This document discusses work-life balance for women in medicine. It provides an overview of the literature on work-life balance, noting that control over time, meaningful work, social support, and saying "no" are important factors. Generational and gender factors that impact work-life balance are explored. Strategies for individuals, such as self-care, relationships, work attitude and philosophy, and for organizations, such as flexibility and wellness programs, are presented to help achieve better work-life balance. The conclusion is that both individual and organizational factors must be addressed.

1. Women of the ANA Luncheon:
Work Life Balance
Kathleen B. Digre MD
University of Utah
September 28, 2015

2. What is work life balance?
• New term 1998—in pubmed, and most
published literature is the last 5-10 years
• The goal is maintaining well-being to
avoid burnout
– Present in 37-47% academics
– Occuring all age groups
– Neurology in higher group (OR1.5)
Shanafeldt et al Am J Med 2003: 114; Shanafelt et al Arch Int Med 2012; 172:1377

3. Shanafelt et al Arch Int Med 2012; 172:1377

4. What the literature says about work
life balance
Things that matter
• **Control over time
(flexible working hours)
• Meaningful work
• Personality
• Social support
• Spirituality
• Children
• Mentoring and Role
models
• Saying «no»
Things that don’t matter
• Age
• High income
• Occupational success
• prestige
Hoff et al Health Care Manage Rev 2015; May 14; Strong et al 2013 J Gen Int Med;
Keeton et al Ob Gyn 2007: 109: 949; Joyce et al Cochrane Review 2010;

5. Generational factors
• Baby boomers (1946-1964): Medicine is a
calling;
• Generation X (1965-1980) less rigid more
practical, rule questioning;
• Millenials (1981-early 2000): life-work
balance
– In 1996 18% and 28% men chose residency for
life style control
– 2003, 36% women and 45% men made the
choice for life style control (Dorsey et al Acad Med 2005;8: 791
Dageforde et al J Vasc Surg 2013; 57:262-7; Howell Acad med 2009; 84:985; Spector et
al Pediatrics 2014;133:1112–1121;

6. Gender Factors
• Women chose tracks for work life balance vs
tenure OR 2.1 (Waljee et al Plast Reconst Surg 2015; 136: 380e-7e)
• Gender roles more challenging for women
• Stigma associated with using family friendly
institutional programs (Strong et al J Gen Intern Med 28: 1596)
• Impact of family: Clinical faculty without
children better vs with children. Non-clinical
faculty with children than without children;
– Women Assoc Professors and above better
balance (Beckett et al J women’shealth 2015; 24: 471-8)

7. (Beckett et al J Women’s Health
2015; 24: 471-8)

8. Strategies used by individuals
• Self-care practice—cultivate your interests
professionally and personally (sleep, nutrition,
exercise, reading, stress reactions)
• Relationships—time with family and significant other,
opportunities to share with colleagues
• Work attitude: meaning in work; find the things you
like (research, teaching) and discontinue or limit the
things you don’t like
• Religious belief and spiritual practice—nurturing
spirituality in self
• Life Philosophy—positive outlook
• Get rid of dichotomy of work-life balance (integration
of profession and life)
Shanafelt et al Am J Medicine 2003; 114: 513; Schwingshacki Frontiers in Pediatrics 2014: Buddenberg-Fischer
2008

9. Strategies of organizations
• Promote physician autonomy—flexibility and control of
schedule
• Collegial work environment
• Foster wellness: exercise opportunities, mindfulness
training, fresh fruits and vegetables (Brennan et al Int J Psych Med
2015: 50: 104-14)
• Minimize work and home interferences—coverage for
life events
• Support services: administrative; mentorship
• Value oriented organizations—mission and values
aligned
• Periodic breaks
• Family Friendly Policies: Part time tenure (Waljee et al)

10. Conclusions
• Many factors (individual, gender,
occupation, family obligations,
organizational) are important
• Discussion and sharing our strategies
helpful

11. Nature 2011; 477:27