Chapter 11. Balance in life beyond bank balances

Dr. Yeshwanth K. Amdekar, DCH, MD (Pediatrics), FIAP

Don’t think money does everything or you are going to end up doing everything for money Voltaire Everything in moderation is a perfect balance Ryan Robbins


Balance ensures relative distribution to avoid fall. Balance in life is an act that demands attention to multiple activities in order to cope up with all of them in spite of conflicting factors. Life earlier was much easy with happiness and containment. Unfortunately, life has been increasingly complex, competitive and stressful, more so for the doctors. Bank balance provides financial security but does not ensure healthy and happy life. We work and earn only to enrich our life. Life has many components physical (diet, exercise, and sleep), mental (stimulation), psychological (success), emotional (happiness) and spiritual (empathy and harmony).

Concept of work-life balance

This concept developed in the western world about 40 years ago and remains mostly ignored in India. Fierce competition, increasing aspirations and modern technology led to ignoring life. Consequences of imbalanced life affected both work and life. After all work is to enrich life and so all of us must define our goals in life clearly and time spent to achieve the same.

Balance in life of a doctor

Two major factors that need balance are related to medical practice andpersonallifestyle, each of them consists of multiple components. Both factors are dynamic and changing but highly interdependent. Doctors in general ignore life in pursuit of medical practice and bank balance. Such an imbalance has its consequences affecting personal and family life as well as quality of medical practice resulting in increasing stress and unhappiness. Unfortunately, by the time one realizes effects pf such an imbalance, it is often too late to change.

Balance related to medical practice

Balance between art and science of practice Medicine is a science of uncertainty and art of probability. Science refers to acquiring knowledge and clinical skills while art consists of ethics, communication, counselling, and documentation, time management, dignified and respectful approach and patient empowerment. One without the other fails to provide holistic care. Every doctor must spend enough time with the patient and art of practice is equally or more important than medical competence and skills.

Balance between practice and updating Medicine is a dynamic science and change is the only constant. So, we need to learn unlearn – and relearn. Thus, constant updating is a need and one can learn by priority what is most applicable in practice. Interactive learning is ideal and one can form local groups to facilitate such learning. It is most important to keep updated so as to give the best to the patient and for which time spent is a good investment. It is possible but choice is yours. If you are not updated, check your pulse, you may be academically dead.

Balance between evidence and experience Evidence and experience-based medicine is an imaginary divide as both are two sides of the same coin. Evidence guides decisions based on averages and not fit for all. Clinical judgment is the key component of evidence-based medicine. So, we need to keep balance between evidence that is based on external research and experience based on internal expertise, one without the other is not desirable.

Balance between traditional wisdom and modern science much before modern science developed, traditional wisdom helped to comfort patients. While modern science treats disease, traditional wisdom treats a patient in which resides the disease. Modern science offers a new test or a drug, traditional wisdom decides for whom to use and when to use. Thus, modern science must be guided by traditional wisdom and we need to use both.

Balance related to life

Balance between profession and personal health Medical profession goes through three phases. First phase is one of aspiration and expectation, second phase of compulsion and greed for money and last phase of addiction to pursue the same. It is a rat race. We have time for patients but not for ourselves. We ignore our own health with irregular eating time, sleep deprivation and lack of exercise. We need to set our goal, regulate work pattern by group practice and create time for many other activities that keep you healthy, happy and still work with passion.

Balance between profession and family Finding time for family during busy practice is a challenge but possible with adjusting work schedules. Group practice helps to achieve his balance. There are many benefits of spending time with the family such as bonding with family members, nurturing positive behavior, promoting healthy life, relieving stress, imparting good values and improving self-esteem of children.

Balance between time, money and energy During initial days of practice, one has enough time and energy but no money, when practice flourishes, you have enough money and energy but no time and finally at the end of practice, you have enough money and time but no energy. So, one must enjoy life when you have money and energy and find time even in busy practice. Otherwise, you will collect money at the cost of health and later, spend all that accumulated money to regain health.

Balance between success and happiness Success is you get what you want at any cost but happiness is you want what you get or what you need. Success lies in happiness. We must learn to give more than take because it gets back with more happiness. Success beyond limits kills but happiness takes care of your life so that you can die young as late as possible. Don’t forget life has an expiry date that is not known.

Current scenario of medical practice

Rational and ethical practice as well as academic updating is sacrificed in pursuit of money. Burnout leads to long term health problems such as obesity, hypertension, acidity, digestive complaints, depression, anxiety, sleep problems, chronic aches and pains. Quality of practice goes down with patient dissatisfaction and poor self-esteem. In turn, it increases stress worsening health problems and unhappiness. It is at the cost of personal health, family time and happiness. This trend must be reversed and it is possible best at the early phase of practice. However, it is never too late.

Personal notes

I maintain friendly relations with my students. I recall when one of my ex-students and now a busy successful pediatrician told me that I always lacked ambition in life. I asked him why he felt so. He said if I had an ambition to become the most sought-after pediatrician, there would have been large crowd of patients in my waiting room at my office. I told him that my ambitions were different and I wanted to lead a balanced life with focus on happiness and passion and not just to build a large practice. I am convinced that person who excels in one area is considered most successful by others but he may not be happy because of imbalanced life. Priorities do change in life at different times but emphasis must be on a balance all the time.

Take home message

Set your goals to begin with and balance work and life. It is necessary to develop enough practice but far more important is to enjoy practice and life. It is possible only when you achieve an ideal balance. Final goal of life should be happiness and make life worth living.