Why Having Work-Life Policies is Not Enough

When former Stanford University School of Medicine dean Phillip Pizzo grew concerned that many talented doctors were foregoing promising academic careers in medicine in order to juggle family demands, he set up a task force.


An analysis found that though the school had virtually every “family friendly” policy on the books imaginable, no one was using them because the policies violated the core culture at Stanford: that excellent work required all-out work devotion, all the time.

As at most large, urban-centered hospitals, doctors at nationally ranked Stanford Health Care-Stanford Hospital, on average, worked 10 hours more a week than other professionals, with nearly 40 percent working 60 hours or more, according to a 2012 study published in the Archives of Internal Medicine. This was due to the combined responsibilities of research, teaching, clinical practice and administration. The stress from these long work hours was leading to burnout, dissatisfaction with work-life balance, and ultimately to doctors leaving. Having family-friendly policies on the books to ameliorate these stresses didn’t matter, if the physicians did not feel they could use them.

“The physicians and scientists feared that if they used the policies, they’d be viewed as not being serious about their careers and would suffer as a consequence,” said Hannah Valantine, a cardiologist who led the pilot at Stanford that was specifically designed to change that perception.

Stanford began offering career planning sessions to “normalize” flexible schedules and alternate career paths, and created a groundbreaking new “time banking” program aimed at easing work-life conflicts for the emergency medicine faculty.

Through the time bank, doctors receive a variety of services, including ready-made meals, housecleaning, babysitting, elder care, handyman services, dry cleaning pickup and more. Doctors also can “bank” the time they spend doing the often-unappreciated work of mentoring, serving on committees, covering colleagues’ shifts on short notice or deploying in emergencies, and earn credits to use for work- or home-related services.

Stanford’s time bank, part of a two-year, $250,000 pilot funded largely by the Alfred P. Sloan Foundation, showed big increases in job satisfaction, work-life balance and collegiality, in addition to a greater number of research grants applied for and received.

Ms. Valantine, who is now chief officer for scientific workforce diversity at the National Institutes of Health, said work-life struggles are still often seen as a side issue in medicine. “The whole idea of addressing work-life fit as an important business case for excellence has not been bought into yet,” she said. “And I would argue that it should be right up there.”