Most of the time when a doctor gets hired they are treated like the average worker when it comes to vacation time allotment. The CEO will think of the doctor’s time in the same fashion he or she thinks of their own time and the time of the other employees at the hospital. But we are not the average worker.
The average worker has a vastly different time off schedule than doctors do. Many workers in America only get 2 weeks of vacation. I had an office nurse once gripe at me for taking 10 weeks off one year. She felt that it was excessive since she only got 2 weeks off. She felt either I should get less or she should get more. But she was also thinking my time was utilized the same way as hers.
The average worker works 5 eight hour days a week and gets 2 weeks of vacation, or 10 working days off per year. If they work the business week, Monday thru Friday, they have 2 weekend days off each week for a total of 104 days off each year. They also go home at 5pm and don’t get called back. Holidays, add another 10 days off each year. So the total time off would be 124 full days and every night.
How would this calculation pan out for a doctor? Let’s look at a surgeon who shares call with 5 other doctors. She is on call every sixth day and every sixth weekend. Weekend call is Friday from 7am until Monday at 7am. Of the 104 days a year attributed to weekends, she will work one sixth of them, which leaves 86 weekend days off each year. Let’s assume she does not make rounds on any of the weekend days when she is not on call. Of the 10 holiday days, the surgeon will work two of them, leaving 8 holidays off. Many doctors get only 4 weeks of vacation and some sick leave and CME time. Counting only the vacation time at five days a week, that comes to another 20 days off each year. That brings the grand total of days off for this surgeon to 114.
The 9 weekends on call include Fridays, so the week days that still need call coverage are Monday through Thursday. Of those, this surgeon will have to work nights on one sixth of them. Adding these 34 days to the 9 Fridays comes to 43 additional days during the year when the average worker works 8 hours while the surgeon works 24 hours. When she is on call she will not likely work all the hours, but she might. So if we allot each of those call days during the week days the equivalent of 8 hours of extra work, an average work day, that would be 43 extra days a year the surgeon had to work, taking call, above what the average worker did.
The average worker with two weeks off each year has 10 more days off than our doctor who is given 4 weeks of vacation. In addition, the surgeon will work an addition 43 days a year to account for being on call on week nights (Mon – Fri). This doesn’t take into consideration all of the times she started work several hours before business hours and kept working several hours after the average worker went home to be with their family.
So to make the comparison equivalent to the average worker, this surgeon would need an additional 53 days off. With a 5 day work week that is an additional 10.6 weeks each year. To get the same amount of time off as the average worker with 2 weeks of vacation a year, the surgeon in this example would need 14.6 weeks of vacation every year. It is a pretty rare surgeon’s contract that will include 14.6 weeks of vacation each year to compensate for the extra call hours worked.
Back to the nurse who was complaining about me taking 10 weeks off that year. I sat down with the calculations and showed her that her 2 weeks of vacation amounted to more time off than I had. She had a new appreciation to my work load.
Doctors need more time off. Those who are employed need to fight for more time off. Those who are self-employed need to work on making their financial situation such that they will feel good about taking more time off. Debt is one factor making self-employed doctors not want to take more time off, since the vacations are unpaid. This lack of adequate vacation time may be one of the factors contributing to the high doctor burnout rate we see today. CEO’s should keep this in mind when they are home having dinner with their families almost every night and weekend and the hospital is still open for business.
If you want more information on how to improve your lifestyle, pick up a copy of my book “The Doctors Guide to Starting Your Practice Right,” and see what ideas you can use to transform your medical career. It applies to both the employed and the private practice doctor. If debt is stopping you from taking the time off you need then try “The Doctors Guide to Eliminating Debt,” and put yourself in a position where you will feel good about taking some needed time off. I think you deserve it.
