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When a Vacation is not a Vacation
July 27, 2008
Here’s an observation: most physicians in private practice don’t take enough vacations. I am often (rightly) accused of this sin. My staff, colleagues, and even patients regularly encourage me to take time off; but still I find it hard.
Why is this? Is it that I love my job so much that I can’t tear myself away from it? Is it that my self-worth is wrapped up in being “the man” for my patients, and being away from this makes me feel insecure? Is work my addiction - the one place that I have control of my circumstances and positive reinforcement?
Perhaps.
But I think the reasons are more basic than that.
- Not only don’t I get paid on my time off, I actually lose money.
- Coming home to a pile of work almost makes it not worth taking the time off.
If you are the main source of your income, then there is no such thing as a paid vacation. When you are not in the office, you are not generating revenue. This does not mean you don’t take time off, but it does mean that any time you take away from the office comes at a cost. You have to balance your income with your need to take time off. It is natural, then, to err on the side of work.
Plus, when you are off your overhead does not stop. Your staff still needs to be paid, your bills continue coming in, and your rent does not stop. With the nature of most businesses requiring you to “zero out” the income at the end of the year (to avoid taxes), it is difficult to put money away for this.
Then there is the issue of coming back. The number of things on your desk when you get home can be astonishing, including:
Phone calls from patients while you were away.- Labs and tests you ordered that need to be reviewed.
- Forms patients need to have filled out.
- Consults and other phone calls.
- Crises that have occurred in your office among staff/patients.
There is one more thing: when you have taken time off, you usually owe other physicians for covering for you. You are usually on call and spending extra time in the hospital and/or office.
What’s the point? I guess I am just answering those who suggest that I should take more time off. Yes, I feel guilty that I am not taking more, but the price I end up paying (both financial and non-financial) makes it hard.
I guess I am just griping.
Poor me.
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Posted in Being a Doctor, Personal Musings
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July 27th, 2008 at 7:04 pm
Amen! People who are not physicians do not understand this concept. It’s not like we are managing a Wal-Mart and are able to take PTO. Likewise, it’s not like Donald Trump (who really probably doesn’t take much time off either) who has people who continue to run the business while he’s gone.
As physicians, we are our own commodity.
July 27th, 2008 at 7:07 pm
No, I don’t think you’re just griping. You make a lot of valid points, especially about how much work is waiting for you once you get back. Most of the doctors I’ve worked with have no concept of vacation or leisure time.
July 28th, 2008 at 8:11 am
That’s NOT gripping, that’s your reality. It’s awful that those who need the break the most, can’t get it. When they do get one, it takes time to even come down from the day to day time constraints. By the time you could start to unwind, you probably begin to think about what is piling up, because it’s nearing time to go back. I can certainly understand how a vacation ends up not being the vacation you need at all. When you have to start back into something loaded with demands the instant you walk in the door. I’d think twice about trying to go away too. You all need to be rescued periodically. Having a sanctuary is a must.
July 28th, 2008 at 10:35 am
I don’t have most of these issues, but have enough classes in accounts to know they’re mostly right (or relate to US tax law).
That said, I’d have thought that your main problem was that you care too much about your staff and patients!
July 28th, 2008 at 10:36 am
Oh and hey, kewel flags, but I want it noted now that I’m not in distress!
July 28th, 2008 at 10:38 am
Nope Ken, caring doesn’t factor into it. I care, but know I need to relax as well to function at my best level. I know I need to take time away, but it is just very hard to do and really feel refreshed. I am still trying to figure out how to do it.
July 28th, 2008 at 12:54 pm
It’s a very valid gripe about a real problem with no easy solution. Many self-employed businesspeople face similar issues.
Is there any way to incorporate smaller chunks of relaxation in your daily/weekly/monthly routine? Smaller, regularly-spaced chunks of time might reduce the ‘impact upon re-entry’ you’d suffer.
I dunno. Just thinking out loud.
July 28th, 2008 at 2:09 pm
I have the same problem with my dental practice.
I take four day weekends. I find that that is the best compromise that I can come up with.
That’s why I can’t see myself retiring. If I didn’t have a place to go with my name on the door, I would descend into a state of nothingness.
Hang in there, you’re making a tremendous contribution. Lord knows we need as much of that as possible.
July 29th, 2008 at 5:36 am
You’re singing my song, Dude.