleep just because the cold was really taking such a toll on my body. I was craving food that I didn’t normally crave. And so it’s really just this experience of realizing it’s temporary, listening to the body. What does my body need? And not denying those things that I needed in the moment.

Kevin Pho: So in essence, that pause kind of let you listen to your body, right? And of course, as physicians, we rarely get that type of pause. We’re always on to the next patient, the next chart, the next shift, the next on-call date, and things like that. So translate what you realized about that pause into what you did in terms of how you managed time as a physician in your clinic or hospital.

Laura Suttin: Yeah, I think, and you said it, that we as physicians are not trained to pause and process what we’re going through. The examples that we get and what we’re trained to do and what we’re literally rewarded for, so we build those dopamine pathways for just moving on: Next patient, next round, next shift, next day, whatever that looks like. And yet that will catch up to us in our body.

And so when we are able to just even stop and just acknowledge what we’re going through, it can have such a big impact. And just again, taking care of our basic needs, like when do we need to eat? When do we need to sleep? When do we need to use a restroom? I mean, even these are things that we denied ourselves and were denied in our training.

And so just knowing that it’s natural to go through these rhythms. It’s natural for our bodies to have circadian rhythms or seasonal rhythms or times when things are traumatic and we have to slow down. We have to honor that. It’s part of nature. It’s not something that is a weakness about us. It’s part of our biology.

Kevin Pho: So after this event happened and you realized that you had to listen to your own body, did you make any changes in terms of how you practiced and your schedule at your workplace?

Laura Suttin: So I didn’t immediately, but I did over time. I realized just how important it is to just notice maybe that inkling when I’m starting to get sick and I might need to get some extra sleep, or something’s going on where I just need to kind of take a step back, take a pause.

But a year after I wrote that article, I had major surgery, and that was another time. It was an unplanned, not emergent, but unplanned surgery. And I also at that point realized how much rest my body needed, and I had to honor that.

So there have been events that have happened over time since then that kind of remind me, “Oh yeah, I need to listen to myself, listen to my body.” And it’s something that I now, as an entrepreneur, I’m in a different role. I’m able to kind of be flexible enough with my schedule that I can honor those needs a little bit more easily than I did at the time.

Kevin Pho: Now, what exactly would that look like? Would it be just seeing fewer patients during the day, or maybe adjusting your hours to be more flexible, or taking fewer call shifts? So at the workplace, as a physician, what exactly would honoring your body and honoring what you needed, what would that look like?

Laura Suttin: Yeah, I think it can be even something as simple as taking a 30-minute lunch break or closing the door to meditate for five minutes and asking your staff to not interrupt you, or taking that bathroom break when you need it instead of just going to see that next patient because you know that next patient’s been waiting for an hour. It can be something really, really simple like that.

I’ve seen other examples, and I’ve worked with other clients that have done things like adjusted their schedule after coming back from parental leave or medical leave, adjusting their schedule to meet the needs of their families. So it doesn’t have to be something really drastic, but it can be something very, very simple. Just eating when we need to and going to the bathroom when we need to can make a huge difference.

Kevin Pho: Now, we talked about how the training and education of physicians is really built on self-sacrifice. How difficult is it for you or some of the clients or other physicians that you talk to in terms of adopting some of this mentality where sometimes they need to put themselves first?

Laura Suttin: Yeah, it is really difficult. And I mentioned dopamine earlier because we get rewarded for that self-sacrifice in our training. And that reward comes in the form of recommendation letters, good grades, maybe coveted rotations. And this even goes back to probably high school, college, maybe when those of us were first starting to become physicians.

I think a lot of us probably had something in our med school acceptance letter like, “Well, I’m not going to ask somebody to do something that I could do myself.” It becomes a badge of honor. And when we get rewarded for that, it builds up dopamine pathways. And then when we get to the point where we can’t continue that pace and it’s not sustainable for us to do that, then it’s really, really hard to break that habit. Just like any bad habit that is triggered by dopamine, our bodies become almost addicted to it.

Kevin Pho: Talk about how the expectations of society and the expectations of our administrators, they have a more traditional view of physicians, where physicians have that image of self-sacrifice. If they see physicians maybe taking a little bit more time and putting themselves first, talk about that tension that physicians have putting themselves first, contrasted with the expectations society has for physicians.

Laura Suttin: Yeah, it’s a tough conversation. And I know there’s been some discussion lately, and even in the popular press, about this kind of generational gap between physicians that worked the 80- to 120-hour workweeks, and I’m not saying that our younger physicians aren’t, but then younger physicians pushing back, saying, “Wait, I’ve got to have some work-life balance.” And older physicians, “Well, we didn’t have work-life balance.”

And so I don’t know what the right answer is. One hundred twenty hours of work a week clearly is not sustainable for anybody, and it’s not healthy for our physicians, and it’s not healthy for their patients either. Patients who are seen by overworked and burned-out physicians have worse outcomes. And so it’s not healthy for anybody in the health care system, this self-sacrificial mentality.

