Despite facing increased pressures from insurers and regulatory agencies, one orthopedic surgeon is determined to maintain a positive work-life balance.
Emeka Nwodim, MD, is an orthopedic surgeon at Bethesda, Md.-based Centers for Advanced Orthopaedics. He recently spoke with Becker's about how prioritizing his work-life balance is a core focus this year. Here, he discusses how he is achieving this for himself and his team.
Editor's note: Responses were lightly edited for clarity and length.
Question: How are you prioritizing work-life balance in your career?
Dr. Emeka Nwodim: Work-life balance has always been a concern of healthcare professionals as a whole, not only physicians/surgeons. However, in the past decade, there has been a significant shift in its priority to be at the forefront of our minds. Healthcare is a demanding field physically, emotionally and psychologically. We face tremendous pressure and expectations from our society to maintain a level of perfection that is unmatched. These pressures come from our patients, government/regulatory agencies, insurance/healthcare systems and from within ourselves. Ultimately if not prioritized, our personal lives take a tremendous toll. Being intentional about work-life balance is necessary to maintain a healthy lifestyle. And I do not believe that in doing so, a [healthcare] professional’s success is limited.
For me, the decision to go into private practice was the first and most important step. Not to say that those in academia or employed positions cannot find that same balance. I am confident they can, and I know there are some that have already exceeded my own goals. Personally, I recognized early on that autonomy in controlling my own schedule, vacations and even short-notice leave was essential to achieving my own goals of being a present husband, father, son, brother, friend, etc. I want to emphasize that this is an ongoing process and I am still working to achieve my goals.
My second initiative, per se, was to build a strong and competent team around me to share the tremendous workload placed on us physicians/surgeons. Again, I want to reiterate that it is not just physicians/surgeons that can be consumed with the stress and demands of healthcare, but nurses (and their aids), technicians, support staff, ancillary staff, managers and even healthcare administrators can succumb to it as well. On a microscopic level, my team [currently] consists of two physician assistants, a medical scribe and an administrative assistant. As the managing partner in my practice, I consider my team to also include every staff member, our practice administrator and even my [physician] partners as everyone’s commitment and decisions contribute to our efficiency, productivity and ultimately work-life balance.
As a member of a larger corporate entity, the Centers for Advanced Orthopaedics, my team also consists of those above me, including the leadership team at CAO, central office and legal team who are all working to establish a greater platform for us to be more efficient, productive and competitive while maintaining our autonomy and [again] ultimately leading to a better work-life balance.
Last but not least is my priority to minimize the work I take home on a daily basis. Although challenging at times, my team and I have remained disciplined in completing all charting and tasks at work and not bringing them home. My team (PAs, scribe, administrative assistant) are all contributors to this achievement and are all aware of this principle. I encourage the same for them and in doing so, we are all able to enjoy our personal lives with minimal [work] interference.
Q: What made you want to start prioritizing work-life balance?
EN: Just seeing the challenges that other physicians have gone through in terms of managing and being present. I know from the time I was in training up until now, you hear about physicians having very limited time with their families, being sometimes withdrawn, and then the stress that comes along with that, both on the professional and the personal side. So it's been a priority of mine since making the decision to go into medicine that I was going to try to find a way to prevent that from happening to me.
During my training, it became a topic that gained a little bit more popularity as there was a transition to limit the number of hours that residents could work in a week due to some mishaps and accidents with residents falling asleep behind the wheel on the way home. There was a big case in New York with a resident that fell asleep behind the wheel and passed away, and that led to a lot of changes and the implementation of restricted work hours. It's important to continue that conversation just like anything else that we strive to excel in.
Q: What has been the most challenging part of this process?
EN: It's an uphill battle because the demand that's placed on us is continuously increasing. The expectations from patients and their families, the increased requirements placed on us by hospitals, government agencies as well as our regulatory agencies, by healthcare systems, hospital systems, and then the level of expectation of expertise and perfection from within ourselves. We have the healthcare system that's very expensive and is constantly looking to cut back on reimbursements to physicians, which ultimately forces many physicians to have to increase their productivity or volume in order to maintain and sustain their practice. And that applies to not just private practice physicians, because as the hospital and health systems also face certain pressures, it is oftentimes the physician's reimbursements and income that gets cut first. Then you have other factors such as the increased prior authorizations needed for the simplest of patient care. You have increased paperwork that is also oftentimes required by insurance companies, and you have the demands from the government in terms of electronic medical records sustaining appropriate protection of your information and technology and patient privacy information. So there are a lot of demands that are placed on us that add day-to-day stress.
Q: Do staffing shortages make this goal harder to achieve?
EN: At this current period in time, staffing shortages are a major factor throughout the economy, especially in healthcare. However, the demands that have been placed on us precede the era when there have been staffing shortages. The demands I mentioned have been continuously increasing for decades, whereas staffing shortages are in the last two or three years.
Q: Is perfection achievable with this goal?
EN: I think it's OK to achieve the closest level of perfection as possible. However, it is important to be realistic and also understand that complications are going to happen, mistakes are going to happen to even the best of us, and [it's important] to know how to manage, respond and mitigate those errors and complications once they arise rather than ignore them.