The Importance of Time Away

I was tempted to write this month on the new legislation regarding prior authorization reform or on the obligation to treat patients who threaten physicians with physical violence. Then I remembered that this was the July editorial and decided to focus instead on physician wellness and the importance of taking some time off away from work to recharge, refocus, connect with friends and family outside of work, and focus on self-care. More on the other topics over the next few months.

I don’t think I am alone in fighting the urge to check email or the electronic health record (EHR) while on vacation or using vacation time to work on projects that don’t always fit into a busy work week. Many years ago, I wrote my Triological thesis while on vacation, a fact that I am a little embarrassed to admit now, but at the time it provided the quiet time needed when my kids were little. Life is about personal growth and finding out what works for you, after all.

Dr. Christine Sinsky and her co-authors write in their article (JAMA Netw Open. doi:10.1001/jamanetworkopen.2023.51635) that physicians often have a very developed sense of mission, making it very difficult for us to take time away. Physicians face the dilemma of feeling like they are burdening their partners or abandoning their patients when they are away. The authors surveyed more than 3,000 physicians and found that having three weeks or more of vacation a year and having full EHR coverage while on vacation significantly decreased burnout. Even 30 minutes of EHR use while on vacation increased the risks of burnout. Clinical coverage and financial concerns were other common causes of not taking a vacation among the physicians surveyed.

I am tremendously fortunate to have worked with the same physician assistant for the past 12 years, whom I trust to care for our patients when I am away. I know that when I am away, my patients are in very competent and compassionate hands. The value of this to me and my family is immeasurable, as it allows me to relax and be more present when away. I know that if she does need me, then she will call or text, and if she doesn’t, then all is well. Despite this, I still struggle with not checking my email a few times a day. We have all experienced how one email, even one that is not that urgent, can derail hours of being present.

Organizational systems that promote time away as a cultural norm and facilitate physicians being able to take time off with less guilt by having systems in place for EHR and clinical coverage go a long way in decreasing burnout. Additionally, small administrative changes, such as making call schedules, especially holiday schedules, many months in advance, decrease stress and allow faculty to plan time away. Leaders discussing the value of vacations and “email holidays” can shift the cultural mindset.

In her book The Joy of Strategy, Allison Rimm writes that happiness is fundamental and stresses the importance of having a strategy for life that aligns with what is most important to you. She also discusses the importance of building a reservoir of joy and how having this reservoir of joy helps us to be more resilient. We all find joy in different ways. I hope that this summer you find time to do the things that bring you joy.   

—Robin