The Most Overlooked Person In Medicine
“Editor’s Note: “Providing insight and ‘handles’ or practical tools Physician’s can use to improve their station in life is one of our ‘wake up’ or mission-minded goals here at CMT. The idea for this story actually came as a result of an email I received from my former Pastor, J.H., whom I admire and respect. His transparent observations on how the church (in general) overlooks a Pastor’s spouse, provided the seed for this story. His personal story, we’ve translated for you to provide context and practical applicability today into the clear and present reality that Physician spouses are also overlooked. Supporting his thoughts are also our own and as a result of three recent podcast interviews and private conversations we’ve had recently with Physician’s and their spouse. The importance of the Spouse in a Physician’s life is critical to our communities. Recognizing this and providing credit where credit is due, we want to thank the physicians, J.H., my former Pastor and the stories many of you have shared with us for your transparency and honest. The insights you’re about to read are not all entirely our own insights and we’ve anonymized any names. We think there are a lot of relevant insights for those “married to medicine,” in ministry or in business. I hope you find it helpful.””
"Yes, the data about divorce rates are low for Physicians and that truly is great news! However, it also signals 'double the trouble' for burnout among both parties if both are working in healthcare. Little is being done in our healthcare culture to acknowledge and support the Physician-Spouse and the role they play in the practice, a clinic, etc. If we're going to even try to do something about this disease called 'Physician Burnout' or 'Moral Injury,' let's start by acknowledging, appreciating and supporting on a regular basis with formalized programs ... the most influential voice in their life, their Spouse!"
Every single year at our annual conference gathering, the Concierge Medicine Forum, I’m always elated and surprised by the spouses who walk up to me at the end of a conference and tell me how much this program(s) or session meant to them.
“I felt like you were talking directly to me …” we hear.
Or, “I've been telling him that for years. Thank you for …, hopefully he'll listen to me now.”
These kind words truly warm our hearts and help us build on the narrative that Concierge Medicine is more about finding career satisfaction than about feeling burned out in medicine. These words from our readers, their spouses and so many others keep us building each year to create an incredible program at the Concierge Medicine Forum here at CMT. It informs us that we’re making a difference and doing something about the insurmountable mountain of Physician Burnout. By not only providing an outlet for you, but insight and tools, handles and connections FOR Doctors and to those people in your life that have the greatest influence on you, your spouse.
So, as we've stated, oftentimes, the most overlooked person in a church is the Spouse. Today, I would also say that in the practice of medicine the same is true as well. The spouse of the Physician is the most overlooked person (employed or not affiliated in anyway with the practice).
J.H., adds reasons to support this for the church. His thoughts I've translated for applicability into "medicine" for context.
Here's why overlooking this person is so dangerous for the health of a local Doctor.
Like most “I'm married to a Doctor” conversations, your spouse will privately encourage you when you’ve had a bad day, you're frustrated or in those quiet, still and sad moments, lost a Patient they've connected with over the years and treated like their own family for quite sometime. You've been with your spouse at the funerals, beside them at graduation and perhaps even listened patiently to their dreams while grounding them in reality or encouraging them to fly.
They have shared their unfiltered thoughts about “so-and-so” and help you carry the impossible burden of “Doctor” with you each day.
That’s just who your spouse is. They’re compassionate, will cry with you, argue with you and even laugh with you. They’re unfiltered and they're every Physician's North Star.
Little do most employees, management, your colleagues or even Patients know (whether you work with the Physician spouse directly in the practice or they have their own career separate from the practice), but a Physician's spouse carries an incredible weight and responsibility all their own as well.
Unfiltered, private conversations between spouses happen ALL THE TIME inside a Physician’s home.
1. Start With Acknowledgement
J.H., notes in his story about spouses and churches, that It’s stunning to me how little this person in their life is acknowledged by employees ... and I'll add to that, perhaps by your medical staff, board of trustees, Patients or your colleagues.
In fact, many times, your Patients know more about your spouse than your colleagues do. And, meeting them once or twice a year during a casual moment at the hospital or during a medical association banquet doesn't count.
