My family physician husband, Don, and I visited a lot of practices before deciding to establish our own in 1979. We envisioned having practice partners with whom we could share our lives, not just a work space and a call schedule. Many physicians then (and now) preferred to keep their work and personal lives separate. So instead of joining a practice, we set out to create one that would function as a small community within the community we actually served.

Over the years we’ve heard physicians say that benefits such as “time off for family, sabbaticals and mission work,” “control over my day,” “positive interpersonal relationships” and “having a purposeful life” mean a lot, not only to them, but to their spouses and families. Although we can’t pay as much as other practices in the area, we offer these benefits and don’t have a problem with turnover. Despite its semirural location, our group has grown to include seven board-certified family physicians and five midlevel providers practicing in three locations.

One distinction of Westfield Family Physicians is that we encourage physicians’ spouses to take an active role in the practice. Some of the spouses are employed by the practice; others are involved in a less formal, noncompensated capacity. When it comes to planning and decision making, however, everyone is involved. All physicians and their spouses attend evening meetings of the practice several times per year. With our lives going in many directions, these meetings help keep us centered and connected with one another. But the main activity that helps keep us a close-knit group is our annual retreat.

The retreat

In the mid-1980s, the group began to experience a great deal of dissatisfaction with the schedule and its impact on our personal lives. For the first time, physicians, spouses and a facilitator went away for several days to work out our problems. The group wanted to stay together and could see that, like a marriage, it was going to take a lot of work and communication to accomplish that.

Every year since then, we close the practice for two days, arrange locum tenens coverage and leave town with our spouses. The date is set six to eight months in advance so that spouses can arrange time off from their jobs. Although infants are welcome, our annual retreat is not a family event. Each couple arranges baby-sitting at home for their children, and the practice picks up the tab.

For the past several years we have rented seven condominiums at a lakeside resort not far from home. We make sure at least two of the units have living rooms large enough for the entire group. We meet in one and share meals in the other.

Arriving the night before the first session ensures us a prompt starting time in the morning. For the next two days we work our way through the preset agenda. Everyone in the room has an equal say in the discussions and an equal weight in the decision making. Spouses in non-medical fields contribute by helping us see things from the patient’s perspective and by serving as consumer advocates. They also bring valuable insight from their own careers and areas of expertise.

Occasionally the group has to make difficult decisions, such as those that adversely affect physician pay or schedules. This is never a comfortable time for anyone, but it is much easier when decisions are made by the group. Everyone participates in the discussion and, consequently, understands why an unpopular decision is necessary. There is more acceptance, less grumbling and less second guessing when everyone firmly grasps the issues.

Our annual retreat has become the highlight of our year. It has philosophic value, symbolizing our unity and the calling we share. It has emotional value, inspiring and encouraging us not to lose heart in difficult times. And of course it has practical value, serving as a mechanism for planning and change. Although we didn’t plan it this way, our annual retreat is the embodiment of our original goal: to create a practice that functions as a community. Our retreat requires significant time, energy and money, but the reward is a practice that reflects our goals and values.