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- Boris Arbit, MD∗ ()
- ↵∗Reprint requests and correspondence:
Dr. Boris Arbit, Division of Cardiovascular Medicine, UC San Diego Health System, 9444 Medical Center Dr MC 7411, La Jolla, California 92037.
A noted motivational speaker, Zig Ziglar often finished his talks on achieving one’s dreams with a story (1). He told of a young boy trying to walk on the railroad tracks and falling off after a few steps. However, when the boy had a partner against whom to push off, the 2 could walk for great distances before stepping off the rails. As cardiologists, the path we have chosen is an arduous one, and the journey is better with a partner.
The process of becoming a cardiologist is long, and it spans many years and phases of one’s life. Depending on how early one identifies his or her goal, the sources of support and encouragement may change from parents, to teachers, to professors, to professional mentors, and to spouses. Whether by their own example of being physicians, gentle nudging, encouraging an appreciation of science, or fostering a love of education, parents are the first in the long line of people who are instrumental in the process of becoming a physician. Certainly, other people may play an impactful role early on. However, it must be noted that the parent–child relationship is unique in that the parents provide mostly unidirectional support.
As one matures and progresses in the academic journey, the role of mentorship gains importance. Much has been written about the significance of this relationship (2). As before, the relationship is generally 1-sided. Mentees may be expected or encouraged to help their mentor with certain projects, but they ultimately stand to gain much more than they give.
Sooner or later (3), deep, committed, personal relationships begin for many physicians. Inherent benefits of such a relationship include affection, friendship, companionship, and general emotional well-being. Studies dating back over 20 years describe married house staff as having stronger support systems and less substance abuse, anxiety, and depression (4). The same study showed that unmarried house staff were much more likely to report feelings of isolation compared with the married group. Most people who stay in relationships long enough to reap the rewards quickly learn that unlike before, the give-and-take is not in 1 direction.
Fellows and junior faculty members are naturally concerned about how they will balance their careers alongside marriage and family obligations. It may provide some encouragement that a recent publication by Ly et al. (5) showed that divorce among physicians is less common than among non–health care workers and other health professions. For cardiologists, 50% of whom work >50 h/week (6), the sample of >48,000 physicians had other reassuring signals—the odds ratio of being ever divorced among physicians who worked >60 h/week compared with those who worked <39 h was 0.79; 95% confidence interval: 0.72 to 0.87. The association of hours worked and divorce was not uniform among men and women. Among female physicians, the number of hours worked per week was positively associated with the probability of divorce (for men, the correlation was in opposite direction). Similar results were reported 10 years earlier from a survey of Johns Hopkins University School of Medicine graduates (7). The blending of sex roles and professional aspirations is a much broader topic, but it is clear that we have chosen a profession that requires a lot of our time. Aligning our personal goals with our commitments to our patients, the hospital, and our research will not be easy.
Personal relationships of cardiologists are not inherently different than those of others. John Gottman, a well-known psychologist, outlines principles in his book, Seven Principles for Making Marriage Work (8), that overlay closely with the findings of Perlman et al. (9) in their brief survey of single- and dual-physician couples. Mutual support and understanding is central. Gottman (8) and respondents in the survey cited the importance of the reciprocal nature of emotional, mental, and occupational support in relationships. It is important to remember that although our lives are stressful and demanding, we now have a responsibility to another person. For relationships to thrive, we need to know the small and big things that are going on in our partners’ lives—how their world is changing. Further, although we may have a sense of professional pride and recognition at work, we must recognize the important roles of each family member.
If our goal is to have healthy, long-lasting bonds, we must invest the necessary time, planning, and attention (just as we have done with our careers). One of the first steps is to recognize successful role models in this regard. Certainly, the success is difficult to define, but at my institution, some of the most prominent and well-regarded cardiologists are also moms and grandparents. We have chosen a profession that is highly meaningful, but also demanding of our time. Making enough time to “be there” for our partners is not an easy task, but will ultimately lead to greater fulfillment. This is something that will not take us away from our chosen field, but will add richness and meaning to it.
- Rajesh Vedanthan, MD MPH ()
RESPONSE: Family and Work: Reciprocation
Dr. Vedanthan is supported by the Fogarty International Center of the National Institutes of Health under Award Number K01 TW 009218-05. The content is solely the responsibility of the author and does not necessarily represent the official views of the National Institutes of Health.
The relationship between family and work has been the subject of countless papers, editorials, books, seminars, and dinner-table conversations. This relationship continues to evolve, as the nature of work—and the nature of family—also have evolved over time. Dr. Arbit highlights the importance of dedication to, and investment in, family relationships, alongside one’s commitment to professional work. It is critically important to recognize and understand the value of relationships, both within and outside of the workplace, to commit to them, and to do so sooner than later.
Although the term “balance” is often used to characterize the relationship between “work” and “family” (or “work” and “life”), I propose that perhaps the term “reciprocation” may be more appropriate. I propose reciprocation in the sense of mutual exchange, moving back and forth, and give and take. This assumes that the relationship between work and family is not a zero-sum game, but has the potential to be mutually reinforcing and supportive. Meaningful dedication to work, combined with an unabashed and steadfast dedication to family and friends, can be symbiotic and mutually sustaining. Indeed, compromise on all sides and from all stakeholders—at the workplace, at home, and within oneself—are often required. The path is full of challenges and is not easy. However, the potential for personal growth, as well as contributions both local and distant, is unparalleled.
In this spirit, I agree with Dr. Arbit that dedication to our family and friends will add richness and meaning to our work. I believe that it is important to note that this need not be limited to a “partner” or “nuclear family,” but can extend to our friends, relatives, and professional colleagues. Likewise, this approach is not limited to the cardiovascular profession, but is relevant to any field of work. Reciprocity is inherent within each set of our relationships—both personal and professional—as well as in the relationship between work and “family” (or “life”).
- American College of Cardiology Foundation
- Ziglar Z.
- Agarwal S.
- Ly D.P.,
- Seabury S.A.,
- Jena A.B.
- ↵Medscape. Cardiologist compensation report 2012. 2012. Available at: http://www.medscape.com/features/slideshow/compensation/2012/cardiology. Accessed April 15, 2016.
- Gottman J.M.,
- Silver N.