We all aim for work-life balance these days. However, do we really understand this concept, or do we simply run the gauntlet, bewildered and exhausted, hoping for a better tomorrow? It is time to perform a thorough exam on the concept of “work-life balance,” nail down an accurate diagnosis, and get the right meds on board. First, we must understand how we got here. It is time to grab your nearest time machine and hop in. All aboard… First stop: Medieval England, 1200 AD Here we find poor English peasants toiling away from dawn to dusk. However, were they entirely overworked? Historical documents1 reveal a few surprising facts. While the peasant put in long days from spring through harvest, the labor was broken up by a catalogue of meals and rest breaks, and the soil he tilled was right outside his front door. Work and life were intermingled, and his children were largely underfoot. Winter—plus a slew of church-based holidays—saw the same peasant idling away in leisure for a good portion of the year. Based on 12-hour workdays, 135 days/year, this group of laborers is estimated to have put in 1,620 hours of work per year. Second stop: America, 1850 AD It is here we find workers grinding their fingers to the bone in the factories of the Industrial Revolution. This is the first time “work” became separate from “life.” Steel workers put in some of the hardest hours, laboring 12-hour days, seven days a week (over 4,300 hours per year) to keep the smelters hot. It was not until 1923 that a federal mandate2 finally forced the steel industry to reduce work hours. Based on an Industrial Revolution average of the “more reasonable” 70-hour workweek, 52 weeks per year, this era of monumental human productivity averaged 3,650 work hours per year. Third stop: America, the recent past A 2005, a JAVMA survey3 reported small animal veterinarians were putting in an average of 43 hours/week at work, while large animal practitioners were averaging 50 hours each week, with some individuals logging 70- to 90-hour workweeks. True, a small percentage of DVMs were working Industrial Revolution hours, but the vast majority were clocking around 2,000 hours per year. More recently, part-time positions have gained popularity, while COVID single-handedly exploded workloads across the board. What do we make of this hodge-podge of numbers? Most of us are working more reasonable hours than our 19th-century cousins, but we struggle with work-life balance. Why? The rules have changed Our definition of work-life balance has changed along with our modern lives. Work-life balance (noun): commonly understood as “the ability to perform well at work while preserving enough time and energy to enjoy one’s personal life.” This definition distills the fact modern workers want to excel at both work and life. The key to our crisis is the fact medical professionals tend to “leave it all on the field” during their day. The problem is, no one can leave it all on two fields. Newer generations desire different things Modern generations approach the work-life problem different ways. Baby Boomers (1945-1964), now the venerable masters of the veterinary profession, grew up doing duck-and-cover drills in case of atomic attack. Cold War uncertainty led to a quest for stability. In broad strokes, work-life balance meant putting in arduous hours to achieve clinical competency and ensure full pantries, two-week family vacations, and self-respect. Decades of practice-building have landed them in demanding positions that leave them craving relief. Medieval peasants had a better work-life balance than most folks in the workplace today. They mastered the art of work-life integration, a concept that could be adjusted for modern day. Gen Xers (1965-1980) grew up in increasingly two-working-parent households before modern childcare options existed. Reduced adult supervision nurtured a sense of independence, as well as a recalibration of their own child-rearing goals. Instead of leaving the TV dinner in the freezer for Junior, Gen Xers began to shuttle their children to multiple activities each week, and to define success by intense home life involvement while seeking professional improvement to pay for it all. Millennials (1981-2000), raised at the center of family activity, value their own individuality. Yet, when they watched the Twin Towers fall on live TV, they also recognized the transience of life. As adults, they revere experiences over material things, and define success as the ability to live life on one’s own terms. While preceding generations might characterize Millennials as unambitious, Millennials have been saddled with the highest student debts to date. They are keenly aware of the need for upward mobility and workplace success, while struggling to achieve a family life that matches their desire for inner achievement.4 Clearly each generation approaches work-life balance from a slightly different angle. The solution—integration How do we find a way forward in the midst of these challenges? Remember our medieval peasants. There was a rhythm to their day that allowed for rest and a buffer for the unexpected. There were seasons