Tuesday, December 22, 2009

Jennifer Frank, MD: The balance

This week has been crazy busy at work as each day has turned out much different than my day planner predicted. After a long weekend, Monday was predictably hectic, but as I perused my schedule for the remainder of the week, I was optimistic that it was manageable and would allow me to get everything done that was necessary on my to-do list.

Tuesday morning I was in a meeting (dutifully recorded in my calendar) when I received an urgent page informing me that I was already 45 minutes late to staff the residents in clinic. I quickly glanced at the clinic’s schedule to see that, yes, I was scheduled for staffing duty that morning. A change must have been made that did not make it to my personal calendar. Frustrated, I worked hurriedly to get through the staffing back up while trying to find a time to reschedule the meeting that was abruptly cut short.

Tuesday afternoon’s planned lunch-hour swim at the YMCA never occurred, as I attended another meeting, addressed a number of urgent issues, and made it out the door 20 minutes late to meet my husband for the kids’ swim lessons.
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Wednesday’s schedule was packed full with clinic and staffing duties. Shortly after waking up in the morning, I received sign-out from a colleague (did I mention I was on call too?) with two laboring patients. I quickly showered, ran to clinic to perform a procedure I had scheduled, and worked with colleagues and staff to rearrange my morning before heading over to the labor deck. While supervising the resident managing the two women in labor, I was able to finish resident evaluations and a self-assessment module for my board certification requirements. I am fortunate that my colleagues are understanding of the urgency of OB practice and covered my patient care and staffing duties for me. The second patient delivered at about 8 p.m. and I was able to leave the hospital by 8:30, having missed dinner, bath, and bedtime.

Thursday seemed ideally planned out – a full morning clinic but administrative time in the afternoon allowing me to attend my daughter’s preschool holiday concert and catch up on charts prior to a vacation day planned for Friday. I finished my 11:15 a.m. patient at 1:10 p.m. (having elected to pursue an overly ambitious agenda for this visit) and was walking back to my desk when a resident stopped me in the hallway to tell me that we were scheduled to do a vasectomy together.

There was no way I could do the vasectomy and make it to the concert (I had promised to attend) on time. None of my colleagues were available to help out and I was torn between doing the right thing for the patient and honoring my promise to my daughter. I tried to figure out where the mix up had occurred but quickly abandoned that exercise as both irrelevant and a time waster. The patient, having been poorly prepared for the amount of time the procedure would take actually requested to reschedule, so that part of the problem was solved. However, working with the front desk to reschedule him, soothing the patient’s ruffled feathers, giving instructions to the resident, and explaining the situation to colleagues took up precious minutes, so that I arrived at my daughter’s preschool just as the concert ended.

So frustrating to be extremely busy but fail to meet your obligations. In moments (days and weeks) like this, I rely on the common sense voice in my head which reminds me that all weeks are not like this one. I am thankful for a husband who records those events I miss and appreciative of the opportunity to share cookies and juice with my daughter who is unaware of my absence. Finally, I am reminded that so little of the pressure I feel to perform is real – much of it is my own drive for perfection. It’s okay to be imperfect, which is good because I am.

Jennifer Frank, MD, FAAFP, is an assistant professor in the University of Wisconsin Department of Family Medicine and a faculty family physician at the Fox Valley Family Medicine Residency Program in Appleton, Wis. She is a mother of four, whose husband, also a physician, is a stay-at-home dad.

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