Looking inward to find balance
Ten-month-old Eva Wise attempted to chew on crayons as her mom, Dr. Amity Wise, tried to listen to a session discussing work-life balance. Clearly, the topic interests-and currently eludes-the equine practitioner and mother of three. Eva became her travel companion when Dr. Wise's mother-in-law couldn't babysit after a back pain flare-up. So, Dr. Wise brought her youngest to the American Association of Equine Practitioners annual convention, held Nov. 17-20, 2017, in San Antonio, while her husband, Aaron, stayed home with Ethan, 10, and Emily, 7.
"It's pretty chaotic," she said, what with all the pickups and drop-offs for the older kids' extracurricular activities, especially during horse breeding season when she's working 60 to 70 hours a week. She and her husband both work for East Holmes Veterinary Clinic, a seven-doctor practice in Berlin, Ohio.
More and more traditional practice owners will hire valuable women as part of their practice—many of them are valuable young parents trying to meet the needs of their families. We have to figure out a way to retain them—to keep a lifestyle that is fulfilling for their family and themselves.
Dr. Margo Macpherson, 2018 AAEP president
"A lot of the younger staff think we work too many hours. They're still learning to do it all," she said. "We burn out new graduates in a year or two. We don't have the retention we need."
Equine practice has always been notorious for long hours along with demanding clients, plenty of late-night emergency calls, and many miles logged during breeding, racing, or show season. Dr. Wise's comments echo what another AAEP member had written in the association's member survey in 2014: "The life of an equine vet is not conducive with happiness. Once I had kids, my goals and employer's goals were conflicting. Unless we can make it more appealing to what younger generations want, I wouldn't recommend [it]. Perhaps we need to come up with a better work-life model, or else we're going to die out. Out of many in my class, only three are still practicing."
In fact, a 2016 AAEP survey showed that one of the top three most important issues identified by members was quality of life. That's why the AAEP has made wellness a priority in its most recent strategic plan.
Dr. Margo Macpherson, 2018 AAEP president, said the topic of work-life balance resonates with her personally (see story). "I'm an older parent with school-aged children, and I'm a professional. I understand how that is something we struggle with every day," Dr. Macpherson said.
"It's hard to be a successful equine veterinarian with the demands of motherhood and wifehood. For me, that the overarching theme of this meeting is based around balance is enormous."
Search for meaning
Dr. Macpherson chose Nigel Marsh as the keynote speaker. The former advertising CEO, leadership coach, and father of four structured his talk around how to approach the issue of work-life balance, persistent myths, and practical advice on how to achieve balance. He admits he loathes the term work-life balance.
"It's ludicrously binary. It suggests that there are only two parts of existence, and that they're in opposition—that you do more of one and less of the other. It suggests work is bad, that we have to spend equal amounts on each," Marsh said. "Work-life balance isn't about organizing your life so you can get home early from work to get on the golf course or on a yoga mat. It's about finding a way of living a life you find meaningful."
He cited Bronnie Ware's online article called "Regrets of the Dying" from her time as a palliative caregiver. The top five regrets she heard were as follows:
- I wish I'd had the courage to live a life true to myself, not the life others expected of me.
- I wish I hadn't worked so hard.
- I wish I'd had the courage to express my feelings.
- I wish I had stayed in touch with my friends.
- I wish that I had let myself be happier.
"Having a successful career that leads to a lonely old age full of regret isn't a smart trade. The point of life isn't to go faster. The person with the most money doesn't win. We're only here once, so when people say work-life balance is a soft issue, I think it is the most important issue. Living a life we find meaningful is most important," Marsh said.
One myth about work-life balance, he said, is that people don't think it is possible for themselves or anyone else in their profession. Instead, he says it's not entirely about the profession but the attitude one brings to it.
"You deal with amazing problems daily, and I refuse to believe if you looked at balance in the right light, you couldn't deal with it as successfully as you do with other problems in your life. The crisis of balance is a crisis of choice and crisis of imagination, not one of circumstance," he said.
So how does one achieve work-life balance?
First he advised where not to look for answers when seeking to make changes: in technology ("Until you have sorted out the fundamentals of balance, technology just makes it worse. It's not a game of time management and efficiency."); at other people's lives, because no one is honest about their struggles, and looking there is more akin to emulating a fantasy; or in a fixed daily routine, since people can make themselves miserable judging their progress or accomplishments on a daily basis, thus setting themselves up for failure.
Instead, Marsh emphasized starting small. He told the story of how, after losing his job, he decided he would pick up each of his kids from school once a month. The first day, he took his son to dinner, and they played together. While he was putting his son to sleep, the boy said it was the best day of his life. After that, Marsh added a new change every month.
"We overestimate what we can do in a month and underestimate what we can do in a year. Because we think we can't do everything, we think we can do nothing," he said. "Twelve changes changed my life."
Change first requires serious reflection. Often this happens only after a health scare, a death, a divorce, or a layoff. Marsh urges folks to reflect before any of that happens.
"The process requires thinking seriously and honestly about the type of person you want to be, the life you want to live, and the legacy you want to leave. Then, sit and think about the gap between goals and what you're actually doing and if you want to address this," he said. "The world isn't going to organize itself so you have better balance. You have to take personal responsibility to get better balance."
At the same time, individuals must acknowledge the realities of their situation. Every business will have things that won't change.
"Don't drive yourself into insanity trying to change things you can't. Try to work around it," he said.
Marsh said if things are to change for a profession, older generations must want the younger generations to have an easier life.
"This is not a revenge thing. If you have done 30 years of 15 hours a day, why should the younger generations do 10 hours a day? Because it's right. Or at least for the sake of the profession. For recruitment and retention. You need to," he said.
Flexible arrangements
Where Dr. Margo Macpherson and others see opportunity for creating professional sustainability is with flexible arrangements. To her, that means continuously looking at lifestyle adaptations so that people can have sustainable and gratifying careers in equine medicine. Ripe for the picking are flexible work hours. She pointed to a practice in Virginia that has a fleet of trucks with a phone attached to each vehicle. One veterinarian will go out on a call and return the truck, and the next practitioner will take a turn in the rotation.
"So you are never 100 percent the person who is responsible for care. In that, there is a community of trust. The veterinarians have to trust each other that you'll do a great job, and the clients have been trained that they'll get good veterinary care no matter who sees them," she said, likening it to obstetricians who rotate delivering babies even if they weren't a mother's primary caregiver.
During a later panel discussion, Dr. Mike Pownall, co-owner of McKee-Pownall Equine Services, talked about the benefits of nontraditional scheduling. After an employee survey indicated that employees were burned out, he decided to have everyone go to a four-day workweek without changing anyone's salary or the practice's hours. A follow-up survey a year later as well as the sound of laughter at the clinic ("I had never heard that in June before," he said) confirmed that employee wellness had improved. But that wasn't all. Revenue had gone up by double digits. "People being fresher and not tired, that's a huge factor" for increased productivity, he said.
Solutions exist, but implementing them will require greater communication between owners and associates as well as compromise, Dr. Macpherson said.
"More and more traditional practice owners will hire valuable women as part of their practice—many of them are valuable young parents trying to meet the needs of their families. We have to figure out a way to retain them—to keep a lifestyle that is fulfilling for their family and themselves," Dr. Macpherson said.
Related JAVMA content:
In pursuit of the elusive life balance (Sept. 15, 2015)
Study: 1 in 6 veterinarians have considered suicide (April 1, 2015)
Thinking creatively about emergency coverage (Feb. 15, 2015)
Motherhood and veterinary medicine (April 1, 2013)