By: Monica L. Lypson, MD, MHPE, FACP, professor of internal medicine and learning health sciences, assistant dean for graduate medical education, University of Michigan Medical School, staff physician, Ann Arbor Veterans Affairs Medical Center
Approximately eight years ago, a medical student asked me, “Dr. Lypson, how do you and Dr. Campbell go grocery shopping?” I responded, “I get in my car and go!” The student mentioned that she had seen me pregnant, seen our nanny drop off my then two year old son at my office, and met my husband–he was her small group facilitator. After a pause, I reconsidered my first response, and I LISTENED to her question. What she really wanted to know was how do we navigate caring for our children. Do we spend time together? Who bears the responsibility of getting groceries into our home? Essentially, she wanted to know how we navigate our busy lives, and where we found the time to have a child. She also wanted to better understand our decision to have children later in life–we were in our late 30s when we had our first child. All these questions were behind the simple, “How do you go to the grocery store?”
This conversation, along with my subsequent understanding of the meaning behind her questions, led me to develop a second-year elective course with approximately six hours of content that focused on hearing best practices from, to be quite frank, my friends. I invited a diverse group of physician couples and individual physicians who, like me, were managing the complicated roles of an academic medical school faculty member, partner/spouse, and parent. We first presented core information on the marriage rates of physicians (by the way, we do better in the marriage category compared to the general population). This is likely because, by the nature of our work, we are providing protections to our relationships. Many physicians tend to marry later, after age 25, delay child bearing for at least two years after marriage, make a sizable income, and share common values and beliefs (medicine and altruism to name a couple) with our spouse. These are factors that have been found to ensure a long lasting union. We then asked the couples and individuals to provide an account of their lives, best marital practices, and proven problem solving techniques. For example, it did not occur to me that I had to schedule date nights with my husband. I needed to add this to the To Do list, just as I would the kids’ doctor appointments, and the budget for the event should include dinner and a babysitter. In addition, partners in same sex couples often exemplified intimate communication. Their negotiations regarding role clarity when gender stereotypes could not be relied upon is a useful tool for all relationships. Other examples were more significant, hearing colleagues struggle with income inequalities between men and women (specifically, women earning more) and having to navigate those identity formation struggles in real time. In theory, it seems easy, however, when learning from a couple navigating tricky terrain, you understand the importance of open and honest communication. We must talk not only about what is true but also about how we feel. Session after session faculty stayed beyond their 30 minute commitment to hear the advice, experiences, and discussions from their colleagues. These “hangers-on” made me realize there was more to the sessions than providing information to trainees–faculty participants also craved advice from others.
This course served as the basis for our research, which we describe in our recent Academic Medicine article. We listened to others describe the best practices of navigating the day-to-day realities of their medical marriages and summarized the themes from their advice.
If I were to be my own marriage coach, I would suggest that I listen closely to the advice offered in our study. Our article adds to the current research on medical marriages by using appreciative inquiry to ensure a focus on the positive aspects of physician relationships. After completing a thematic analysis, four themes emerged from our data: (1) we rely on mutual support in our relationships, (2) we recognize the important roles of each family member, (3) we have shared values, and (4) we acknowledge the benefit of being a physician to our relationship. These themes have the potential to help others and myself in what we like to call “marriage immunization.” I would also suggest that I remember that my husband and I are a team with two other terrific members who are two and eight. As the new school year starts and my husband and I face the challenges of finding more time to spend together, I will remember to stay grounded and understand that the happy family memories that we create along the way are what makes it all worthwhile.