Does work-life balance exist, and can it exist?The greatest concern for doctors is that of work-life balance. A simple, but highly relevant metric, is the number of hours spent on work on a weekly basis. During parliamentary debates, the Minister of Health clarified that the working hours for house officers should not exceed 80 hours per week, including night call hours. As a simple comparison, the accepted standard is that of 60 hours a week, with anything above considered as “overtime” by the Ministry of Manpower. Thus, it is clear that work-life balance is a valid concern.
Furthermore, existing statutory schemes such as flexible work arrangements, do not sufficiently safeguard the doctor’s ability to maintain a desirable work-life balance. For one, the health and well-being of patients are at stake. On another level, the increased workload on the medical profession as a whole has reduced breathing space.
Given that proper guidelines DO exist, it is clear that this balance can and does exist - the question is how to go about it. Making sure to schedule time for activities outside of work aside, it is important to be mindful and aware that you are working towards this balance, as all too often doctors fall into the trap of simply forgetting that such and such an activity was supposed to be a priority for the day, instead of work.
What are the signs of burning out?Speaking of work-life balance to doctors would predictably trigger cynical responses. Indeed, cynicism is the most illustrative of the early signs of burn-out. If you have been in practice for some time, you would be no stranger to hearing about or experiencing the dread of going to work. You may feel less empathetic towards patients. You would have observed the changes in attitude from the day you first started working, till this day.
However, this should not be the case. Remember that you are doing this to help people. Altruism and compassion should not be weighed down by institutional burdens. While some may find success with stress management and work-life balance strategies, others may not. For the latter, here are some possible avenues for you to continue your journey.
What are the alternatives to medical practice?Doctors should not be afraid to try new things. Consider changing your speciality, or even your working environment. Workplace stress is a great contributor to burn-out. For instance, demanding superiors or patients, understaffed departments, insufficient infrastructure, and the list goes on. Ultimately, every person is wired differently, and knowing that something is NOT good for you is almost as important as knowing what is. Change is not always comfortable, but it beats a certain path of burning out and falling off the waggon.
A more common path taken nowadays is that of becoming a family doctor. While it could be more financially rewarding and less stressful, it does not come without its pitfalls. For one, you may be confined to working with run-of-the-mill cough-and-flu patients which could be detrimental to your initial ambition of entering medical school in the first place. For another, private practice means that you are nevertheless an employee and may have limited promotion opportunities within the hierarchy of doctors. Alternatively, running your own clinic is not a risk-free venture. In sum, the grass is not always greener on the other side.
The solution: do meaningful workIf you have been working for several years, it may be the time to volunteer your services abroad. Dr Lim Chin Siah, who volunteers with Doctors Without Borders, is a full-time consultant at the Department of Emergency Medicine at Singapore General Hospital. He has consistently juggled unpaid leave to attend to his volunteer duties with the humanitarian organisation. But, wouldn’t this have been too much work?
This is illuminating in that burn-out might not necessarily be the result of too much work – but too much work of the wrong kind. For Dr Lim, the fulfilment that he receives from helping others was what kept him going back. Seek out your original purpose, and this can be answered by a simple question: why did you become a doctor? Then, perform your duties as a doctor, whatever those may be, for that purpose. MIMS
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1. 13 July 2015, Parliamentary QA, “Working hours for housemen on night shifts”. https://www.moh.gov.sg/content/moh_web/home/pressRoom/Parliamentary_QA/2015/working-hours-for-housemen-on-night-shifts-.html
2. 24 October 2011, Ministry of Manpower, “Law protects employees from working excessive hours”. http://www.mom.gov.sg/newsroom/press-replies/2011/law-protects-employees-from-working-excessive-hour
3. 20 May 2016, Adrianna Quek, “Bombs and bullets don’t stop this Singapore-based doctor from saving lives”. https://pride.kindness.sg/singapore-based-doctor-saving-lives/