Monday, March 9, 2015

Holiday Road

Last week, there was a mention over on Cartoon Guide to Becoming a Doctor about never telling patients that you're on vacation, always say you're at a conference. While it wasn't the main point of the post, it caught my eye.

I know a lot of doctors who do that. Hell, I think my Dad (a lawyer) used to do it, too.

But me? No. If I take a vacation, I have no issue with patients knowing. If they don't like it, or get upset when I'm out sick, they can eat rocks. Or, better yet, find another neurologist, one who (as Annie puts it) "can provide for your very special needs better than we can."

Here's my weekday schedule: Alarm goes off at 4:00 a.m., so I can begin hospital rounds and see new consults that came in overnight. I get to the office between 6 and 7 so I can review stuff that came in overnight, look at charts for people coming in that day, and finish up any dictations from the day before.

Starting at 8, I see patients straight through, finishing up around 5:00 p.m. Unless there's a drug rep bringing lunch I usually have a noon patient, too. Crammed into the gaps I'm reviewing test results, returning calls, dictating notes, and exchanging insults with Pissy and the staff.

Then I have another 1-2 hours of hospital stuff to go back for. EEG's to read, test results to check, patients to send home, new consults to see. Then I get to head home. So, by the end of an average week, I've logged 60-70 hours.

Weekends? If I'm not on call, it's relatively quiet. That's good, because I need the time to catch up on all the crap that got tossed on my home desk during the week I didn't get a chance to look at. But if I'm on call (once every 4 weekends) I'm pretty much stuck at the hospital. I'm required to be able to be there within 30 minutes if called urgently. Since I live about that far away, it's easier to just stay there and deal with the pile of consults as they come in, rather then try to return home to do anything but sleep.

I'm not looking for sympathy. I signed up for this. I'm not bragging, either. This is what I do. I have a family, staff, and patients who depend on me.

But after living like that, week in and week out, I never feel guilty about taking time off. Besides, I don't actually go to conferences. With my schedule the last thing I want to do with my free time is use it to hang out with other doctors.

I work pretty hard. Like most of my patients, I have a family and a life outside of my work. And if they don't like that, or have a need to think that I live for this shit 24/7, then they're welcome to find a doc who does. It isn't me.


Anonymous said...

I, for one, am glad you take vacations Dr. Grumpy; if only for the fodder the time off provides for future blogs!

McDuckGA said...

Amen, Brother! It happens on the veterinary end as well. I had a knee replacement a year ago, after putting it off for at least a year. Had a newly diagnosed Cushings dog, who we had just started on medication. When I told the owner that Dr. Other Associate would be doing the next ACTH Stim test since I would be out for a few weeks, she asked if we could move the test until I got back (No!) or if I could put off my surgery (Double No!)

bunkywise said...

I agree with you a billion percent. It took me a long time to realize that I DESERVE to take time off and I don't have to respond to every phone call, email or text while I am off. If we don't take care of ourselves, no one else will make much of an effort to do so. And you forgot to add in "maintain this incredibly humorous blog to the delight of my fans" in your list of things you do.

Anonymous said...

Where can I "like" this?

Hattie said...

Even the "retired" docs I know work hard. The one I know best works for piddling wages because he is the most experienced orthopedic surgeon around here and feels he has to be present at some surgeries. His "retirement" is what most of us would consider a full time job.

Anonymous said...

Frankly, and Mariely and Craigly, too, I'm surprised that you don't take more time off. I just covered two weeks for my boss, and after working two weeks straight, I'm ready for a 'straight' jacket.

clairesmum said...

Bravo, you are a wise Yak Herder! At the end of life no body ever talks about regretting not spending enough time at the office, no matter what job or profession they had.
Don't know the song..but the lyric lingers in my brain...
"It's a mighty short trip, from the cradle to the crypt, so you better get it while you can"

Anonymous said...

I don't care what you do, everyone needs a vacation.

Lauren Crum said...

I'm a pharmacist and I schedule rph vacation and time off for 13 stores in my district. Even though I send an email out that I am off I still get calls at random hours. I used to respond or forward the info on to the person covering. I have finally learned to just stop and enjoy my time off.

Anonymous said...

I've always said everyone should spend one...just ONE day shadowing a physician to understand what it is like to walk in his or her shoes. Oh, and I learned the hard way to never wear heels when shadowing. Running shoes might be more appropriate.

