Domains of Wellbeing: Personal Life
Last post, we began our exploration of four separate domains of wellbeing. In order for an individual to truly thrive, attaining the top rung of the Ladder of Wellbeing, they must maintain either balance or outright success in all these domains.
Not all domains need be “outright successful”, but if a person maintains balance in three domains and succeeds above and beyond in one particular domain, they will thrive. Likewise, if they suffer a tragedy in one domain but are balanced/succeeding in the other three, they may also thrive.
As we begin to explore beyond the domain of Work Life, we’ll consider ways in which the domains interact with and affect each other.
For our purposes, the four domains are:
Work Life
Personal Life
Health
Wealth
Let’s look at an example. An individual has a job they enjoy, all is going well there. It’s balanced but not exceptional -- Work Life? Balanced. They make enough money so they don’t worry about finances -- Wealth? Balanced, not a stressor. Their health is good, nothing to complain about. In their personal life, they’re expecting a baby in the next few months. While that is certainly happy for many couples, it can also be a stressful time of transition. But with balance in the other domains -- this individual will certainly thrive.
Another example may be someone who has an extremely supportive and loving family, a job that pays extremely well, and is flexible with hours. Then, they receive a cancer diagnosis from their doctor. This individual may also be able to thrive, even through a stressful health crisis, due to support in other domains of their life.
Personal life encompasses not just life at home, but life with immediate family, extended family, community, and society at large.
It includes personal relationships, personal ambitions, “wish-lists”, “bucket-lists”, and charity and philanthropy. Several studies have focused on the relationship between burnout and a variety of personal factors. Despite the notion that burnout is primarily linked to work-related stress, personal life events also demonstrate a strong relationship to professional burnout. Compared to the general population, physicians have an increased risk of burnout and a decreased likelihood of being satisfied with work-life balance. Studies also show that problems at home are often related to problems at work.
Long hours at work create conflict between responsibilities at work and at home. Both long hours and work-life conflict have been found to be significantly associated with burnout. Physicians' satisfaction with work-life balance has decreased since 2011 and is significantly lower than the rate among the general population. Studies also show that surgeons in dual-physician relationships are more likely to have a recent career conflict with their Domestic Partner (DP) than surgeons whose DPs are not physicians (1). Physicians married or partnered to another physician are more likely to have depressive symptoms and low mental quality of life than surgeons whose DP works in another field. Work-home conflicts appear to be a major contributor to surgeon burnout and are more common among female surgeons. Although factors contributing to burnout were remarkably similar among female and male surgeons, women are more likely to experience work-home conflicts than their male colleagues.
Additionally, female physicians have a substantially higher prevalence of divorce than male physicians (2). On average, women employed full time in any field still spend 8.5 additional hours per week on child care and other domestic activities, including care for elderly parents. While marriage in most populations is considered to be an effective buffer to emotional distress, this does not seem to be true for female physicians. While those outside the medical field may believe that physician divorces are less frequent than the general population, marital problems are common, perhaps in part because of the tendency of physicians to postpone addressing marital problems and to avoid conflict in general.
We see that the benchmark for “balance” in any one domain can be different for different physicians due to factors (like race or gender) that are both unable to be changed and beyond the individual’s control.
Next week we’ll continue our discussion of domains by exploring individual health. Looking at domains both individually and in relationship to each other will help us to understand how wellbeing functions in everyday reality.
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Sources:
Dyrbye LN, Shanafelt TD, Balch CM, Satele D, Freischlag J. Physicians married or partnered to physicians: a comparative study in the American College of Surgeons. J Am Coll Surg. 2010;211(5):663‐671. doi:10.1016/j.jamcollsurg.2010.03.032
Ly DP, Seabury SA, Jena AB. Divorce among physicians and other healthcare professionals in the United States: analysis of census survey data. BMJ. 2015;350:h706. Published 2015 Feb 18. doi:10.1136/bmj.h706