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Managing personal and professional needs and obligations can be a major challenge. Here's advice from some PTs and PTAs.

You're late. You need to drop one child off at daycare and another at school, and you need to get to work but your 6-year-old s dinosaur project is due and T-rex's head has fallen off. Your 3-year-old, who hates to be rushed, is in the beginning stages of meltdown. Your 6-year-old is doing the dance-of-1,000-demands-"Fix it! Fix it!" You grab the "bonds anything" glue without noticing the clogged nozzle. The tube splits, covering your hands with glue. As you contemplate the feasibility of driving (possibly to the airport to catch the next plane to Bora Bora) with your fingers glued together, a headless T-rex stands in silent disapproval. Balance?

Americans work more hours than people in any other industrialized country, and 64% of married couples both work compared with just 36% 25 years ago. A recent US government survey asked 250,000 working women, "Imagine for a moment that you had been invited to meet with the president and top White House officials. What would be the first issue you'd want to discuss with them?" The number-one answer was their inability to balance work and family.1

Are physical therapists (PTs) and physical therapist assistants (PTAs), along with the rest of America, working longer hours and finding less time for family, friends, and themselves? What strategies do PTs and PTAs use to achieve balance?

Some PTs and PTAs seem to be endowed with more than 24 hours in a day. For example, Terry Trundle, PTA, is on the Membership Committee of the Orthopaedic Section, is RBNA Representative for the Georgia Chapter, and an APTA "Members Mentoring Members" participant. He works at Velocity Spine and Sports Rehab, is director of Athletic Rehab Institute, and is a continuing education seminar presenter for Orthopedic Rehab of the Knee and Shoulder/Cross Country University, Quest, Inc, and Motivations, Inc. In addition, Trundle assists local high schools with athletic training. Still, he finds time for involvement in his church and for personal relationships (children, grandchildren, significant other).

When asked how he manages it all, Trundle says, "It is important to like what you do as well as to respect what your spouse does in order to have a successful personal life. Professionally, I dedicate myself first to my practice. Then I plug in athletic activities. In between, I lecture." Trundle admits, though, that not having children at home makes a big difference: "Professional and spiritual maturity and kids grown certainly decreases demands. When the kids were at home, it was a different story."

Tonya Apke, PT, OCS, echoes Trundle's philosophy, "It's important for husband and wife to value each other's careers." Apke works full-time as the academic coordinator of clinical education (ACCE) at the College of Mt St Joseph, sees patients in an outpatient clinic 2 afternoons a week, is studying for her DPT, and has a 9-month-old son. She continues, "My husband also is a PT, manages an outpatient clinic full-time, and does athletic training for the local high school football team. We understand each other's issues-I know he has a full caseload of patients and it's harder for him to cancel or have someone else take his patients. But I went to school for a long time, too, and I want to use that education."

And Behind Door Number One. . .

PTs and PTAs must make choices affecting how they juggle work and life: where to work, how many hours to work, and even to enter the profession in the first place. APTA life member Mary Propst, PT, says, "As a single parent, I made conscious decisions about where to live and what job to take knowing I would need to juggle work and parenting." She adds, "I chose to make continuing education and professional involvement my social life!"

Sometimes these choices are creative and unique. After Anne Coffman, PT, MS, CGS, gave birth to her son, she went from being a full-time area manager of operations for a rehabilitation care group to working seasonally. Her husband's business also is seasonal-spring, summer, fall-so Coffman works full-time December to April and her husband stays home with their son. She says, "One of the reasons I went into physical therapy was the flexibility, and work setting is important to that flexibility. For instance, in nursing homes you have a 'captive audience.' The patients are right there, so you have more flexibility and can prioritize your caseload. In outpatient care, you have less flexibility. Even in the nursing home, though, sometimes a new patient will be admitted on a Friday afternoon. As a professional you just stay and get it done."

Nancy White, PT, MS, OCS, the mother of 9- and 11-year-old girls, also made some creative career choices. "The profession of physical therapy docs allow for work/life balance depending on the choices you make. Balance is easier when you work in a setting where you control your appointments. Currently I work 10 hours a week in the Arlington Free Clinic, see private patients in association with a practice called Body Dynamics, and teach at Marymount and Howard universities. I am not totally committed full-time to any one place, so it is easier to say 'no.' Since it's important for me to know what's happening in my children's education, being able to volunteer in the classroom is a big asset. If my child's teacher asks me to help out on Wednesday, I don't schedule patients on Wednesday." She continues, "I am glad, though, I had the chance to practice full-time for 15 years to build my skills and gain a professional reputation. It is much harder to make children the priority when you are just starting out in the profession."

Apke agrees that her work setting plays an important role in how she balances work and family. "Academia allows more flexibility than being a clinician. I have been very fortunate that, after my maternity leave, I was able to return to work full-time at the College of Mt St Joseph but actually work from home a majority of the time. I put my clinical work on hold for 10 months and just recently returned to it. This has worked very well for me since I need to adjust to things in increments."

"Academia is inherently flexible," says Jane Oeffner, PT. The director of the Doctor of Physical Therapy Program, Hahnemann Programs in Rehabilitation Sciences at Drexel University, and mother of a 4 ??-year-old daughter and two grown stepsons, adds, "However, once you commit to an outpatient setting, you must be in the clinic from 8-5. It's more challenging for clinicians to achieve work/life balance."

What's the answer for clinicians? For some, strict time management and advance planning can be a solution. Nancy Kirsch, PT, has worked full time, owns a private practice, teaches at the University of Medicine and Dentistry of New Jersey, and has served as president of the New Jersey Chapter of APTA and on the New Jersey Board of Physical Therapy.

She advises, "Plan ahead." Kirsch, who has six children, says of her involvement in her children's activities, "One key was getting the school calendar in advance for school functions. At the beginning of the year, I'd know that I'd have to take off a day in October and I scheduled that. I also would call the teachers in advance for certain activities and ask if my child could go first or last. The teachers were very willing to help. I missed very few things my kids did because I made it my priority, I planned around it, and my patients understood it.

"We also had backup plans for sickness. I felt a definite responsibility to my children that they're well cared for, but also to my patients that I wasn't abandoning them," Kirsch says.

Staying Connected

Staying involved in the profession is important whether or not you choose to reduce your work hours to achieve balance.

Currently on the APTA Foundation Board of Trustees and soon to be its president, and active in her state chapter, White states emphatically, "It's important, regardless of how you balance, to stay in touch with the profession. If you do take a break from practice, don't make that break too great. Things change so much, it's so hard to catch up. I will be able to step back in full-time because I have maintained the contact."