Balancing Medicine and Marriage Medical marriages have a lot of challenges. Experts, physicians, and their spouses all agree that medicine makes a lot of demands on doctors and by extension, their spouses. Without conscious attention, medicine's long hours, stress, relocations, and training for decisiveness rather than negotiation can work to undermine a marriage. "Medicine crowds everything out," says Dike Drummond, MD, a physician coach and CEO of TheHappyMD.com. "[After giving] empathy and compassion all day in your practice, you can come home and feel pretty tapped out. Doctors have to be very conscious about putting their intimate relationships in their priority structure rather than letting their role as 'doctor' wash everything out by default. If you don't have an 'off' switch, it's really hard to come home and put your spouse first." A 2015 study of US physicians published in the British Medical Journal found that, despite the long and unpredictable hours, job demands, and potential conflicting personal and professional obligations, divorce is no more common among US physicians than in other healthcare professions and non-healthcare professions.[1] In fact, the prevalence of divorce among physicians (24.8%) was similar to that among pharmacists (22.9%) and dentists (25.5%) and substantially lower than that of nurses (33%), healthcare executives (30.9%), lawyers (26.9%), and other non-healthcare professionals (35%). divorce among physicians is less common than among non-healthcare workers and several health professions, according to the BMJ study. Female physicians have a substantially higher prevalence of divorce than male physicians, which may be partly attributable to a differential effect of hours worked on divorce. What's more, 8 out of 10 physicians told Medscape they are "very happy" or "happy" in their marriage.[2] Medscape's Physician Lifestyle & Happiness Report 2019 shows little gender divide in this area: Male physicians were generally similar to female physicians in describing their marriage as "very good" (53% vs 50%), whereas female doctors were somewhat more likely than their male counterparts to call their marriage "good" or "fair" (46% vs 42%). Medicine and Marriage: A Demanding Union That doesn't mean that married life is sunshine and roses for physicians. The demands medicine can impose on a relationship aren't felt exclusively by the physician partner. Lara McElderry, the wife of a trauma surgeon and mother of five, is so familiar with the challenges she launched MarriedtoDoctors.com, a weekly podcast on the subject. Within 13 months, the podcast had more than 100,000 downloads. "It's funny," McElderry says of the community of listeners that subscribe to her podcast. "We all have such diverse backgrounds—different races, different religions, men, women, different countries—but we have these common and shared experiences that come with being married to a doctor." Although the particulars of their situations may differ, she says her listeners know what it's like to feel socially isolated after relocating for their spouse's training or job, particularly if the move has disrupted their own career. They know the strain medical school debts can place on the family budget, the challenge of trying to plan around their spouse's schedule, and the burden of sometimes managing the lion's share of the work at home. "It's easy to find yourself feeling very resentful," she says, "but I think the number one challenge is the loneliness. You may be in a new town or your spouse is working crazy hours, or they're around but they're sometimes distracted thinking about the next procedure or charting or the last patient they saw. You're disconnected." 10 Strategies to Overcome the Challenges Recognizing and addressing those challenges requires a conscious, concerted effort, Drummond says. Physicians need to learn to build their lives and prioritize their primary relationships, he says. "That's not something they are taught, and it's something that can simply go by the wayside when they're trying to make it through residency." What can you do to keep your marriage on track? The following are among the strategies suggested by physicians, experts, and spouses: Manage expectations. "When we got engaged, I said to my husband, 'You understand that you want to marry someone who is going to become a doctor?'" recalls Tochi Iroku-Malize, MD, a family physician in Long Island, New York. "My husband moved here from the United Kingdom because I was going to be in the United States for training. Before he did that I needed him to know what my work was going to entail. I explained what residency training involved. How during the next 36 months that were coming up, my schedule would be mapped out—that it wouldn't take into consideration holidays, birthdays, and weddings, that my time really wasn't going to be my own. I was brutally honest." Take turns with opportunities. Twenty-one years and three children later, Iroku-Malize says, those frank conversations are still important. "Each time I've tried to do other things besides just clinical care, we've first talked about how will this work, what extra things will we need to do? Who else will we have to pull in? Sometimes you need to let opportunities pass as your spouse pursues his or her opportunities." Mind the calendar. "You can't have a calendar for work life and one for home life," Iroku-Malize insists. "You have to have one calendar to see what is happening in your life. My family knows when I'm in meetings or seeing patients, and I can see when my kids have a game or a show or there's a parent-teacher meeting. Having it all in one place lets me look ahead to see what I can and can't do." Get on the same page. Although they've been married less than 3 years, LaTasha Seliby Perkins, MD, and her husband have twice sought out marriage counselors. "We got married at 35," says Perkins, a family physician and the mother of a newborn. "We'd gotten to a point in our lives and our careers where everything is very conscious and very practical. Just like you take care of your health and your credit and your car, you need to take care of your relationship." "Anything that you need longevity out of, you need to have checkups along the way," says Perkins. She and her husband make a point to have "checkups" with each other every few months to revisit their family goals and make sure they are both feeling professionally, emotionally, and spiritually supported. Seek support. That may mean paying for help with child care or housework. It may mean seeking insights from older physicians who have experienced similar challenges, or trading tips and shifts with peers who are in the same situation. It may even mean seeking the perspective of an outsider: Perkins and her husband get insights from another couple who serve as their "marriage mentors" and participate in their church's marriage ministry. Make time for each other. Drummond says every couple should schedule biweekly "date nights" and that the first order of business on each date should be scheduling the next one. But there are other, less formalized ways to carve out time as well. For example, Perkins refuses to bring charts home. Iroku-Malize tries to keep Friday nights open so she can help drive her kids to their various activities or just spend time with her family. Develop a ritual to transition from work to home. Whether it's consciously taking a deep breath when you pull into the garage, changing your clothes when you get home, or taking the dog for a walk around the block, create a "home ritual" that tells your brain to leave work behind, Drummond says. "When you come home, you need to be fully present, even if you are planning to work later on or chart after dinner." You think it's tough to take away an Xbox from a teenager? Try to take a cell phone away from a physician. Turn off the electronics. "There used to be talk about 'quality time,'" says Kathy McMahon, PhD, president and CEO of Watertown, Massachusetts-based Couples Therapy Inc. "I think that's a misnomer. It's just time. Time for slow, unpredictable, 'boring' conversation. You don't develop intimacy without time, and it has to be time without electronics. You think it's tough to take away an Xbox from a teenager? Try to take a cell phone away from a physician." Have a plan for kids. Children can fundamentally change a relationship and the way a household operates. Although doctors will differ on the best time to have a baby, most agree the timing of such a life-altering event is something to consider. "We were married 11 years before we got pregnant," says Tessa Woods, DO, a trauma surgeon in Springfield, Missouri, and the mother of two toddlers. "I don't think I could have done it as a resident, and I was only able to manage when I did because of the amazing support of my husband, who stays home with the kids, and my family." Take a deep breath and listen. "Being able to stop and listen to your spouse and actually hear what they are saying without being offended is crucial," says Tessa Woods' husband, Landon Woods, a former Marine. Tessa agrees. "Almost every big fight we've ever had has been a communication issue. It hasn't been about money or kids." When thrashing out a big problem, the Woods use a communication strategy called the "microphone technique," in which one partner voices their thoughts. The other can only speak or have the "microphone" after encapsulating what they have heard to the other's satisfaction. "It forces you to slow down and really listen to the other person," Landon says. Source
