Because our profession necessitates maintaining clear boundaries for therapeutic and safety reasons, this integrative concept may best be applied in terms of how it affects our self-concept, by easing our need to find a way to split our identity. In addition, the emphasis of integration over balance suggests that you are a whole person, with an identity and sense of wellness spanning, affecting, and being affected by all areas of work and non–work life. The word integration lessens the need to separate oneself into disparate parts to address various areas of life. The corporate world has pushed to reconceptualize this as work-life integration rather than balance. On top of that was the need to simultaneously manage distance learning for our children, negotiate infection control, deal with pandemic fears, and so on. The drawing of a line between work and home life became impossible as we were suddenly thrust into telepsychiatry mode, without any clear ways to apply our office-based approaches and boundaries. The idea of creating and maintaining balance has always been difficult and even more so during the COVID-19 pandemic. When faced with the age-old question, “Do you live to work or do you work to live?” it seems many of us would reply affirmatively to both options. However, it may also be difficult to separate work from our other senses of self. 1 This may be both a blessing and a curse: Data suggest this viewpoint may play a protective role in our resilience. But consider this: More than 40% of psychiatrists believe their careers in medicine are “a calling.” Thus, we tend to have a deep connection to our work. It refers to the ability to effectively attend to one’s work responsibilities and one’s personal responsibilities, with adequate reserves to balance it all. The reality is that achieving work-life balance must be emphasized and encouraged early-with our trainees, our colleagues, and ourselves.Ī work-life balance refers to a sustainable and effective distribution of self between one’s work and life obligations, suggesting a clear separation between “work” and “life” with minimal spillover of one into the other. The second step might be to acknowledge that burnout can start quietly, creeping into our mental health, patient care, and relationships, and surreptitiously affecting us without our notice until we reach a crisis point. Perhaps the initial step is to determine the components that require balance, including the nuances unique to psychiatric practices that make that achievement even more challenging ( Figure). So how, then, do we achieve this elusive work-life balance? Or they bring psychologically jarring elements of work (ie, difficult interactions or traumatic events) into their home lives without the ability to decompress or uncouple from those experiences. In fact, many colleagues report they bring work home, often finding themselves charting late into the night. In addition, most of us do not have the ability to clock in and out and leave work completely behind. And so many of us do this exact thing, tirelessly. Yet overworking-especially in invalidating, exhausting, or even downright toxic environments-without the ability to refuel by tapping into enriching or meaningful personal areas of life is a fast track to burnout.
We are often of the mind-set that dedication to our profession requires extraordinary sacrifices-to our health, time with children and family, and anything else outside of work. Understanding and Addressing Physician Substance Use and Misuse
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