1. Work-Life Integration
Julie Welch, MD
Department of Emergency Medicine
Indiana University School of Medicine
IU Health - Methodist Hospital EMTC

2. Work-Life Integration
Why does it matter?
Defining “Work-Life”
Developing your Work-Life Integration Strategy
Tips and Tools
Work-Life Integration
Outline:
Poll the audience:
To get an idea of the audience today, how many of you are:
Residents
Faculty
Fellows
Students
Other
Married or in a committed relationship
Single
Have children?
Care for a family member?
Have activities outside of medicine that really mean a lot to your health and well being?

3. Work-Life “Balance” & “Integration”
Feeling derived from being whole and complete
Avoid viewing it as a scale of taking from one to give to another
Creating harmony in your life
Cultivating the areas of your life that are truly important
Mixture of…
“Balance”
Feeling derived from being whole and complete
Avoid viewing it as a scale of taking from one to give to another
“Integration”
Creating harmony in your life – mixture work, family, health…
Cultivating the areas of your life that are truly important
Keep things in perspective
Yes, at times you will feel a pull to dedicate much more time to medical school or residency or your career than you think is healthy. At times your schedule is not your own, taking call interferes with your anniversary or your child’s ball game. There are sacrifices we make in becoming a physician, no doubt, but keeping in mind your goals… to succeed as a physician (provide excellent patient care, perform worthwhile research, to teach and make a difference in lives.) and then to succeed out side of work with your family and community.
Your view of work life balance or integration will change though out your career, so arming your with FIRST AWARENESS and SECOND with TOOLS, will hopefully set you on a journey of success and happiness in all areas of your life.

4. Why does it matter? Workplace culture is changing
Major recruitment and retention issue
Research: Work Life Balance is a Priority

5. Why does it matter? Workplace culture is changing
Gender divide is narrowing : workforce 50% women
More dual-career couples
Shared child/family care responsibilities
Generational issue no longer
Early career physicians want predictability
Phased retirement
Child/family care responsibilities
Survey of female physicians (residents and faculty) N=115
41 % mom primary, 41% split evenly, 17% partner primary

6. Why does it matter? Workplace culture is changing
Major recruitment and retention issue
Flexibility is #1 issue to keep good talent
Schedules
Work Life Policies (Family leave, childcare, elder care, benefits…)
In recruiting new faculty (from ICAW stats):
TOP 3 THINGS TO KEEP GOOD TALENT:
Flexibility (58%)
Trust in leadership (47%)
Meaningful work that has a clear purpose in meeting organizational objectives (40%)

7. Why does it matter? Workplace culture is changing
Major recruitment and retention issue
Work Life Balance is a priority
Theme of needs assessments of students, residents, faculty
88% said it was the most important topic for which they needed guidance and mentoring.
Child/family care responsibilities
Survey of female physicians (residents and faculty) N=115
41 % mom primary, 41% split evenly, 17% partner primary

8. Do physicians succeed at work-life balance?
Failure of work life integration leads to: STRESS
Spillover
Crossover
Physicians are at higher risk of:
Divorce
Substance abuse
Depression/ Anxiety
Domestic Violence
Stress (When you are a stressed out mess, who suffers? You and everyone around you, friends, family, patients, co-workers…)
Spillover (spills over with the worker into other areas of life; take it home and it is felt by the worker; anxiety, depression, anger)
Crossover (when effects of the workplace on the worker are felt by others; children have more stress)
Positive/negative outcomes thus impact health and human development of work, families, and children
A healthy happy physician is a better physician all around… focus on learning, caring for patients, beside manner, concentration, compassion…

9. Career/ Life Satisfaction (3 studies of 8,094 physicians total)
Career Satisfaction: 79%
Work-Life Balance Satisfaction: %
Mommd.com survey 504 female physicians
BMC Heatlh Serv Res Sept 16:9: male and female physicians
Specialty specific data on career satisfaction:
#1 EM peds,
then geriatrics, ped subspecialties, neontal medicine, IM/Peds, peds, derm, child psych…. FP….
Significantly lower satisfaction include neuro surg, pulm critical care, nephrology, OB/GYN.

10. Career/ Life Satisfaction (3 studies of 8,094 physicians total)
Career Satisfaction: 79%
Work-Life Balance Satisfaction: %
Factors that were NOT strong predictors of career satisfaction, work-life balance, or burnout:
Gender
Age
Specialty
Physician gender, age, and specialty were not strong independent predictors of career satisfaction, work life balance, or burnout.

11. Career/ Life Satisfaction (3 studies of 8,094 physicians total)
Career Satisfaction: 79%
Work-Life Balance Satisfaction: %
+ predictors:
Income
Academic career
- predictors:
Working > 50hr/wk
Full owner practice
Reliance on managed care
Uncontrollable lifestyle
Satisfaction was significantly and positively related to income and employment in a medical school, but negatively associated with more than 50 wok hurs per week, being full owner of the practice, greater reliance on managed care revenue, and uncontrollable lifestyle.
Physician gender, age, and specialty were not strong independent predictors of career satisfaction, work life balance, or burnout.

