Beyond Work-Life “Balance”


Balance isn't sustainable, but perhaps we can achieve dynamic equilibrium.

Fam Pract Manag. 2016 Mar-Apr;23(2):7.

Author disclosure: no relevant financial affiliations disclosed.

The desire for better work-life balance is a common concern among physicians and a key reason for choosing employed practice.1 But the term work-life balance has always struck me as problematic.

In my experience, achieving a true balance between work and non-work activities is incredibly challenging and, when achieved, is fleeting. My moment of balance is quickly upended by a sick child, a partner's vacation, a new project at work, a patient in labor, etc. True balance is unsustainable.

Additionally, the term work-life balance suggests that work equals bad and life equals good. This does not ring true for me because there are many aspects of my work that I love (and some aspects of my life that I don't always love).

Because of this, I've started thinking about work and life as a dynamic equilibrium. A dynamic equilibrium is a steady state where inputs equal outputs even though they are continuously changing. There can be chemical reactions going on in the middle, but the outcome is no net change. Using this metaphor as a work-life model makes a lot of sense to me. For my outputs (e.g., work, hobbies, or relationships) to be at their highest potential, I need inputs (e.g., sleep, exercise, and time for myself) to maintain the system. There will be times when outputs increase, like when my partner is on vacation or I am working on a special project. But to reach my potential as a physician, teacher, mentor, mother, partner, and friend, I need continuous inputs as well. Inputs do not have to equal outputs every day or even every week, but they should match up over time. A mismatch over months can be problematic.

Here are some tips to maintain a dynamic equilibrium:

1. Evaluate your steady state at regular intervals. This could be as simple as a Sunday night “check in” or a once-a-month appointment with yourself. Are your outputs consistently over-reaching your inputs? If so, that can lead to burnout and is not sustainable.

2. Pay attention to the inputs. Although our work involves taking care of others, doctors are notorious for not taking care of themselves. Getting enough sleep and exercising can boost the amount of energy you have for your work and leisure activities.

3. Limit your outputs. Can you say “no” to a request for your time? Learning to say “no” is an important skill to have while trying to achieve equilibrium. Without it, you will overcommit.

About the Author

Dr. Schrager is a professor in the University of Wisconsin Department of Family Medicine and Community Health, Madison, Wisc.

Author disclosure: no relevant financial affiliations disclosed.


1. Kane L. Employed vs. self-employed: who is better off? Medscape. March 11, 2014. http://www.medscape.com/features/slideshow/public/employed-doctors. Accessed Jan. 28, 2016.


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