dedicated to family and seasons dedicated to work. Yet, through it all, work and family occupied the same location on the map. What they experienced was not work-life balance, with its implied equal and opposite forces vying for primacy on either side of a fulcrum. The peasants of yore experienced work-life integration.5,6 Work-life integration does not demand a tally of minutes spent on work vs. life at the end of each day. You will never strike perfect “balance.” Some hours require more work, some days more family. Some months pull you toward personal improvement, others toward professional confidence. In this way, “work” is no longer seen as the nemesis of “life.” Instead, the idea of work-life integration allows for success in both realms simultaneously. Veterinarians often struggle to find balance due to debt, work hours, families, and social lives. One increasingly popular model for work-life integration is the job-sharing, part-time DVM who uses virtual care to fill in the gaps. Here are three examples of how that works: 1) The school calls because your child is running a fever. Normally, you would have to cancel the rest of your appointments that day to get little Evie home and cared for. Now you can change the next three in-person appointments to video visits arranged through the telemedicine app on your laptop and perform them from home after you have tucked Evie into bed, while your job-sharing colleague covers the afternoon for you. 2) You have zero appointment slots available for the next two weeks, and Muffy the colitis dog is at it again. Before stepping into your 2 p.m. cat vaccine exam, text Muffy’s owner through the telemedicine app on your cell phone to ask for details about Muffy’s behavior, appetite, skin turgor, sclera, and MM color. Tell the client to send a photo of the stool or a video of the defecation behavior. Perform your cat vaccine visit, exit the room, and retrieve the cell phone from your pocket. Evaluate the client’s information and either send home empirical therapy or schedule a tech appointment for the diagnostics you want to run. Text the client your treatment plan, then step into your next room. 3) Your favorite band is in town and your spouse surprised you with concert tickets. You block yourself out early that day, but before you depart, you notice five urgent callback notes on your desk, two from clients who are known talkers. Normally these would set you back more than an hour. But this afternoon, you leave the clinic on time. While your husband drives to the concert, you text each client through your telemedicine app to answer their questions. The app automatically requires payment for communicating with you, and the texting compels both you and the clients to be succinct. With PMS integration, the texted discussion becomes part of the patient record effortlessly. You knock out the callbacks by the time you arrive at the concert and are fully present with your spouse when the music starts. Telemedicine can be performed in real-time through a phone conversation or video chat (example 1). However, it really shines when performed through texting (examples 2, 3). This mode of communication requires far less energy than face-to-face appointments, phone conversations, or video chats with clients, while potentially reaping the same monetary compensation and clearing your schedule whether you are at the clinic or not. To succeed at work-life integration, first prioritize where you need to be when. Then leverage the flexibility virtual care offers so you can treat your patients, support your clients, and live your life in greater control of your time and energy. Telemedicine may very well be to us what penicillin was to the troops of World War II: the right medication at the right time to survive our battle wounds and live a brighter future. Holly Sawyer, DVM, human-animal bond certified, is a 1999 graduate of UC Davis School of Veterinary Medicine. After 19 years in small animal private practice, she became a veterinary regional director for GuardianVets, a triage and virtual care provider. For more information, go to https://www.guardianvets.com/telemedicine. References Schor, Juliet B. The Overworked American: The Unexpected Decline of Leisure. New York: Basic Books, 2008. http://groups.csail.mit.edu/mac/users/rauch/worktime/hours_workweek.html Moye, William T. “The end of the 12-hour day in the steel industry.” Monthly Labor Review Sept (1977): 21-26. http://digitalcollections.library.cmu.edu/awweb/awarchive?type=file&item=430142 JAVMA News. “Not enough hours in the day.” March 1, 2006. https://www.avma.org/javma-news/2006-03-01/not-enough-hours-day. Forbes. “The evolving definition of work-life balance.” March 18, 2021. https://www.forbes.com/sites/alankohll/2018/03/27/the-evolving-definition-of-work-life-balance/?sh=3dca09699ed3. Medical News Today. “Work-life balance for physicians: the what, the why, and the how.” September 22, 2020. https://www.medicalnewstoday.com/articles/318087#Is-work-life-balance-just-hype? The Veterinary Idealist. “The myth of work life balance.” January 23, 2020. https://vetidealist.com/myth-work-life-balance/.
