10/24/2012 05:07 pm ET Updated Dec 24, 2012

Building the Doctor's 'Off' Switch

One of the reasons work/life balance is so difficult for physicians is the missing "off switch" on our doctor programming. We are trained so thoroughly over such a long time how to be "on" as a doctor that our physician programming can dominate our entire lives, running continuously both at work and at home.

Work/life balance can begin only when you are able to shut that doctor programming off -- something we were never taught how to do in medical school or residency. This inability to punch the clock and put our doctor-ness away until our next shift is, I think, a major contributor to the epidemic of physician burnout. Surveys repeatedly show an average of 1 in 3 doctors are suffering from burnout on any given office day.

Here's a personal example of the effects of the missing off switch. When was the last time this happened to you?

You had a stressful day in the office... couldn't wait to finish your last patient and get out of there... thanking your lucky stars you are not on call after a day like this... then...

On the way home the hassles of the day kept repeating themselves in an endless loop in your mind. You walked through your front door to be welcomed by your family; even the dog is wagging its tail.

You flop down at the dinner table and eat for the first time today, and the tape in your head just keeps on running. Your eyes are open, you are looking at your family as they talk to you... and you realize you are not there.

The little voice in your head is wondering if you prescribed the right dose for one patient and can't remember if you told your partner on call about another patient's delirium the last time he was in the hospital.

Does any of that feel familiar? Here's why.

We are all trained on how to practice clinical medicine. Along the way we are conditioned to be a workaholic, superhero, emotion-free Lone Ranger. These skills and programming work very well to produce an effective and efficient doctor, but they were never intended to be used outside the clinic or hospital.

We all need an off switch. Here's how to install yours.

It is called a "boundary ritual." Your boundary ritual is a specific action you take at the boundary between work and home that sends an "off" signal to your conscious and subconscious mind. This ritual is something you design and practice with the mindful intention that it will switch off the parts of your doctor programming that don't serve you when you are away from work and stow away the stresses of this day until you return.

With your doctor "off" switch you can be completely present with your family and your own personal needs and desires. Flipping this "off" switch is the first activity in creating any work/life balance.

Three keys to building an effective "off" switch

1) Use all of your senses.

Your boundary ritual ideally contains as many sensory modalities as possible. The four big ones are a movement, a sound, a feeling and an intention.

2) Use a "trigger" to help you remember.

A trigger is an existing habit -- something you always do each time you leave the office or come into your home. You use this as a trigger to remember to perform your boundary ritual. Common triggers are:

- Turning your office lights off
- Putting the keys in your car ignition
- Turning the car off when you get home
- Grasping the doorknob of your home

3) Mindfulness and intention

Practice your ritual with mindfulness and a clear intention to release, relax, let go and turn the doctor programming off. You can even say to yourself (or out loud) a short phrase like, "I release the doctor until the next time he/she is needed."

Here are some work/life balance boundary ritual examples:

- Before you sit down and talk with your family, take a shower and/or change your work clothes for home clothes.

- Take a deep cleansing breath, sink into your seat or give yourself a whole body stretch and an audible sigh as you release the cares of your work day.

- When you get home you go for a short walk around the block before going in the door and practice using your steps to release work and come to the present, preparing to be with your family.

Now it's your turn to build your off switch. What would you like to use as your first pass at a boundary ritual? What will you use as your trigger to help you remember your ritual? When will you try it out?

Remember too that building your own "off" switch and creating true work/life balance is a process. You have been conditioned to be always on for years now. It will take some practice and tweaking to refine your boundary ritual into a solid off switch at the boundary between work and home.

Please leave a comment and tell us what you will use as your boundary ritual. If you have one already, tell us how it's going.

Dike Drummond, M.D., is a family physician, entrepreneur and executive coach. He provides stress management, burnout prevention and leadership development services to physicians and other healthcare professionals through his website, The Happy MD.

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