Medical marriages

Some brave doctors shared their views and tips with Julie Sladden about how to have a thriving (rather than merely surviving) marriage

"Men are from Mars. Women are from Venus. Doctors are from Krypton," according to Dr Greg Skipper from the Alabama Physician Health Program (see further information) and he has a point. Medical marriages face many of the same stresses and strains of any marriage but there are some unique issues that face both dual-doctor and doctor/non-doctor marriages.

Although there is no evidence that divorce rates among medics are higher than other occupational groups,¹ studies suggest that many medical marriages may be chronically unhappy, yet stable.² This is not helped by the well documented inability of many doctors to seek help, especially when their relationship is in trouble.³ But it's not all bad news. A group of doctors, married to doctors and non-doctors, were brave enough to tell me their opinions on the issues affecting medicine and marriage, and here they offer some tips on how to have a thriving (rather than merely surviving) marriage.

What are the benefits of being married to a medic?

Understanding and empathy

This figures highly. As one general practitioner (GP) couple put it, "They understand on call, call outs, and after hours work. They understand the 'busy day', which is sometimes out of control and the implications of mistakes in medicine." It can be useful to have a sounding board at home who has "insight into when a doctor is being manipulated by members of staff, or patients." Another GP couple felt a major benefit was "knowing you're not alone and having empathy for each other at difficult times."

Conversation

Conversation and having interests in common is another perceived benefit--but this also has its pitfalls. "We have great discussions. No over dinner silences, but we always seem to end up back at medicine--in any conversation" (general practitioner couple).

In a dual-doctor marriage there is no need to explain technical details and it can be useful to get an "instant second opinion." It also helps keeps things in perspective--"we have a mutual understanding that allows us to laugh about some of the situations we find ourselves in" (female junior doctor).

Financial benefits

This also got a mention. "This is sad, but true," as one doctor put it. The financial rewards of a dual-doctor marriage means, "We have a reasonable income and therefore a better standard of living." But with the income achieved, there are often "expenses to match."

What are the pitfalls of being married to a medic?

Pitfalls include a wide range of topics, from geographical complications--when two doctors are unable to get jobs in the same area--to "our letterbox is always filled with medical literature and associated junk mail." Other main pitfalls are given below.

Time, tiredness, and workload

Not enough time, too much work. "When both partners work long, demanding hours it places excessive demands on family life." One male consultant explains, "Sometimes both of us are very tired, balancing family life and career, and need a break. I've had to learn to make sacrifices, try and avoid going on too many 'jollies' and conferences, and put my family first before saying 'yes' to an increased workload."

Balancing workload with family life isn't easy. "You find levels of tiredness never experienced before, and I'm surprised how one can still carry on!" (female general practitioner).

Career compromise

In order to avoid long periods of separation, or when children arrive, often one of the medical couple, usually the female, makes changes to accommodate the needs of the family. For example, one former staff grade doctor, married to a consultant, has taken a career break while their children are young. "Fortunately I'm not very ambitious and have therefore been able to submit my career plans to those of my husband".

Another female doctor stated, "I have had to reduce my hours and eventually change career path (to general practice). It's very difficult to maintain two 'full-on' careers with children unless you compromise on quality time as a family. Therefore one of you, or both, has to make adjustments creating a new phase of married life."

Social scene

Doctors seem to socialise with doctors. As one doctor put it, "We have a narrow social sphere--most of our friends are medics or health professionals. You need to work hard to have friends outside of, and interests other than, medicine."

What if you're married to a non-medic?

Lucky you! The benefits are, "They have regular work hours, sane jobs and different moans to your own." They can also offer a different perspective to the familiar medical view. You get to see more of them, and the "career competition is less of an issue."

There are some drawbacks, however. "My partner often feels left out of medical conversations as medics tend to be a bit cliquey! Also, he doesn't always share my fascination with details of work." In addition, some non-medics may have "difficulty understanding the implications of working in medicine."

