Doctors who work themselves into a crisis

This society admires individuals who drive themselves --
up to a point

By Amanda Alvares

A three doctor expense-sharing general practice in suburban Toronto came apart last winter because one of the partners worked too hard. It turned out to be a good thing -- the remaining two partners took on not one, but two new members, and the practice has since moved to larger quarters and has added yet another. "It was such a relief when Joe left," recalls the present senior physician. "It didn't matter how early you came in or how late you stayed, he was always in the office. At first it was great but after a couple of years it began to drive me nuts. It was as though he was always looking down his nose at Bill and me. The implication was we somehow weren't pulling our weight."

From the outside, many physicians appear to be workaholics. Certainly the profession has more individuals who work longer hours and have busier working lives than most. Lawyers, accountants and architects don't have endless lines of needy clients filling their waiting rooms to overflowing. Even large dental practices have considerably more control over patient flow. The truth is, though, that the compulsive element that turns a mere hard worker into a workaholic comes from the inside, not the outside. The true workaholic physician not only works long hours but also skips meals and holidays, is poor at delegating and feels restless and at loose ends when not at work.

But just because the hours are long, it doesn't mean they're effective. Take the case of the Toronto partnership. Says the second partner, Bill: "Joe put in the long hours, that's for sure, but I felt he was often just spinning his wheels. He always seemed distracted. Before he could focus on one thing, it was off to the next." Dr Lee Lipsenthal, Medical Director of Lifestyle Advantage in Sausilito California concurs. "Workaholics often don't connect well with patients because they're focusing on the next 12 things they want to do," he says. "In essence, workaholics are in a revved-up state of burnout. Instead of functioning efficiently, they're likely to be irritable and rushed. Therefore their decision-making, diagnostic, and treatment-planning capacities are diminished."

Something else that's common to chronic over-workers is that they're unaware of their weakness for driving themselves until something snaps. Small wonder, workaholics are generally looked up to as pillars of the profession given the energy they apparently devote to medicine. Then a financial deal goes sour, a spouse walks out, they develop a stress-related disease and they crash.

Do you have workaholic tendencies? Take the test in the accompanying table to find out.

Work addiction risk test

The following test was devised to help you evaluate yourself. Count the score that best fits you for each point: 1--never true; 2--sometimes true; 3--often true; 4--always true

Total your score, then look at the scale below.

1. I prefer to do things myself rather than ask for help.
2. I get impatient when I have to wait for someone else or when something takes too long.
3. I seem to be in a hurry and racing against the clock.
4. I get irritated when I'm interrupted while I'm in the middle of something.
5. I stay busy and keep many irons in the fire.
6. I find myself doing two or three things at once, such as eating and writing a memo while talking on the telephone.
7. I over commit myself by biting off more than I can chew.
8. I feel guilty when I'm not working on something.
9. It's important that I see the concrete results of what I do.
10. I'm more interested in the final results of my work than in the process.
11. Things never seem to move fast enough or get done fast enough for me.
12. I lose my temper when things don't go my way or work out to suit me.
13. I ask the same question, without realizing it, after I've already been given the answer.
14. I spend a lot of time planning and thinking about future events while tuning out the here and now.
15. I find myself continuing to work after my co-workers have finished.
16. I get angry when people don't meet my standards of perfection.
17. I get upset when I'm in situations where I cannot be in control.
18. I tend to put myself under pressure with self-imposed deadlines.
19. It's hard for me to relax when I'm not working.
20. I spend more time working than on socializing, hobbies, or leisure activities.
21. I dive into projects to get a head start before all the phases have been finalized.
22. I get upset with myself for making even the smallest mistake.
23. I put more thought, time, and energy into my work than I do into relationships with other people.
24. I forget, ignore, or minimize celebrations such as birthdays, reunions, anniversaries, or holidays.
25. I make important decisions before I have all the facts and have thought them through.

Scoring:

25-56 —You are not work addicted.

57-66 —You are mildly work addicted.

67-100—You are highly work addicted.

Source: Bryan E. Robinson, Chained to the Desk: A Guidebook for Workaholics, Their Partners and Children, and the Clinicians Who Treat Them (New York University Press, 1998), pp. 52-54.