How Do I Manage It All?

How do I manage it all? Physician, wife, mom of 3 young kids, Board member of 2 non profits (Big Brothers Big Sisters Hawaii and Project Vision Hawaii) and managing partner of my practice. It's one of the most common questions I get. And the thing is, there is no secret answer.I don't have it all figured out. It may look that way on social media, but it's a complicated dance and I'm always adjusting and readjusting. I think to pretend that all it takes is hard work and determination would be a disservice to those who are embarking on this journey now. So how do I do it?⠀

1.  Prioritize⠀

I am constantly making choices. Which will get prioritized today - family or career?This has changed throughout my career and will continue to change. Because we need to acknowledge that choices are necessary, to pretend that there isn't a  trade-off  downplays what goes into being both. I never want to create unrealistic or unattainable expectations.  Though I am lucky, I can bring my kids to the office, like in this picture.  This is actually mine and my husband's office (which is why I'm wearing a white coat in this family shot).I have made a conscious choice to put family first in this season of my (and their lives).  My kids are still in elementary school, with my youngest just starting kindergarten last week.  They still want to spend time with me.  They still need me to help keep them organized, nourished and loved (well, they'll always need the last part).I am in clinic only 3 days a week.  One day is reserved as an Administrative Day, to handle the  Managing Partner aspects of the practice.  These were things I used to try to do after I put the kids to sleep, starting at 9 pm at night.  That left me drained and exhausted, with little to no down time for myself.  Once I actually built in an admin day to my work week to handle these matters, my happiness with my job as a physician and mom improved drastically.And, then the other day away from clinic is for the kids.  I can now attend their open houses, field trips and pick them up from car line instead of having them wait until 5 pm in after school care.  It also allows me time to serve on the Boards of non-profits I care deeply about.   I can't be physically present all of the time, but it's important for me to be there as much as I can.There is a trade-off.  By cutting back on my clinic hours, I am not building my patient base as fast as I otherwise could.  I'm not doing as many surgeries as I would want.  I may be putting off referring physicians because I'm not in the office on certain days.  And, the other downside is that even when I am home, I'm always working.  There is no separation of work and life.But, since, it's been brought up by some male physicians, that women are not as productive as men for this very reason, I do want to qualify my clinic schedule.  Working just 3 days a week, I see the same number of patients and perform the same number of surgeries as the majority of other physicians who are in clinic 5 days a week.  Just as most women, and most mothers are, I have become much more efficient with my time.  In fact, when I look at my earnings over the past 10 years for our practice, I have only increased each year, despite "working less" 

2.  Organize

There are many times when I feel like I should be doing more as a mom.  I am ultra organized.  I have a gmail calendar for myself, for our family, for our work.  I have a dry erase calendar for our weekly dinner menu.  I have a weekly dry erase calendar for our kids' activities.  I got a LOT of calendars, all in a desperate attempt to keep my life organized. I try as hard as I mightily can, to structure, organize and to regulate everything I can.Yet, I do feel like I'm operating from the baseline of frazzled the majority of the time.  Sometimes, I feel like I'm shortchanging both my patients and my kids.  I'm not running perfectly coiffed from the operating room to the piano recital, though it might seem that way.  An article in The Atlantic, gave a term to women like me, "Scale Backers".  We have dialed down our high powered careers to be able to be mothers and workers.  And, the thing is, apparently we are the most stressed out women of the group, compared to the "Highest Achievers" (the woman who are not primary care givers for their kids) or the "Opt Out Group", the women who have left their careers to focus on family life.  As I push myself to continue increasing my patient and surgical volume, you can understand why that would lead to more stress.  But, despite that, I still love being able to do both. 

3.  Outsource

I do the majority of the cooking in our house, as well as the putting away of all the backpacks/toys/clutter and light cleaning.  But, I definitely outsource and have help.  I hate doing hard core cleaning like bathrooms or the vent hood, so I have someone do that.  And for the first 5 years of having kids, we had a nanny.  There's no way of getting around having one, unless you do day care.  Since I had a nursery in my office, our nanny came to the office.  She loved it because she wasn't secluded at home, only interacting with our kid.  And, I loved it because I never had to worry about my baby and I could breast feed instead of pumping.  Once my daughter started preschool, then we started using college students about 20 hours/week to help in the early mornings and evenings. And,now that all 3 kids are at the same school, we manage without a nanny.  But, for sure, we needed a 40 hour/week nanny in the early years when I had 3 kids under the age of 4.The preschool didn't start until age 2, so that's basically why we used her full time.And, I also have help cooking.  My mother-in-law will cook for us at least 6-8 times a month, which is so nice!

4.  Kids can be responsible

Our children's preschool really worked on making them as self-sufficient as possible, which was great.  At first, I thought "my son can't do that, he's only 2 years old", but in fact, he CAN and DID!  So, my kids are now ages 4,6 and 9 years old.  I remind them to pack their backpacks the night before and pack snacks in their backpacks as well for the next day.  They are responsible for it.  If they forget, then they don't get a snack.  And, I'm not trying to be a mean mom.  But, I am trying to teach my kids to do things for themselves.  I am failing as a Mom if they turn 18 and look to me to do everything!So, that's a little snapshot of how I manage my career and family life.  What works for you all?