Themes

The recurring theme seems to be to "make time for each other." It sounds simple and obvious but putting it into practice can be difficult considering the demands that are already placed on time.

Assess and compromise were two other themes. "Sit down together and review your hours of work, where your career is heading, and whether adjustments need to be made". When there are two doctors in the family often one has the less "high-powered" career or chooses to reduce their workload in order to support and sustain family life. It is important to check at regular intervals whether you are both happy with the situation, and readjust as necessary.

Conclusion

Medical marriages face similar problems to other marriages, but there are also some specific issues given the demanding nature of the vocation of medicine. The big things to pay attention to are time and compromise. As one medic put it, "give your marriage the same attention you give your career and you'll be over half way there.' And finally--"marry your best friend and go for lifestyle options when possible. Life is too short not to know your family."

1. Doherty WJ, Burge SK. Divorce among physicians. Comparisons with other occupational groups. JAMA 1989;261(16):2374-7.
2. Gabbard GO, Menninger R. The psychology of the physician. In: Medical Marriages. Washington, DC: American Psychiatric Press, 1988;23-24.
3. Skelly FJ. Physician Marriages. http://www.physiciansguide.com/docwed.html (accessed 27 Oct 2004).
4. Sotile W, Sotile M. Success in Medical Marriages. http://www.docrates.net/feature/emb/sotile.htm(accessed 27 Oct 2004).
5. Sotile WM, Sotile MO. Physicians' wives evaluate their marriages, their husbands, and life in medicine: results of the AMA--Alliance Medical Marriage survey. Bull Meninger Clin 2004;68(1):39-59.

       

           

Responses published this month Articles Responses LIFE Medical marriages       Julie Sladden (December 2004) Abigail Coleman (November 26, 2004) Read this response LIFE Medical marriages       Julie Sladden (December 2004) Abarna (December 13, 2004) Read this response LIFE Medical marriages       Julie Sladden (December 2004) Abigail Coleman (November 26, 2004)       4th year MBChB, University of Birmingham abigcol@aol.com Editor - I was heartened to read the article on medical marriages in last month’s student BMJ1. My fiancé and myself are both medical and recognised many of the benefits and pitfalls listed in the article - whilst it is helpful to understand the nature of each other’s work and the implications of medicine as a career the pressures of time and workload can often still prove troublesome. I agree with the tips given in the article and the viewpoint that the marriage is more important than the career, but sadly in practice this is not often the opinion reflected in the workplace. Inflexible and increasingly antisocial hours, in part due to the new working time directive, and fixed holiday both as a student and junior doctor leave little room at times for flexibility and quality time within the relationship. Some of the recommendations such as placing boundaries on work are very difficult to implement within the current system. This is despite evidence that marriage is beneficial to psychological health and well-being and therefore beneficial in the workplace2. Such an ethos has in part attracted both of us to General Practice, which offers more opportunity to combine family life and a successful career and I am sure that we are not alone in this opinion. If a career in hospital medicine is to remain attractive to students and junior doctors then there needs to be increasing flexibility and recognition of the importance of family within the hospital environment. References Sladden J. Medical marriages. Student BMJ, 2004:12:472-473 Marks N, Lambert J. Marital status continuity and change among young and midlife adults: longitudinal effects on psychological well-being. Journal of Family Issues, 1998;19:652-86 LIFE Medical marriages       Julie Sladden (December 2004) Abarna (December 13, 2004)        ha0180@qmul.ac.uk After reading the article entitled medical marriages I felt it would have been good to also get a perspective of family life and how it is for children. Especially considering that many children with medical parents go on themselves to work in the medical field. As a daughter from a medical background it makes you realise what family and married life will be like and the compromises you might need to make in terms of career. It seems a real shame that in this modern day world with many time saving devices it is still hard to juggle a career around family life. This causes many to redirect their original career paths towards a less demanding route. Especially for a women there remains high pressure to have it all, a successful family, job and marriage and this must even more difficult with a demanding job such as medicine. Thus the support of a good marriage be it dual medicine or not is essential