Candida Gomez said...

If anyone deserves their vacations, it's doctors. The people who get picky about that are probably the same ones who see a worker off the clock, out of uniform, and at another store, and still expect that specific person to help them right now.

Anne's as much fun as Mary. You have an awesome staff.

Anonymous said...

I was at one of my standard OB appointments and my Doc told me she was going to Hawaii with her kids for their spring break. I was excited for her (okay, living vicariously through her at that point) that we spent much of my visit gabbing about her impending trip! She then told me that she was taking her laptop so she could "keep up with test results and emails" and i told her NO WAY. I couldn't believe she felt like she had to spend her precious one week off in paradise WORKING!

I truly care about my OB, we've formed a great relationship and she delivered my two kids. I want her to take time off and be with her own kids! I can't believe patients would think their Dr's shouldn't go on vacation!

Anonymous said...

thank you for reminding me that med school really wasnt the best thing for me. dont get me wrong, i admire every single doctor who is badass enough to do it but holy moly.

Packer said...

The essential problem of the soloist, you don't work, you don't get paid. Which usually means, as it did for me long weeks, months, years few days off....sudden onset health issue. Many working Americans do not take their full allotment of time off.Shoulder to the wheel and all that. Heck even Hillary Clinton took her Blackberry when she travels.

Anonymous said...

Medicine is not for the lazy.

Anonymous said...

My dad is a doctor, and this reality of a doctor's life is exactly why I get pissed off at all the ignorant things that people assume about doctors. I was pretty young when I started responding to questions of "Are you going to be a doctor when you grow up?" With "Not a chance, I don't want to live like that."

I once was working as a cleaner on a ship and got flack when someone found out my dad was a doctor. All the rich/lazy stereotypes came out. I told him the hours my dad worked. How my mom had to hold it all together with him almost never around. That my dad always wanted to have dinner as a family and that meant most nights we ate at 11pm because the probability of a new case coming in, that couldn't wait an hour to avoid a day of fees was relatively low then. I told them about how my dad tried to come to all my performances, but often had to walk out of my concerts and recitals, even visits with his own friends. How there was never a plan (outside of vacation) that couldn't be interrupted. Then I told him and his buddies how much the family income was after malpractice insurance and office expenses. The guy realized he and his wive were making a comparable income (with out that stress). He treated me and my friends to lunch. He said he never felt so rich in his life.

RehabRN said...

Yippee! Glad you can do it.

I have ways to be connected, but I've just said no to my job when I'm off.

I leave a list of who to contact for what, and if it's an emergency, call 911 (because that's our official procedure anyway.)

Felt guilty when I forgot to turn on my out of office message, but there weren't that many messages, anyway.

med2 said...

Hi Dr. Grumpy,

I'm a med student (older) and I know medicine is going to be crazy. I also know I used to work full-time and have a second job on the side and would schedule my vacations at one so I could work at the other... Which meant I'd go back to the first one *more* tired. After a dozen years like that... I took a break.

And breaks are good.

The schedule you have outlined is not a very humane schedule. But it is your own practice! So the good AND bad news is that it's *up to you* to be a little kinder to *yourself* and give yourself a bit more time and enjoyment! Thank goodness you are not a working single mom going to McDonalds to clock in double shifts on the bus (just for perspective).

I know it is hard to change what is "working" but you are obvs upset about your current system. And you should be because it's not really fair to you. Maybe 20 minutes between hospital rounds and your own office--just time to chill out with the paper and a coffee--plus let's say the same at lunch--i.e. *take lunch*--plus INSISTING you be gone by 6 or 6:30 and then moving dinner a few hours earlier, with time to relax and finish dictations and so forth at home, after, once you are cozy--would give you more balance.

The upsetting fact is that you will NEVER get the huge massive thank-you that you deserve from other people. But you are obviously a very committed physician, and you obviously deserve one! So try and be that little voice that says thank-you to yourself. Do little nice things to make yourself happy.

Studies show that time off boosts productivity on the job; who knows, your patients might even prefer it... My heart just reached out and wanted to say that you know you deserve it, so please start creating it!

I am working on the same thing and I have A LOT to study but you know what if I spend my life in a race to get somewhere, the finish line is when I die. That's not what I want to be working towards. So I am insisting on a now, too.




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