Which Healthcare Professions Offer the Best Work-Life Balance... and the Worst

I have three criteria for defining work-life balance

When I graduated dental school, I had not heard the term “work-life balance,” but I was very familiar with the idea that healthcare workers had difficult, stressful jobs that could absorb our personal lives. We work earlier than 9 AM and later than 5 PM. We work weekends. Our non-healthcare friends have cozy and predictable schedules but we’re a different breed of cat. We dedicate our lives to serving others at their most vulnerable moments and our needs are secondary.

Sure, I didn’t love having to go to bed early on a Friday so I could be fresh for my first patient at 8 AM Saturday morning. But it’s what I signed up for.

Since I entered the working world twenty years ago, work-life balance has become a hot topic and for good reason. We’re paying more attention to mental health and normalizing seeking support. While the well-being of our patients is paramount, it does not necessarily have to come at the expense of our own.

I’ve touched upon work-life balance in other posts (see Do Other Countries Have Happier Doctors and The Healthcare Gig Economy: The Rise of Temp Work) but I see value in defining this more clearly. For some of us, it can still feel like a fuzzy, touchy-feely buzz phrase wielded by a younger generation that doesn’t want to work as hard as we did. That’s nonsense. Every generation has its lazy and entitled workers— the folks who just want to coast and complain. Let’s get past all that and recognize placing some more importance on our own happiness is a great thing in and of itself, will decrease job turnover and colleagues leaving the profession, and will benefit patient outcomes.

In this article, I’ll share my three-point definition and highlight the careers that I think offer higher and lower opportunities to achieve balance with our personal lives.

Defining work-life balance

I think some people will say they have poor work-life balance but they’re really just burned out on their current job. What’s the difference?

The Cambridge Dictionary defines it as: “the amount of time you spend doing your job compared with the amount of time you spend with your family and doing the things you enjoy” (source). I think that’s a good one. It makes it clear that we’re not talking about hating your job (see Should You Quit Your Healthcare Job for my take), rather we’re talking about your ability to have the time and energy to devote to your non-working life.

With that in mind, I think there are three criteria to determine a profession’s ability to create space for a personal life:

(1) Flexibility

What are the normal hours you can expect to work? Is it 9-5 or 12-hour overnight shifts? And are you able to build a unique shift structure that fits your personal needs, like childcare?

I came across a 2007 Yale Medicine article that defined the “E-ROAD” medical specialties that offered the best lifestyle potential— emergency, radiology, ophthalmology, anesthesiology, and dermatology (source). These specialties are certainly not free from stress, but they allow physicians significant control over their schedule.

Perhaps the profession most impacted by a lack of flexible working hours are nurses in 24-hour care facilities, such as hospitals (source). Rigid shift structures plus staffing shortages are tipping the work-life balance scale and increase turnover.

(2) Boundaries

Is it customary to have to work when you’re not working? Are you ever “on-call” or will you be expected to cancel your plans to come into work?

As an associate (employee) dentist, I did not have to take call, but that changed when I opened my own practice. For 11 years, my partner and I split time carrying an emergency phone. It didn’t ring often, and when it did I could usually address the matter with some comforting words and a prescription order to a pharmacy. I can count on one hand the number of times I had to go into the office after-hours for an emergency root canal or child with a broken front tooth.

Certainly PCPs, surgeons, and OB-GYNs have more routine and challenging emergency calls than a dentist or their E-ROAD medical colleagues.

(3) Intensity

How stressful is your work? Could it take an emotional toll on you even when you’re home?

There are articles that will list jobs like occupational therapy and speech-language pathology among the least stressful (source), however a quick Google search will lead to articles like this one which state there is a larger problem yet to be properly recognized.

Look, all healthcare jobs carry some stress with them. Taking care of patients isn’t for the faint of heart, regardless of what services you’re providing. But let’s agree that the stress a dentist or dental hygienist faces just isn’t on the same level as a NICU nurse.

With all of this in mind, here are the careers with better and worse work-life balance, based on my criteria and my preliminary research.

Professions with better work-life balance

Dermatologist

A prime example of a high work-life balance physician. Dermatologists typically work weekday clinic hours with a possibility of a four-day workweek, encounter few urgent after-hours calls, and have relatively low stress treating non-emergency conditions​

Psychiatrist

Psychiatrists generally conduct scheduled appointments and have flexibility to set their hours (many work in private practice or outpatient clinics). They are one of the best examples of telemedicine in action with the ability to conduct virtual visits from while working from home. They experience minimal medical emergencies compared to other physicians​ and while emotional strain can occur, the lack of frequent life-threatening situations keeps acute stress lower.

Occupational/Physical Therapist

Most physical and occupational therapists work daytime hours in clinics or schools, and part-time work is common, allowing personal scheduling needs to be met​. They rarely have to respond to emergencies once they leave for the day, and while the job is active, the stress is more about helping patients progress rather than handling crises. This means good flexibility (many therapy clinics run roughly 8 AM–5 PM), clear boundaries (no on-call duty), and moderate stress levels.

Professions with worse work-life balance

Trauma Surgeon (and Other Surgeons)

Surgical specialties (especially trauma surgery, cardiovascular surgery, neurosurgery, etc.) are notorious for extremely long and unpredictable hours. Surgeons often start their day pre-dawn for rounds, spend long days in the operating room, and take emergency call at night and on weekends. This means poor flexibility (the workday is whenever and however long the patient load requires), poor boundaries (a surgeon’s pager can go off at 2 AM) ​and high stress (lives are on the line). The dedication required leaves little room for personal time, which is why surgery is often cited as a field with challenging work-life balance.

Obstetrician/Gynecologist

OB/GYNs struggle with similar challenges. Babies don’t adhere to schedules, so an obstetrician might have clinic by day and be called to the hospital in the middle of the night for a delivery or emergency C-section. Overnight and weekend call is routine in obstetrics.

Frontline Nurses and Paramedics

An ICU or ER nurse typically works long shifts that rotate day and night, deals with life-threatening situations for multiple patients at once, and may even stay past shift end to finish critical tasks. Paramedics endure grueling 12–24 hour shifts​ and face traumatic emergencies in the field regularly, giving them little respite physically or mentally. Both jobs offer minimal flexibility (shifts must be covered as scheduled), blurred boundaries (EMS crews must be ready whenever called; nurses often extend work if units are understaffed or a patient crashes at shift change), and high intensity (constant exposure to emergencies).

Conclusions

On Leaving Healthcare, I address why people change jobs, or even leave patient care entirely. Burnout, depression, mental health… these are terms that have increasingly joined our discourse over the past decade (especially post-COVID) and are worthy of consideration.

It takes a special kind of person to dedicate their lives to the health professions. If you’re in one of the careers that has better work-life balance, that does not mean you have an easy job or will be more likely to be happy. Conversely, if you’re in a career with a worse work-life balance, that does not mean your job is necessarily harder and that you’re destined to be unhappy. You might be able to change the setting for your job (urban vs rural, out-patient vs in-patient, employee vs owner, etc.) and find that you are able to regain the flexibility, boundaries, and/or level of intensity that you need to achieve work-life balance.

Let’s be more candid with one another about this stuff. The next generation can be more discerning in choosing a career path, and those of us who are already committed on our journeys might be able to better identify how we can restore balance.