Marriage to a doctor: Keep your priorities in check


by Mamta Gautam, MD

Parkhurst Exchange
Vol 16, No 6, June 2008

Many medical marriages are happy, fulfilling and satisfying. Doctors are bright, well-educated, caring and thoughtful people and so have many of the necessary ingredients to be wonderful partners. Yet, we're not always available to offer these attributes to a significant other. The stress of medical life can put a serious strain on an intimate relationship, whether it's marriage, cohabitation, or a same-sex union.

The closest relationships of physicians are largely unstudied. Much of what we do know comes from older, male physicians in traditional marriages with stay-at­home wives. Our current understanding is that the divorce rate of physicians, both men and women, is similar to that of other professionals.

Drs. Glen Gabbard and Roy Menninger studied physicians' marriages over a IQ-year period of workshops for docs and their families. Some of their findings follow.

Doctors are highly conscientious and strive for perfection. We feel very guilty if we don't meet our level of responsibility. There's a need for control, largely to ensure the best possible outcome (for which we feel accountable). We need to please others and gain approval. We're able to delay our gratification - having done this through long years of med school and residency to get to where we presently are.

Yet, these same qualities can lead to relationship trouble. Patients don't complain about these traits, nor do peers. In fact, we ourselves don't complain either. Spouses, however, do. In the drive to be responsible, perfectionistic, conscientious and approved of, we docs put off meeting our own needs and often the needs of our family. We do that one last round on the wards before we leave, thereby delaying dinner; we dictate proper, detailed, lengthy reports that take time and energy; we sometimes don't book holidays when there's a staff shortage.

A natural evolution

Changes in relationships are normal. When we first meet and fall in love, we come as close as healthy people can come to being psychotic. We lose a sense of connection to time and reality, wanting to be with that other person every minute, thinking of them constantly, pushing ourselves to do things even when we're exhausted. This is not sustainable, though, and things usually settle after a few months. Couples require a sense of secure bonding and emotional attachment. The number one cause of separation is a loss of friendship.

Dr. Michael Myers is a Canadian psychiatrist who's worked with physician couples for years, and has identified some warning signs of trouble:

  • tension, irritability, insomnia, anxiety
  • physical symptoms
  • not feeling loved or appreciated
  • not wanting to go home after work, even if tired
  • self-medication - use of alcohol, drugs, medications
  • increased awareness of attractive or interesting people in your life
  • fantasies of separation
  • children acting out and symptomatic of the problem
  • arguments, anger, violence
  • avoidance, withdrawal, detachment
  • lack of sexual intimacy
  • fantasies of affairs, acting on these thoughts, affairs.

Often, when we sense any difficulties in our personal life, we exercise the same set of skills we use at work - we do more, manage more, endure more, achieve more, deny more. We work harder, longer hours, in an unconscious attempt to avoid addressing problems. Unfortunately, this doesn't work well in the long run.

Warning signs

Dr. John Gottman is an American psychologist who's studied couples closely and intensively. His work tells us that the average time that a couple waits between realizing they're in trouble and seeking help is 6 years! He reminds us that it's normal for things to go wrong in a relationship - what matters most is the ability to repair them when they begin. Seventy percent of marital woes are perpetual, that is they keep coming up and are not going to go away. The goal is to have constructive dialogue, not a fight, about them. Dr. Gottman describes the Four Horsemen of the Apocalypse - behaviours that are predictive of divorce - namely:

  • attack/accuse
  • withdrawal/defend
  • contempt
  • stonewalling, detachment.

At this point, couples drift apart, lose their sense of closeness, don't feel loved or appreciated, lead separate lives and eventually divorce.

The 5 major sources of conflict are magnified if there are additional family, personal or social stressors. These can include a medical illness in the physician, partner or child, aging and needy parents, academic or behavioural difficulties with children, lawsuits or complaints, issues of interracial or interfaith relationships, or gay and lesbian partnerships.

Dual-doctor couples

Dual-doctor couples have relationships similar to those of other two-professional couples. On the positive end, they are two people who are bright, committed, equal, and offer mutual respect. Tensions and difficulties arise when the male doctor considers his work more important than his wife's, and asks her to change her schedule to accommodate family needs, or refuses to move to allow her a promotion or new job opportunity. Sometimes, there's a lack of empathy for the other's sense of commitment to medicine and long hours. It's tough to come home after both people have had an equally long day and accept an unequal division of home and family duties. It's a fact that even when they work outside the home, women have the greater responsibility for this.

Balancing the demands of medicine with our personal lives isn't easy. It involves accepting this as a responsibility, and making a personal choice to do so. This balance is dynamic and requires constant attention and readjustment. There's professional help available through marital counselling, if needed. While the investment of time and energy in our relationship is great, the payoff is greater!

The 4 A's - Strategies for problem resolution

  • Assessment: it's essential to assess the problem and empathize ­ 'walk in the other's shoes.' Try to turn the resentment into compassion, i.e. it helps to remember that the doctor doesn't want to be late for dinner either, so it's more productive to support rather than berate.
  • Acceptance: some of the issues in a medical marriage require an acceptance of them as 'a way of life, not a problem.' For instance, being late for dinner may occur - knowing and accepting this allows one to plan for the possibility in advance and go on to plan B, if necessary.
  • Anger management: resentments are the number one killer of relationships. It's very helpful to recognize when you feel this way, identify it and let it go. We need to stop making sacrifices, and stop keeping score. Remember that resentments = unmet needs. It's imperative to recognize, identify and meet our own requirements.
  • Action: work together as a team. Blame the situation, not each other. And, keep up the courting.


Address main sources of conflict

  1. Time: be specific about your requests.Don't take lateness personally. Stop waiting and go ahead to do what you need to do. Balance time together and alone. Take it for yourself and offer it to the other.
  2. Money: set clear financial goals together. Make big decisions as a team. Obtain help from financial professionals. Stick to basic economic principles. Be realistic and don't overextend.
  3. Housework: set clear chores, and accept that good enough is sufficient. Ask for, and allow, help. Be clear, specific. Use a list. Eliminate things that don't need to be done. Prioritize and let go. Look for options, other sources of assistance, and delegate!
  4. Children: define what needs to be done. Say "yes" to help and "no" to any extra demands when children are young. Teach and allow kids to help around the house. Anticipate and plan for the tough parts of the day - e.g. have necessities ready in the morning, plan meals, keep bedtime rituals. Organize enjoyable things to do with the kids; relax and have fun with them. Be available.
  5. Intimacy and sex: set this as a priority. Focus on all 3 stages of intimacy:
    - emotional intimacy - make time to be together; share thoughts, hopes and feelings; be considerate; express appreciation; listen to each other. Try to slow down, waste some time - be unproductive. Just be together to sit, talk, listen to music, laugh.
    - physical non-sexual intimacy - sit close, hold hands, hug. Give each other massages. Try long kisses.
    - physical sexual intimacy - talk about sex, what you do and don't enjoy. Respect each other's needs and differences. Make your partner feel special and loved. Have an affair with your beloved, before someone else does.



Gabbard GO, Menninger RW. Medical Marriages. Washington, DC: Amertcan Psychiatric Press; 1988.

Goldman LS, Myers M, Dickstein IJ,(ed) The Handbook of Physician Health: The Essential Guide to Understanding the Health Care Needs of Physicians. Washington, DC: American Psychiatric Press; 2000, pp 52-79.

Myers, MF. Doctors' Marriages: A Look at the Problems and Their Solutions. 2nd edition. New York: Plenum; 1994.

Sotile WM, Sotile MO. The Medical Marriage:

A Couples Survival Guide. New York: Carol Publishing; 1995.