12. Career/ Life Satisfaction (3 studies of 8,094 physicians total)
Career Satisfaction: 79%
Work-Life Balance Satisfaction: %
+ predictors:
Control over schedule
Working part time <40 hr/wk
Married, partnered
Having children
- predictors:
Working full time >40 hrs/wk
Divorced/separated
Mommd.com survey 504 female physicians
BMC Heatlh Serv Res Sept 16:9: male and female physicians
Specialty specific data on career satisfaction. #1 EM peds, then geriatrics, ped subspecialties, neontal medicine, IM/Peds, peds, derm, child psych…. FP…. Significantly lower satisfaction include neuro surg, pulm critical care, nephrology, OB/GYN.
Physician gender, age, and specialty were not strong independent predictors of career satisfaction, work life balance, or burnout.
Satisfction was significantly and positively related to income and employment in a medical school, but negatively associated with more than 50 wok hurs per week, being full owner of the practice, greater reliance on managed care revenue, and uncontrollable lifestyle.

13. Career/ Life Satisfaction (3 studies of 8,094 physicians total)
Career Satisfaction: 79%
Work-Life Balance Satisfaction: %
+ predictors:
Income
Academic career
- predictors:
Working > 50hr/wk
Full owner practice
Reliance on managed care
Uncontrollable lifestyle
+ predictors:
Control over schedule
Working part time <40 hr/wk
Married, partnered
Having children
- predictors:
Working full time >40 hrs/wk
Divorced/separated
Mommd.com survey 504 female physicians
BMC Heatlh Serv Res Sept 16:9: male and female physicians
Specialty specific data on career satisfaction.
#1 EM peds, then geriatrics, ped subspecialties, neontal medicine, IM/Peds, peds, derm, child psych…. FP….
Significantly lower satisfaction include neuro surg, pulm critical care, nephrology, OB/GYN.
Physician gender, age, and specialty were not strong independent predictors of career satisfaction, work life balance, or burnout.
Satisfction was significantly and positively related to income and employment in a medical school, but negatively associated with more than 50 wok hurs per week, being full owner of the practice, greater reliance on managed care revenue, and uncontrollable lifestyle.

14. What does “Work-Life” mean to you?
Career Activities
Consider areas of:
Patient care
Education
Research
Service
“LIFE”
Relationships
Personal well being
Physical
Mental
Spiritual
Hobbies/ Passions
Exercise: I want you to personalize this session. Think about the terms “Work” and “Life” for you. What elements or themes fall under these two main topics.
In a 3 minute elevator speech, how would you describe your “work” and your “life?”
WORK – list the key aspects of your work including career activities, roles and responsibilites. Consider the areas of patient care, education, research, service…
LIFE- describe briefly the key activities, roles, responsibilites, themes of your personal life. Be mindful of your relationships and your personal well-being.

15. WORK: My Emergency Medicine Career
EM physician level one trauma center
Academic faculty at a medical school
Primary patient care
Educate
Scholarship
Service
Mentor
Fellowship
Dean’s Office of Faculty Development
EM physician academic level one trauma center
Clinical faculty at a medical school
Educate students, residents, RN, NP
Simulation Medicine Lab instructor
Grand Rounds, Lectures
Bedside teaching
Committee Service
Mentor students, residents, faculty
Scholarship gender issues and mentoring
Fellowship in Dean’s Office

16. WORK: My Emergency Medicine Career
Other EM opportunities during my career:
Lifeline flight physician
Safety Team physician for IRL (Indy Racing League)
Physician for medical missions
Medical coverage for NFL games

17. Academic EM Physician’s Typical Month
12-16 shifts in the Emergency Department
Serve on committees
Lecture to students and residents
Simulation Medicine Lab instructor
Attend Grand Rounds & Journal Club
Mentor students and residents
Write monthly evaluations
Scholarship – research, writing, etc…

18. Academic EM Physician Emergency Department physician roles
Direct patient care
Bedside teaching of students and residents
Coordinate patient transfers into ED (EMS, life-flight services)
Oversee department flow

19. LIFE: My Other “Career”
Relationships
Dual physician marriage (to an EM physician)
Mother of 2 busy boys
Sister, aunt, and daughter
Network of friends, mentors, mentees
Personal well being
musician, exercise, travel, cooking, church

20. “Work Life Integration” factors:
Your Work Life Indicator profile (Integration) is comprised of three factors:
Behaviors: the degree to which you combine or separate your work and family life
Identity: the degree to which you identify with and invest yourself in your work and family roles
Control: the degree to which you feel in control of how you manage the boundaries between your work and personal life
These factors combine to influence how you manage the boundaries between work and the rest of your life.

