After spending over 25 years, as surgeon questions of a work life balance become increasingly important. Today, many of us are running on an endless treadmill at work and the demands of patients, academics, and a health-care system that wants 24 × 7 availability.
As the pressures of competition and our own needs and wants increase, it is essential to get perspective on work and life. The nature of how our life evolves depends very much on where and how we choose to work. One can choose to be in a teaching institution – Public or private or can run their own hospital/clinics/nursing homes or alternatively be a freelancer in the private sector or else work within the government sector as a specialist.
Young and old vascular surgeons are faced with a choice as to how their professional life evolves. This choice often has significant personal, professional, and financial consequences. I look below at the choices on offer and the good and the bad of the same. This is the perspective of someone who has spent many years in vascular surgery but has worked only overseas or within the corporate sector of India. I trust these views will not offend anyone and if they do it is purely out of my ignorance and I apologize for the same.
Teaching institutions, whether public or private, certainly offer huge benefits. Complex and major vascular work, especially open arterial surgery generally needs some sort of institutional platform for the backup and expertise available. Operating on a complex thoracoabdominal aneurysm needs the facilities of an institution to provide the care and support that a routine recovery would need, but more importantly, the support required when dealing with complications. Unfortunately, such major surgery can be significantly expensive both in terms of time and resources and may not always be affordable to the patient or the surgeon. Such major open aortic work often needs the support of government institutions where it can flourish. However, the privilege of dealing with these challenging and surgically satisfying cases involves a significant investment of time, energy, and stress, and unfortunately, the government sector rarely appropriately financially remunerates those who do such exemplary work. Fortunately, some private hospitals are supportive of this kind of work, but as a vascular surgeon, it is imperative to find a balance − many would find that you do the complex arterial work for the joy of surgery, but your bread and butter comes from the mundane and more minor work. Institutional practice gives you the benefit of having colleagues to share the burden with and juniors to teach and train even as they support the work you do. The downsides are that you are always answerable to someone within the institution and institutions can be incredibly bureaucratic and frustrating and colleagues you are stuck with for life may not always be of your liking and vice versa.
Being your own boss is a huge privilege whether it be in a clinic/nursing home or hospital setup. You have the choice to develop things the way you envision it. The potential to manage your time and remuneration can be very significant. This does come at the cost of the need to be available readily and not really ever being fully “off” all responsibilities. It also entails the challenges of working with government and local regulators and their needs and demands. It obviously needs someone with a sound business sense to make a success of it. Outside of a hospital setup, it will need sacrificing doing complex open work as doing so in a single practitioner setup can be very challenging. The workaround to this is to have colleagues you can call upon to join you in the bigger case or to be affiliated with a larger hospital setup for the more complex cases. In fact, having a colleague you trust for help and opinions can be a huge support in any situation.
I have the greatest respect for the freelancer who provides care across multiple hospitals and nursing homes. The ability to juggle time, travel, and the skill required to provide care across a wide network is truly special. Many surgeons would choose to keep freelancing limited with their primary work being at a few centers and would choose to be selective in what they would operate.
How to strike a work life balance in any of these sectors is really down to the individual. What is an appropriate work life balance is also different for each person. However, it is a question we should ask ourselves and not remain stuck running blindly on a treadmill only to burn out.
It is also very important to choose whom you work with. Remember most of us probably spend more waking hours at work with colleagues than we do with our families – Choosing your colleague is almost as important as choosing whom you marry! It would also do well to remember that no one is indispensable to anyone but their families, patients, hospitals, and clinics will function just fine with or without us.
I end with this quote by Brian Dyson, the former Vice Chairman of Coca Cola “Imagine life as a game in which you are juggling some five balls in the air. You name them – Work, family, health, friends, and spirit and you're keeping all of these in the air. You will soon understand that work is a rubber ball. If you drop it, it will bounce back. However, the other four balls are made of glass. If you drop one of these, they will be irrevocably scuffed, marked, nicked, damaged, or even shattered. They will never be the same. You must understand that and strive for balance in your life.”
Wishing all happy working and even happier living.