With burn out rampant in the physician community, you would think physicians would cherish their vacation time. Since vacation is a time to take a break from our normal routine and recharge our body battery, we should come back from our vacations rested and ready to work again. But many physicians don’t get any rest during their vacation time.
They use vacations to cram as much “play time” or “quality time” or “family time” into their schedule as they can. They concern themselves with the “we may never get back here again so we need to see everything” attitude rather than the “let’s take some time for a refreshing recharge of our lives.” Then when they get home, they need a vacation from their vacation, but instead they must get back to work. They come home from their time off more tired than when they left.
Vacations done right combat burnout. Vacations done wrong contribute to burnout. Following are six vacationing mistakes physicians make that are contributing to burnout.
One: Never take more than a week off at a time
Two big reasons that lead physicians to take short vacations is either they think they are indispensable, or they don’t know how to make proper arrangements so their work does not pile up while they are gone.
Those who think they are indispensable feel their practice cannot function if they are not present. They feel no one else can do the job they do. But the fact is, if you died tomorrow and never came back to work, your patients would get taken care of by someone else just fine. If patients can continue to get their medical needs met upon your death, they can survive if you take two weeks off.
The other reason physicians don’t want to leave for longer than a week is they hate coming back to the big pile of unfinished work that builds up while they were gone. There are three solutions for this. First, have someone cover for you so your urgent patients are being seen and therefore don’t build up. Second, arrange for your nurse to do everything possible to keep your paperwork and email up to date. Third, make the first day back to work a catchup day with nothing scheduled. Spend that day signing charts, returning emails, returning phone calls, reading mail… without any patient obligations. Then you can start clean the next day.
The job we do is very stressful and requires down time to recharge. The first week of vacation is just unwinding from work. The second week is the actual vacation.
A few years ago, I discussed this principal with one of my physician friends who was in his 60s. He realized he had never taken more than one week off in a stretch in his whole career. A couple of months later he decided to take a two-week vacation. He came home more refreshed, having had extra time to destress. He was also upset that he had never taken an extended vacation before. He was a typical work-a-holic and felt lost if he wasn’t at work. He never understood the real meaning of vacation until after he took his first two week vacation. After that, he scheduled all his vacations for at least two weeks.
I took a three-week motorhome trip almost every summer during the years I practiced medicine. Every time I came home refreshed and ready to return to work. I also took two four-week vacations and one six-week vacation during my 20-year practice. Don’t miss out on the opportunity to have that second, true vacation week, at least once each year.
Two: Don’t use all their vacation time
I never understood why people did not take all their allotted vacation time. They speak of it as if it was some great feat they were performing in not using their vacation time, as if they would get some reward for working extra.
You get vacation time for a reason; because you need it! Don’t leave it on the table.
Some physicians don’t use all their vacation because they have put themselves in a position to need the money. In private practice, you lose money when you are not seeing patients. If you feel you need the money more than you need a vacation, then make changes in your financial situation so you can afford to take vacations. Often this means PAYING OFF YOUR DEBT.
Most employed physicians do not have a contract that gives them enough time off to recharge even when they take all their vacation time. Skipping earned vacation is very hard on them, their patients, and their family.
Three: Only go on vacations that have CME
Some physicians are so obsessed with money that they only travel if it is for CME so they can write it off. Better financial planning will remove this burden.
This is a horrible mistake! CME is work and the purpose of vacation is to get away from work and give our mind and body a break. Our family doesn’t see us enough when we are home, now they are not even seeing us while on vacation because saving a few dollars in taxes by attending a CME meeting is more important than vacationing with our family.
When you go to CME events, leave your family at home so you can work and get what you are supposed to get out of the CME. When you go on vacation, leave your work at home so your family has all of you during the vacation. There is no such thing as a “working vacation.”
Four: Send the family on vacation while you stay home and work
Another horrible idea. Your family doesn’t want to go without you and you shouldn’t ever let this be an option. The main reason physicians do this is because they feel they can’t afford to not be working. All physicians make a good income and all physicians can afford to go on vacation. If you feel you can’t, it is time to get your finances in order so you feel you can go on vacation. I can help with this if you need outside assistance.
When I was young my grandfather was the superintendent at a mill. He truly believed the mill could not get by without him for long. Although he owned an RV trailer, he rarely used it. But each summer he would take my brother and I to a nearby lake on the weekend, drop us off to spend the week with our Grammy. The next weekend he would come back to pick us up. We went on vacation without him.
We loved the week with Grammy, but it would have been a lot better if both our grandparents were present.
Five: Only take long weekends
Another horrible idea. It was hard to believe my friend had never taken more than a week of vacation at a time. But to discover physicians who have never taken a full week off was even worse.
I always ask my coaching clients, “When was the last time you took a week of true vacation?” The most common answer I get is: I don’t remember.
They then proceed to tell me they tend to use their vacation a couple days at a time and take multiple long weekends each year.
A long weekend is definitely not enough time to let your work worries leave your mind so you can rest and recharge. Please take at least one real vacation annually.
Six: Cram all they can into their vacation
Vacation is a time to recharge, not a time to cram every activity you can into the week. Cramming activities into your schedule is what you do during the weeks you work. Vacation is a time to slow down.
I recently wrote about how I screwed up the start of a vacation by cramming to much stuff in before I left. I ended up pulling an all-nighter before leaving. What a mistake, the first couple of days of vacation I was too tired to enjoy myself. The next trip I took I intentionally had no planned obligations the day before we left, and we took off on an afternoon flight the next day. What a difference that made, this time we started our vacation unfrazzled.
Many physicians work all day Friday, run home, grab the family and catch a red eye flight in order to start their vacation as soon as possible. They cram the days full of activities, run themselves into the ground getting no rest or recovery. Then they take a late flight home, getting back just after midnight, only to wake up at 5am Monday morning to start their work week.
These people need a vacation from their vacation! This problem is self-imposed. Slow down while on vacation, have fun and relax. Enjoy the place you visit without cramming everything in. You can come back another time if you really need to see the rest of the tourist attractions.
Return a day early so you can start your work week rested. Maybe even take Monday off, as mentioned earlier, to catch everything up at the office so you can start Tuesday all caught up, rested and ready to conquer the week.
Bonus: Taking a “nanny” on vacation
If this is a family vacation, you should not need a nanny. Be a parent and enjoy time with your children. If you want time for you and your spouse to be alone, then take a separate vacation for just the two of you, and leave the kids with someone like a grandparent while you are gone. Give your nanny the week off.
I took 8-12 weeks of vacation every year while I was in practice. Yes that cost me a lot of money to be gone that much, but if you plan for it, the money will work out just fine. One of those weeks each year we scheduled a trip for just my wife and I. We would get some alone time and the kids would get some extended time with their grandparents.
We took care of the kids for these annual honeymoons three ways. The kids went to their grandparents’ home while we were gone, the grandparents came to our home for a week (great while the kids were in school), or the kids went on a motorhome trip with their grandparents.
Summary
A physician’s life is tough, with a high rate of burnout. We need to do all we can to get enough rest and relaxation to recharge from our busy schedules by making our vacations count. One of my favorite memories happened when we were ending a three-week motorhome trip. As we rounded the last corner and our son saw our house, he turned to me and said, “No dad! I don’t want to go home yet.”
I love that my son loved our vacation together so much that he didn’t want it to end. He didn’t, however, feel that way as a teen. Enjoy it while you can.
Spot on Dr Fawcett. Most of us are guilty of all of the above