21. Understand what motivates you?
3 elements:
Autonomy
Mastery
Purpose
What motivates you to do your work? To pursue a fellowship? To do research or teach? What motivates you to pursue a sport, play a musical, be a mom or dad?
3 elements: page 222
Mastery page 158
Purpose page 154-5

22. First, understand what motivates you?
3 elements:
of inherent satisfaction in what we do
that lead to professional and personal success
Autonomy
Over task (what you do)
Over time (when you do it)
Over team (who you are with)
Mastery
Engagement produces mastery –becoming better at what matters
It is a mindset
It requires the capacity to see your abilities not as finite, but as infinitely improvable
Mastery is a pain – demands effort, grit, and deliberate practice
It is impossible to fully realize – simultaneously frustrating and alluring
Purpose
By our human nature we seek purpose – to make a contribution and to be a part of a cause greater and more enduring than ourselves
What motivates you to do your work?
To pursue a fellowship?
To do research or teach?
What motivates you to pursue a sport, play a musical, be a mom or day?
3 elements: page 222
Mastery page 158
Purpose page 154-5

23. Individual Development Plan & Work-Life Integration Strategy
Tools for Planning, Inspiring, and Integrating your
Professional & Personal Goals
Develop your own plan:

24. IDP & Work-Life Integration Strategy
Complete annually
“SMART” (assess viability)
Share with mentor/ spouse
Reflect on advice
Actively implement
Follow progress and revise
IDP & Work-Life Integration Strategy

25. Planning worksheet exercise:
“Opportunity is Knocking”
Tool to objectively
evaluate a new opportunity
Planning worksheet exercise:

26. 10 Work Life Integration Tips

27. Work-Life Integration Tips
Focus on your values and priorities.
Make an Individual Development Plan
Set and know your limits and boundaries
With a new opportunity – don’t say “yes” immediately
Protect your time

28. Work-Life Integration Tips
2. Hone your time management skills.
Find your time wasters
Utilize all available time (listen to audio CME on drive)

29. Work-Life Integration Tips
3. Get ORGANIZED!
Keep a “TO DO” list, Prioritize, Retrograde plan
Strategy
Empty inbox (4 D’s – do, delegate, delete, decision)
Schedule time vs on-the-go phone/ipad (limit 2-3x day)
Turn off interrupting dings

30. Work-Life Integration Tips
4. Find a “usable” calendar system.
Easy, sharable, real-time, integrative
Share it with family and caregivers
Plan your vacations/ personal/ family time in advance
Schedule time for yourself (exercise, spa, writing)

31. Work-Life Integration Tips
5. Establish a mentor network.
At work
Career guidance, advice, sponsorship, skill acquisition
At home
make friends with other families in your neighborhood.

32. Work-Life Integration Tips
6. Double Dip.
With every project, find a second goal it could satisfy.
Turn a lecture or program into scholarship
Combine the activities you love with your family/friends.

33. Work-Life Integration Tips
Know the Work-Life Policies of your
employer.
Family Leave policies
Part-time policies / flexibility in scheduling
Childcare options (on-site, back-up sick care)
Academic center – promotion and tenure clocks

34. Work-Life Integration Tips
Cultivate relationships with family and
friends.
Family time, date-night, & “no electronic” times
With your partner : communication is the key!
Be accountable to someone in your life (mentor, spouse, friend)

35. Work-Life Integration Tips
9. Invest in Family/Home Responsibilities.
Foster teamwork – coordinate/ delegate activities and chores.
Find reliable childcare and have backup.
“Hire it done!” (house cleaning, yard work, food delivery)
Keep numbers for home/car repairs accessible.

36. Work-Life Integration Tips
Build Healthy Personal Habits.
(physical, mental, spiritual well-being)
Exercise, eat healthy, sleeping habits
Read, relax, hobby, music
Let go of guilt & maintain a sense of humor!

37. Work-Life Integration Tips
Focus on your values and priorities
Hone your time management skills
Get ORGANIZED
Find a “usable” calendar system
Establish a mentor network
Double Dip
Know the Work-Life Policies of your employer
Cultivate relationships (family and friends)
Invest in Family/Home Responsibilities
Build Healthy Personal Habits (physical, mental, spiritual well-being)

38. Work-Life Integration Tips
You can have a successful, satisfying career and life by doing what you love!
Set your own standards of importance
Let go of guilt
Be flexible… things change
Maintain a sense of humor
Count your blessings

39. Doing What You Love: EM Career Benefits
Work is work, home is home
Don’t take call
No office overhead
Job Security (there are always medical emergencies)
Mobile (don’t have to re-establish patient practice)
Ability to cut back and work part-time
Changing needs (child rearing years, graduated retirement)
Flexible Scheduling
Advanced scheduling
Shift work variety

40. Questions: