Small Changes Big Impact
Small Changes Big Impact
Work life balance and achieving personal happiness with Dr. Aisha Lofters
In studio today, we have Aisha Lofters, family physician and Chair and Implementation Science at Women's College Hospital, clinician scientist and associate professor at the University of Toronto. Today's episode focuses on the importance of work life balance and achieving personal happiness.
Small Changes, Big Impact: a DFCM podcast. I'm your host, Dr. Jeremy Rezmovitz. In studio today, we have Aisha Lofters, family physician at Women's College Hospital, Chair and Implementation Science and Health Equity, clinician scientist and associate professor at the University of Toronto. Today's episode focuses on the importance of work life balance and achieving personal happiness. I hope you enjoy the show. This is actually going to be a really, um, awesome day. I like, I really, I look forward to exploring, um, the changes with you today.
Dr. Lofters:Great.
Dr. Rezmovitz:Yeah. Um, tell me what small changes, um, did you make or what small change did you make that had some impact in your life personally or professionally?
Dr. Lofters:So, I'm so glad you asked about personally cause when you- when I first was invited and I was thinking about yesterday and I was looking at the email for the first time and I was thinking about a change that I've made professionally that's had an impact. And I thought, man, I've been a researcher for 13 years and I can't really think of an example of a change that's had a real impact in my work. Um, but the personal aspect that I can give you an answer because I feel very strongly about what we call"work life balance"- for those who can't see me I'm doing bunny ear quotations because I don't love that term.
Dr. Rezmovitz:We're going to have the best day.
Dr. Lofters:I feel very strongly about like when I leave work, I leave work. Um, I am very anti checking email during the evenings and sending emails to people on the weekends and working late at night and things like that. That's just, um, the antithesis of how I approach work. Um, so small changes that I made because- so I'm a researcher. I do- 70% of my time is devoted to research and in research, um, your success often gets kind of diluted down to how many publications have you had this year, how many presentations, how many grants have you gotten? So it does mean you have to sit down at some point and actually do some work.
Dr. Rezmovitz:It's because the metric is poor. What about all the mentorship? What about all the collaboration?
Dr. Lofters:Exactly. Um, there's so many elements of research that don't get captured with those metrics and there's so much work that goes into a publication that gets rejected the first two or three times. And then like, yeah, exactly. Then gets accepted two years later if you haven't already been broken, uh, by the rejections, but those really don't get captured, right? So it does mean as a researcher, you've got to kind of- you have to sit down, just do a whole bunch of work and hope that there's something at the end of the year that you can put down on paper. So the change that I made, um, because I realized I got to get my work done, but also the fact that home is so important to me was with my calendar. My work calendar, I realized was quickly filling up with meetings, meetings, meetings, and if I have a free spot and you invite me to a meeting, I would say yes because the spot is free in my calendar. Um, so what I've started to do in the last year or so is to both, um, block off time for work. So I'm going to sit down and work on this particular thing and I block it off on my calendar and I block off time everyday for email. So I block off 30 minutes a day to go through my inbox, get it to a manageable point. And that time is my- see, I'm not giving away my secret though. So if people invite me to a meeting during that time, I say I can't because I am busy and that has allowed me to actually get work done during the work week, which should be a normal thing, but it's not. And it's allowed me to not let email take over my life.
Dr. Rezmovitz:So it sounds like, um, we need to help you redefine the, or operationally define what you're doing. Um, so what it sounds like you're doing is having a meeting, but it's with yourself.
Dr. Lofters:Yes.
Dr. Rezmovitz:So it's not that you're not available for meetings, it's just you're in a meeting. It's just with yourself. Right.
Dr. Lofters:My most productive meetings are with myself.
Dr. Rezmovitz:Well, you're a researcher. You've been handpicked for having meetings with yourself.
Dr. Lofters:This is true.
Dr. Rezmovitz:Yeah. No, but that's what it is. Um, you know, the same thing could be said for whether or not you have a meeting with yourself to do physical activity, whether or not you have a meeting with yourself to um, meditate. And so, uh, I learned this about three years ago and uh, I gave up on work life balance, uh, because I, what I was doing was I recognize I had this awareness that my work life, work dash life, my work life was balanced, but my home life was not. And so it turns out that I said, forget this- there's other words I wanted to use, but forget this. And what I realized is that I created work-life boundaries. Do you know what? You're never going to be in balance. Have you ever tried to balance? It turns out that your muscles, antagonistic and agonistic muscles are in, are in balance. They were opposing each other to try to keep you in balance, but you're never actually static. And so what we're looking for, or what I was looking for was something more concrete. And so I created work-life boundaries.
Dr. Lofters:That's a much better word.
Dr. Rezmovitz:And so work-life boundaries allowed me to have a actionable metric, which was,"wait, did I go beyond the boundary or did I stay within the boundary?" And then I could reflect on it and go,"you know what? Things are now- now, I feel balanced.
Dr. Lofters:Yeah.
Dr. Rezmovitz:Because I could know whether or not I was in or out. And it's too, unfortunately, we don't, we don't do this enough. We don't, um, we don't create those boundaries. And there's actually one word in the English dictionary that helps you create that boundary. Are you familiar with it?
Dr. Lofters:Is that a two letter word?
Dr. Rezmovitz:It's two letter word.
Dr. Lofters:Does it start with"n"?
Dr. Rezmovitz:It starts with" n".
Dr. Lofters:And is it"no"?
Dr. Rezmovitz:It's no. And we say it a lot to our kids.
Dr. Lofters:Yes. We sure do.
Dr. Rezmovitz:We do. Yeah. But we don't role model. We don't. You know, I can't tell you the number of times I say to my kids"no". Uh, and they, they push and they push and they push and it's reflective of the culture that we then take to work because people push and push. They want you to go to that meeting.
Dr. Lofters:Or take on this task or do this one thing for them.
Dr. Rezmovitz:Yeah. Okay. So you've created these boundaries.
Dr. Lofters:Yeah. So the other thing I do- you mentioned physical activity. I do the same thing. So for me, physical activity is very important, but I am by nature, incredibly lazy. So-
Dr. Rezmovitz:I have the gene for it.
Dr. Lofters:Me too. It's very strong.
Dr. Rezmovitz:Which means that you have to plan to do the activity because it's important to get it in your life.
Dr. Lofters:Exactly. And I have to go to classes because I need someone telling me what to do or else I'll just kind of like halfheartedly stroll on a treadmill or something.
Dr. Rezmovitz:That's why I got married.
Dr. Lofters:So I go to classes. So I put those in my calendar. And again, if I'm going to a class- sometimes I go to a class at noon or 1:00 PM. So I'm unavailable because I have a meeting with my good life instructor.
Dr. Rezmovitz:That's right. So, okay, so here's the important thing then. So, okay, so you're doing this and it's fantastic.
Dr. Lofters:It is fantastic.
Dr. Rezmovitz:It is. So there's two things obviously, that we're going to talk about.
Dr. Lofters:Okay.
Dr. Rezmovitz:What were the barriers and what's the impact? Both positive and negative?
Dr. Lofters:Great questions. So the barriers I think, um, ultimately come down to the culture of what we were just talking about, right? The culture of academia and medicine and research and being endlessly productive. And I think a general culture today, uh, of being endlessly available because, you know, we have emails, so that means you should always be using it, and you should always be checking your EMR messages. And there's kind of this culture of, of boundaries falling down, right? Because it's possible for the boundaries to fall down. Somehow we've decided that means they should fall down.
Dr. Rezmovitz:Oh my God, we did this on another podcast. There's no"shoulding" in this podcast. Nobody here should be"should on." Okay. We do not"should" on people in this podcast.
Dr. Lofters:I love it. I love it. Uh, so that to me was a big barrier. So it's not that somebody was coming to me and saying, you know, you really should do email at night. Nobody was saying that. But you know, on a Monday morning I'd open my inbox and there'd be an exchange of 10 emails that have gone back and forth between a group of people. But I was in this group and I was not contributing cause I was not checking my email. Yes. Complete chaos. Or I'd be getting requests on a Saturday afternoon and on a Sunday morning. Second. Just wanted to follow up on my email. Um, so there were those components. And there's, there's also that- and again, it's, it's, nobody was explicitly saying this to me, but you see, research can be a very, um, it can be a competitive environment. It can also be incredibly collaborative. We see"oh, this person's doing so well" and how am I being perceived? And I'm being as productive as I could be. Uh, because again, if I never slept and worked all the time, I would be more productive. Right? Like that's a fact. I wouldn't last very long. Um, but it's a fact that that's true. So the barriers at first were kind of getting over those mental humps, I would call them.
Dr. Rezmovitz:Well you took a huge risk.
Dr. Lofters:Yeah, it was a risk.
Dr. Rezmovitz:In a system that didn't support not playing by the rules of the game.
Dr. Lofters:Exactly. Exactly. So it was kind of being explicit with myself, I'm going to take these risks. I'm going to, maybe I'll have one or two less papers a year because of this. Or maybe I'll get less grants, have less- go to less conferences because they're over a weekend and things like that. And then I said, okay, well what's the worst that can happen? You know, I will be less productive. Really. That source can happen. What's the best that can happen? I spend more time with my kids. I don't have my kids telling me to get off my phone, which I had once- that broke my heart, right? To have your four year old say,"get off your phone." Um, spend more time with my family. Watch more Netflix, which is very important to me.
Dr. Rezmovitz:Really?
Dr. Lofters:Yeah, man. I love watching TV. I told you I'm lazy. I'm very peaceful.
Dr. Rezmovitz:What are you watching on Netflix?
Dr. Lofters:So right now on Netflix, um, I am in the midst of The Dark Crystal TV series. When I was little, The Dark Crystal was my favourite movie.
Dr. Rezmovitz:Haven't seen it.
Dr. Lofters:Are you serious? I don't get out much. But you don't have to get out to do this.
Dr. Rezmovitz:I'm kidding. I get out. Maybe I get out too much.
Dr. Lofters:You get out too much. Yeah.
Dr. Rezmovitz:I'm not watching a lot of TV this year.
Dr. Lofters:I will say The Dark Crystal involves a lot of puppets. Um, so a lot of it is nostalgia for me from back in the 80s when the original movie came out. Cause at that time it was very, like, it was a technological like mindblower but it's puppets.
Dr. Rezmovitz:Are you into puppets?
Dr. Lofters:When I was a kid, I loved Jim Henson. Yeah. So I loved like Sesame street. Um, uh, the Muppet show Fraggle Rock was amazing, right?
Dr. Rezmovitz:It really was.
Dr. Lofters:Yeah, it's amazing. So The Dark Crystal was like that, but with like magical fantasy flying people and stuff like that.
Dr. Rezmovitz:So I'm gonna have to check it out.
Dr. Lofters:Check it out.
Dr. Rezmovitz:So that's your number one, The Dark Crystal.
Dr. Lofters:Yeah, The Dark Crystal.
Dr. Rezmovitz:Ok, number two?
Dr. Lofters:Um, Raptors the Raptors have returned.
Dr. Rezmovitz:Did you watch the game last night?
Dr. Lofters:Yeah.
Dr. Rezmovitz:It was pretty good.
Dr. Lofters:Yeah. I love the Raptors. Yeah, I do. I do.
Dr. Rezmovitz:You they're going to make it this year?
Dr. Lofters:No.
Dr. Rezmovitz:Okay.
Dr. Lofters:I'm a realist. I love them, but I'm a realist.
Dr. Rezmovitz:Do you use realist design in your, in your research?
Dr. Lofters:No.
Dr. Rezmovitz:Okay. What do you use? Just plain old, objectivist post-positivist experimental design?
Dr. Lofters:Yeah.
Dr. Rezmovitz:Fantastic. Hopefully you're doing mostly like retrospective cohort studies that are like easily accessible through databases where you don't actually have to like, you know, prospectively wait for the information to come in.
Dr. Lofters:It is a lot easier. I'll send you those retrospective[inaudible]
Dr. Rezmovitz:Yeah, you figured it out, right?
Dr. Lofters:Secret sauce.
Dr. Rezmovitz:It is the secret sauce. Right. You figured it out. Okay. So what's the impact? What's the, so now you have all this extra time?
Dr. Lofters:The impact is- so the barrier I told you it was kind of getting over the mental health hump. The impact is mental too, right? Like, I just, I feel good when I shut down my email on a Friday and I know I'm not going to touch it till Monday and whatever, um, whatever work issues are percolating in my mind because I made that explicit kind of conscious decision, I find that I don't think about work much during the evenings and weekends because I just decided I'm not going to. And I've learned because I'm not checking my email, I'm not kind of diving back into it- there's no point. And like, here are my, here are my children and here's my husband and here's my television. So why would I be thinking about work right now. So-
Dr. Rezmovitz:You know, there are listeners right now who are just like dying inside a little bit who are like in such shock and awe."How do they do that?"
Dr. Lofters:I know. And you know, everyone's different. Like some people have told me that they just couldn't do this. Um, and Hey, like, whatever works for you. I'm all about that. Um, but for me, I've just found that it works so well. Um,
Dr. Rezmovitz:So here's my question because I guarantee it wasn't cold turkey for you. I guarantee there was a training, um, effect here.
Dr. Lofters:Yes. Yes.
Dr. Rezmovitz:There's no way that you could just shut it off on the weekend, um, and um, and go from there. Or maybe you, you are that type of person, I mean, I don't know. Tell me, because I would argue that if you want to practice something like this, you want to be consistent with your, your boundaries- it's g onna take time. You're g onna have to train it.
Dr. Lofters:Yeah, it was definitely a time- it took time. So what started out first is that I had my- so I have an iPhone, so I had the mail app and I had my work email on my phone. So I would see the number, like- I don't know what you call it, the little badge thing that tells you how many new emails you have? So I would see that like it's 45. And then like even like,"okay, mom's going to quickly check to see if that one email came", and then I realized, okay, that's not working. So then I actually took my work email off my phone.
Dr. Rezmovitz:Just turned off the notification[inaudible]
Dr. Lofters:But even that- so I did, sorry, I did do that. I turned off the notification but I would still see them and then it would just trigger like mentally it would just get me to start thinking about my work email, and then like I would end up sometimes- not always, but sometimes peeking so that I just completely took work email off my phone.
Dr. Rezmovitz:So now what if a patient, um, uh, issue comes up?
Dr. Lofters:So we have an on call service. So we have a system so that if issues come up, there's, there's always somebody on call. So again, to me, I think evenings and weekends we have a system that, you know, if you really need to get ahold of me, you can page me and then they'll call my cell phone. Any like any emergency people can get a hold of me by calling on my cell phone.
Dr. Rezmovitz:Actually, emergencies- there's rooms set up all over Ontario for those such emergencies.
Dr. Lofters:Exactly. So yeah, so that, that I found was fine. So taking the- so when I got to the point of tacking email off of my phone, I found that it works great because now I have to like literally go and type in like mail dot, utoronto dot ca, and I'm not doing that. So that for me was like the magic.
Dr. Rezmovitz:And I think we've established why you're not doing that.
Dr. Lofters:Cause I'm lazy?
Dr. Rezmovitz:That's right.
Dr. Lofters:You got it. You've got me figured out.
Dr. Rezmovitz:Well it's your MO. Maybe it's not lazy. Can we just reframe?
Dr. Lofters:I would love to reframe it.
Dr. Rezmovitz:Efficient.
Dr. Lofters:So efficient energy. Efficient.
Dr. Rezmovitz:Right. Energy efficient. So I call it pragmatic minimalism.
Dr. Lofters:Ooh, that sounds lovely.
Dr. Rezmovitz:That's me. If you said, Hey, describe yourself in two words. Pragmatic. Minimalist. Right. If I need to get off the couch, I get off the couch, but I'd rather play a game with you called while you're up. Okay. Have you ever played that game? It's amazing. I play with my kids. I'll say to my kid,"Hey, stand up for a second." They'd be like,"why daddy?" And they stand up. I'm like,"Great. While you're up, go get me-" It's wonderful. I suggest you try it.
Dr. Lofters:I will. I will.
Dr. Rezmovitz:It's a great game to play at a party or something like that. Usually- that's where I learnt it, you know. At a party when, uh, everyone we were out of beer and we'd say,"Hey Doug, stand up." And Doug would stand up and we would be like,"Hey Doug, while you're up, go get us some beers" and he'd be like,"you got me." Okay. So what was the impact then? Did you have any negative consequences of, of um, of making this decision?
Dr. Lofters:Um, so the negative consequences, I guess there are the kind of intangible that maybe I'd be more productive and maybe I would be more successful and maybe I would achieve more professionally if I was working harder. But I actually don't think so.
Dr. Rezmovitz:It sounds like- Okay. You know, you mentioned metrics before and we don't want to do the proper math. I don't think we measure- we have the right metrics for, uh, individuals in our department for the work-life boundaries that are set up in order for- productive because everybody's going to have different goals obviously. And everybody's in a set of different systems. So I would argue that myself, I'm a system. Um, my wife and I are system, the family as a whole is a system, and the community is a system. And so, um, being in the department it's a system. And so if you look at productivity, it sounds like you're quite productive with your family system.
Dr. Lofters:I agree. Yeah.
Dr. Rezmovitz:It sounds like you've made like- so your four year old doesn't ask you to get off the phone anymore? My four year old, I guess he's, he's three, sorry, three year old now. Um, I was thinking about the other- I've got too many. Um, they actually- they asked me to get off the phone so they can use it."Get off the phone. I want to watch YouTube.""Okay, sure." Um, but it sounds like you're very productive. It's just we're not capturing the metric. Maybe you are with your mood, maybe you are with your soul, maybe you are with, um, the impact that that's having on your family.