So when I talk with my colleagues who are working directly with students and residents, and they’re advocating for a better way where, again, even in the small ways where we take our bathroom breaks, take our meal breaks, those can have a huge impact.

Kevin Pho: So are you seeing that generation gap among your coaching and physician clients? Are you seeing sometimes older physicians being a little bit more hesitant about putting themselves first?

Laura Suttin: Yeah, again, because it’s how they were trained, and it’s ingrained in them. And so when they pass that along, it becomes really difficult when that’s what’s modeled. So it is an interesting dynamic to see kind of this conversation. And I don’t know how it will all shake out. I imagine it will be some sort of happy medium, but I think it’s just an interesting conversation.

Kevin Pho: How does that discussion go? Let’s say if you have an older physician who is burned out because of all the hours and all the self-sacrifice that they do. They perhaps come to you, and they’re burned out of medicine, and maybe they’re less willing to put themselves first. How does that conversation go when you coach them?

Laura Suttin: Yeah, I mean, they might feel like they’re unwilling to put themselves first, but with enough kind of digging really deep, we can understand maybe there is something that they want. Maybe they want to adjust their schedule so they can spend time with their grandchildren or take up a hobby. Rarely do I see a physician who’s been working sixty, seventy hours a week for thirty years that wants to continue at that pace.

And so there’s going to be some small way in which that physician is wanting to address their own needs. And so it’s how do we start wherever that physician is? What are their individual goals, and how can we work on those together?

Kevin Pho: So talk about some actionable steps that we can share with the physicians who may be listening to you now to obviously prevent them from getting into a situation where they’re burned out and they’re wondering, “Why do you have to self-sacrifice so much?” What are some things they can do earlier on in their careers?

Laura Suttin: Yeah, so a couple things. I would say that it’s not a weakness of the physician. It’s not a failure of the physician when these ingrained models and these thoughts come up about, “Well, I can’t do these things for myself.” This is how we’re trained. So it’s not a weakness. You’re not alone. And reminding ourselves of that, I think, is really, really important.

And then again, what’s something small that you can do? It might be as small as using the restroom when you need to or taking that lunch break, maybe saying no to that walk-in patient that comes in at 4:59 because you said you would go to your child’s soccer game. What is something small that you can do to exercise that agency? Because if you don’t advocate for yourself and you don’t take that for yourself, then nobody else will.

Kevin Pho: What does that say about a profession when something as simple as going to the bathroom and taking a lunch break signifies putting themselves first, right?

Laura Suttin: Yeah, I mean, that’s biology. It is crazy. I was talking to somebody about this yesterday, just about the airline industry and mandated rest for pilots and flight attendants. And so, I mean, I think we’ve all been probably on a flight that got canceled because the crew timed out. And so I wouldn’t want to get on a plane with a pilot that said, “Well, I didn’t get much sleep last night, but it’s all right because I’ll power through.” I mean, we need to treat our physicians the same way.

Kevin Pho: Now, you’ve been coaching for a while now, and you wrote this article a few years ago. Have you seen the needle move when it comes to health care organizations and hospitals and clinics in terms of better addressing physicians’ natural rhythms and perhaps not asking them to self-sacrifice so much?

Laura Suttin: Yeah, I have. I’ve started to see organizations and health care groups, and I’ve started to work with these as my own clients, that are recognizing the impact of burnout and really wanting to see a change. So I’m very hopeful about that. And I really enjoy working with groups as well to help them make the changes that they need to so that our physicians are thriving.

Kevin Pho: And what kind of examples are such changes that organizations are instituting?

Laura Suttin: Yeah, hiring coaches is one. I really feel like every physician needs a coach. I feel like if LeBron James gets a coach, and he probably has multiple, then our physicians need coaching. So that is one.

And really listening to what the physicians need rather than kind of putting first aid kits or Band-Aids over some of these burnout symptoms. It’s really listening to their physicians and making changes to the schedule, accommodating alternate scheduling options, understanding that our physicians are human, and we need to take care of ourselves first too.

Kevin Pho: We’re talking to Laura Suttin. She’s a family physician. Today’s KevinMD article is “An argument against time management.” Laura, let’s end as we always do with some take-home messages that you want to leave with the KevinMD audience.

Laura Suttin: So if you’re feeling like you always have to sacrifice yourself as a physician, again, you’re not alone. Reach out for help. Start small. Start with something small that you can do to take back that agency for yourself. And it is not a sign of weakness to have our bodies that need attention. That just means that we’re human. So don’t ignore it because it will come back to bite you.

Kevin Pho: Laura, thank you again for sharing your perspective and insight, and thanks again for coming back on the show.

Laura Suttin: Thanks for having me.

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