It will come as no surprise to physicians and their spouses (40 percent of which are also medical professionals 2014 Work/Life Profiles of Today’s U.S. Physician), that a marriage including at least one physician brings unique challenges. The task of balancing a rigorous work life with marriage and often children, can be an extremely challenging one.
A physician coach and CEO of The Happy MD, states it rather bluntly, “It is as if you married a person who has always (and will always) have a lover on the side - a jealous one at that." At times this lover is your spouse's #1 priority and that hurts if there is no balance. The medical practice will naturally tend to take over ‘available bandwidth’, and to prevent the disintegration of the relationship, you must be proactive in carving out time and energy for your marriage. Once this is done, protect it. In my work with couples, I have seen the result of proceeding without consciously devoting time and energy to the relationship. Without continuous awareness of “how this relationship is doing” and making the appropriate corrections when necessary, the natural tendency for the marriage is disintegration over time. What psychologist John Gottman calls the “distance and isolation cascade” (a.k.a. growing apart).
Dr. Drummond recommends three books for couples to read together: The Medical Marriage by Wayne and Mary Sotile, The Seven Principles for Making Marriage Work by John Gottman, and The Way of the Superior Man by David Deida. I am familiar with Gottman’s work and highly recommend it (and have recommended couples read it together). I have not read the other two books, but after browsing through them, they appear to be very good.
Whatever recommendations you choose to follow, in my experience, it comes down to a pretty simple thing: Explicitly talking about what it means to be in a medical marriage, hearing each other out, and committing to the task of finding balance and connection as a shared goal. You cannot simply ignore concerns with, “You knew what you were getting into when you married me”. This kind of approach does not have a good prognosis.
MedPage Today staff writer, Parker Brown, reviews a University of Michigan study of marriages with at least one spouse being in academic medicine. Many specific comments from participants are quoted in the piece to illustrate one of four successful strategies for the relationship. The four strategies are:
- Having shared values
- Relying on mutual support
- Recognizing the role of each family member
- Acknowledging that being a physician brings a benefit to the relationship
In a survey of physician partners conducted by Shanafelt et al, almost 87% of respondents were satisfied with their relationship with their physician partner6. Analysis of the data showed weekly hours worked, practice setting, and specialty area were not correlated to satisfaction for their spouse. What was significant for satisfaction was number of nights on call per week (less is better) and most importantly, daily time spent with each other (more is better).
In this example, we see one benefit of a two-physician marriage:
“The biggest benefit is having somebody who understands what you’ve gone through and what you go through on a daily basis,” said David Sandberg, MD, a pediatric neurosurgeon at the Children’s Memorial Hermann Hospital, where he works with his wife, Amy Schefler, MD, a pediatric ocular oncologist. “It’s very rewarding to have somebody go through the journey with you who understands it,” Schefler said7.
Fider, Fox, & Wilson looked at dual-career couples, including at least one physician, and studied their strategies for adapting to a marriage they knew would be a challenge, with or without children. Those developing a sense of “us” managed much better with these challenges. A key factor in developing a sense of “we”ness is time spent together. These couples intentionally made the relationship a priority and scheduled time together8. How much time is necessary? John Gottman’s research suggests 5 hours a week can make the difference. Some will be scheduled, but much of it does not have to be. Like getting your 10,000 steps in a day, time together, even for short periods, adds up. Take a look at The Magic Five Hours for a Successful Marriage to see what I mean. Making time for even brief periods of connection is very powerful, and according to Gottman, predictive of relationship success9.
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Drummond D. The Medical Marriage - Date Night Power Tips and more. The Happy MD. https://www.thehappymd.com/blog/the-medical-marriage-date-night-secrets-and-more. Accessed June 6, 2017.
Brown P. Doctors Spouses: What’s Not to Like? Medpage Today. https://www.medpagetoday.com/psychiatry/generalpsychiatry/47289. Published August 19, 2014.
Shanafelt TD, Boone SL, Dyrbye LN, et al. The Medical Marriage: A National Survey of the Spouses/Partners of US Physicians. Mayo Clinic Proceedings. 2013;88(3):216-225. doi:10.1016/j.mayocp.2012.11.021.
Fider CO, Fox CA, Wilson CM. Physicians in Dual-Career Marriages: Nurturing Their Relationships. The Family Journal. 2014;22(4):364-370. doi:10.1177/1066480714547699.