Dr. Lofters:Totally. 100%. And for me, I think, um, I say it's kind of a, it's a theoretical negative impact because I think if I were doing those things, you know, having meetings the entire day, then going home and like working every night and being more productive for a short period of time in the long term, I think I would fizzle out. I really do. And I think one thing I've been so happy to see recently, um, is that there's finally being more attention paid to wellness and to burnout. I think now the next step is how do we systematically approach it? I think telling people to do things like meditation and yoga is, is good, but from a systems perspective, that's not a system's response, right? But I know for me, just because of, because of my, uh, what'd you call it? Pragmatic minimalism. Um, and I really value- as like cheesy as that sounds- I really value like happiness and being happy. Like one of my visions for myself is to be happy every day. So I can't-
Dr. Rezmovitz:So what do you do?
Dr. Lofters:Uh, watch and set my boundaries. It's as simple as that. Really. Like the days when I find myself really grumpy are those days when, let's say there's a grant coming up due or I'm, I'm going to be out of town for a long period of time and I find I okay, I have to do some work. I'm resentful. Like I'm literally there typing angrily on my computer cause I'm resentful that that time is being taken away. Um, so I think I would be more productive on paper in the short term, but I wouldn't be able to sustain it in the long- term.
Dr. Rezmovitz:As an aside- just listening to the way you, um, you speak and the semantics they use. Um, if you don't mind- I just want to tell you, um, kind of what I've been doing. So I got rid of happiness as a goal in my life and I'm using contentment as the, as the, as the bar, um, cause happiness is fleeting. You know? Have you ever been given a cake with candles in it and you look at your face right now, it's like joy and you see it in your eyes too. But, but contentment, satisfaction with your lot in life. To me that, that's the goal. Um, but to generate happiness every day is a great goal. I mean, you can do that with, um, have you watched The Dark Crystal on Netflix?
Dr. Lofters:Exactly. Yeah. So I will say, yeah, it might be a matter of semantics because to me when I am- like I said like today is a sunny day, so I'm happy. Um, when I- last week I had some long days and I came home and put on my sweatpants and my slippers and I texted my friends. It's like, I'm so happy cause like I'm wearing my sweatpants and my slippers right now. So I think it is, it's the same idea. So I'm not looking for kind of grand, wonderful things every day, but just those little moments that make you smile, that make you feel content, that make you feel gratitude for life.
Dr. Rezmovitz:Right. Exactly. That's amazing. Um, do you have any, um, inspirational words that you'd, you know, want to impart on our listeners- if they only knew kind of thing?
Dr. Lofters:Oh geez. I don't have good catch phrases, but.
Dr. Rezmovitz:You don't need a catch phrase. There's no catch phrase. There's just like be genuine.
Dr. Lofters:I just, yeah- I mean, like I said, I think people have to do what works for them, but we get caught up in this kind of endless rat race and we can constantly- we can all constantly be doing more in our workspace, but we could also constantly be doing more for ourselves. And I think we just have to recognize how important our selves are. Like when I'm 95 and I'm lying wherever I am, you know, it's my family that's going to hopefully be around me. Um, maybe some people from work, but probably not a lot. So I'm not saying the work doesn't matter. Work is crucial and work is what, um, for me, I find work incredibly rewarding, but I think just those boundaries are so important. And just because a boundary can be broken down like we've talked about with email and with other things, it doesn't mean that they should be.
Dr. Rezmovitz:So I've been doing talks recently and part of the talks is, um, discussing deathbed goals and, um, tell me what you think about these three goals.
Dr. Lofters:Okay. Okay.
Dr. Rezmovitz:One first question. Did I live passionately? Two, did I love deeply? And three, did I serve others well? Because when I get there, those I think are the questions that are going to pop up and it's not going to be, did I get that grant in on time?
Dr. Lofters:Exactly.
Dr. Rezmovitz:Yeah. Right. Did I really did, you know, how did I spend time? And so it's really important that we as academic physicians, community physicians, um, healthcare providers, uh, primary care providers, researchers, support staff, um, nurses- everybody who's working in health, um, understand the importance of also making time for yourself and setting boundaries. And so with that, I want to thank you very much because we've hit a boundary right now. We have to-
Dr. Lofters:Let's respect that boundary.
Dr. Rezmovitz:Yeah. We have to respect your time too. Right? Um, so I would just want to thank you so much for coming on the podcast today.
Dr. Lofters:Thank you. This was so much fun.
Dr. Rezmovitz:Great. Have a great day. You too. This podcast was made possible through the support of the Department of Family and Community Medicine at the University of Toronto. Special thanks to Allison Mullin, Brian Da Silva, and the whole podcast committee. Thanks for tuning in. See you next time.