J.H., writes At a farewell event the Church staff hosted for [my spouse] and me before our departure, I shared that I had one regret. I regretted that most people had no idea how much [my spouse] had led that Church.
J.H., also noted, The countless conversations we had when I was hurt, frustrated, anxious and, concerned kept me going. The times I wanted to quit, she said, “Not yet.” The times I wasn’t sure I was able to do the job, she said, “You got this. The Lord is with you, and so am I.” The moments I needed great advice, she provided it. And the times I needed to be called out or corrected on something, she was a voice of truth.
2. If married to another healthcare worker, recognize that while the divorce rate is low, the burnout risk is now double.
Business Insider reported the Top 10 occupations with the lowest divorce rates were Directors of religious and educational activities and Physicians and Surgeons.
#9 Directors, religious activities and education — 21.3%
#10 Physicians and surgeons — 21.8%
That's amazing! Congratulations.
But, while that might seem like great news and it is ... it also may mean double the trouble related to career satisfaction, pressure and stress at work and that you BOTH carry home ... especially if you marry another Physician.
Physicians Practice writer Janet Kidd Stewart recently penned an article entitled Supporting Your Spouse’s Career where she writes … Your spouse puts up with the long hours and short temper your stressful practice tends to create, but you know it's taking a toll on the marriage. High divorce rates prove this is no easy task, particularly as medical marriages often today include two busy professionals.
While this might seem like good news, and it is, we cannot take for granted the important role of supporting the Physician's spouse, whether they are working in the practice or filling an important role at home or in their own profession.
There's a lot to unpack here.
If Physician's aren’t careful, this can begin to take a toll on a your marriage as well, and the data is proving this to be true as well. In February of last year, (eg 2020), Medscape cited that One in four women physicians are married to doctors, and 16% of male doctors are married to physicians, says a survey of more than 15,000 physicians in 29 specialties.
The AJC reported that Female physicians and surgeons are most likely to marry male or female physicians and surgeons.
The Washington Post wrote not too long ago as well, Physicians had a 24 percent likelihood of divorce; it was 23 percent for pharmacists; 25 percent for dentists; 31 percent for health-care executives; 33 percent among nurses; 27 percent among lawyers; and 35 percent for non-health-care workers.
Finally, the AMA cites that About 80% of physicians are married, according to a recent online survey, and these doctors often marry other doctors or other health professionals.
Is that double the burnout risk?
You bet.
3. Talk about how the work is affecting you.
Wayne Sotile, PhD, a clinical psychologist and author of The Medical Marriage said "One predictor of marriage failure is never talking about work," he says. "Just don't focus constantly on the minute frustrations. Instead of talking about how many procedures you did, explain how the work is affecting you."
So, knowing this, I believe it is improper of medical management, employees and practice colleagues and leadership in your medical practice or health system if they do not encourage, acknowledge or care in some way for the Physician’s spouse.
J.H., writes Knowing this, I believe it is negligent if leadership doesn’t encourage, shepherd and care for the lead pastor’s spouse. Now, let me be clear. I’m not suggesting some weird entitlement program.The pastor and the pastor’s spouse shouldn’t be treated as if they are royalty. That’s not what I am suggesting. At the same time, when there is no acknowledgement of the role the spouse plays, the leadership of the church does itself and the couple a huge disservice.
Interesting viewpoint here. Does this dovetail well into medicine?
Well, yes.
BRAVO even made 118 episodes of a popular, dramatic reality tv show about this relationship between Physician and Spouse called Married to Medicine. Married to Medicine (also known in some countries as Married to Medicine: Atlanta) is an American reality television series that began to air on March 24, 2013 on Bravo and was created by Mariah Huq.
Think about that for a moment, 118 episodes? For context, Home Improvement, an American television sitcom starring Tim Allen, that aired on ABC from September 17, 1991 to May 25, 1999 made 204 episodes. BRAVO is over half-way there. So, yes, this is an important, dramatic and big deal that extends far beyond the exam room, the tv, the living room or your medical practice lobby.
We need to help provide tools, conversations and acknowledge the role of the Physician spouse today, or else our communities will suffer.
For example, have you ever met a grumpy Doctor who recently got divorced?
Do you really think that doesn't have an impact on staff moral and Patient Care over time?
Back on point. What we're talking about today is specifically aimed at the emotional and psychological acknowledgement that “being married to medicine is really tough work … it impacts the family, not just the person treating Patients inside the exam room.”
4. Host lunches, random appreciation events, lectures, workshops, etc., for physicians and their spouse.
Dr. Edward Krall, a psychiatrist at the Marshfield Clinic in rural Wisconsin, started a physician spouse group there several years ago. The informal group, known as The Network, hosts lunches and welcome events for spouses of prospective and incoming physicians at the clinic and some social events for existing physicians.
"The clinic had hired a New York marketing firm to do some research around our brand, and part of that was a survey of recent job candidates to find a profile of what types of spouses would be happy here," he says. "It found the Marshfield spouse drives an SUV, not a BMW, drinks Gatorade, not a Manhattan, and values family activities over ample shopping. We know that if the family isn't happy, the physician isn't happy, so we felt we needed to address that more directly.” Krall and the clinic also host lectures and workshops for physicians and their families on work/life balance, workplace stress, and other personal issues.
"All of the data suggest that a supportive spouse is key to a physician's success," Krall said.
So what can you do if you’re in leadership at a medical practice and want to implement and/or acknowledge a colleagues spouse or support their role in a Physician's life.
Keep in mind, they don’t have to work there. In fact, that’s all the more reason to actually do something, say something or write a thank you card for goodness sake. You might never see this person but you absolutely know the role which they play in the Doctor’s life and they're decisions are critically important and will impact you.
5. Create a formal spouse program, like hosting a social gathering for all spouses in the practice or paid, private, proactive counseling for the "couple"
So to get granular, here are some suggestions from J.H.'s, email letter that I think you might find quite helpful. We've modified them to be applicable from helping Pastors to helping you, the Doctor.
We modified the specifics to be applicable to the Physician and I think (personally) medical practice management and leadership should provide the following, immediately to Physician’s and their spouses:
Paid, proactive counseling for the [Doctor] and his/her spouse as a “couple”
Say thank you. (And don’t wait for the Christmas employee dinner.) The [medical staff, your physician peers] and or senior management should consistently express appreciation to the [Doctor’s] spouse.
Pay for [one weekend] off-sites getaway for the couple.
Bring the spouse into a leadership team or management meeting and ask, “What feedback do you have for us to improve how we serve you and your spouse?”
If you are a large [group physician practice], make sure the spouse of the [Doctor] doesn’t get lost in the maze of the organization. Being in a large [medical group or health system], often times a [Physician’s] spouse can often feel even more invisible, neglected, put on hold, feel like they’re competing for time, confronting a gatekeeper at every turn and ultimately, un-cared for. If you don’t believe me, ask them.
Janet Kidd also notes … If your [medical practice, or] group doesn't have a formal spouse program, a good place to start is simply hosting a social gathering with spouses. Today's busy lifestyles have put a damper on socializing at work, but a little effort here can help the whole group deepen their commitment to each other.
Theresa, wife of a Doctor, Mom of 3 and working professional penned a blog recently about 15 Non-Glamorous Realities About Being Married To A Doctor. In the post she writes … It’s the saddest fact of all but burnout is a major health crisis for doctors. Every year, over 400+ doctors commit suicide. That’s among the highest of any profession. Try to visualize the equivalent of an entire graduating class of medical students of a state university who die each year.All the stress and burnout doesn’t just stop at the hospital. Our DrSpouses bring it home, emotionally and mentally within the walls of our home.
J.H. drops this final note on us in his letter when he writes ... If you serve in this type of role and disagree with me, then let me close with a question: “When’s the last time you brought the spouse into the [practice] and thanked them?”
Certainly insightful thoughts to ponder.
Thanks for reading.
FOR DOCTORS,
Concierge Medicine Today, Editor
Correction Issued to Original Article re: #9, #10 (Correction Date Issued: May 24, 2022)
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