Vacation Rx
“What I realize (and our patients will never know), what they don’t teach in medical school is how to really take a vacation.” Pam Lenkov, MD from her poem "Away Time" in her commentary “How to Take a Vacation.”
When is your next vacation? And the one after that? In our fast-paced professional world, we often find ourselves in a perpetual state of unending demands and “to do’s”, making the need for quality downtime not just a luxury, but a necessity for well-being and sanity. At the same time, many find it very challenging to do exactly that, often waiting until they “need” a vacation before scheduling one, if even then. Yet, if you wait to take a vacation until you “need it,” you’ve waited too long, because most of your vacation will be spent in “recovery” rather than “rejuvenation” or “renewal.” While recovery is sometimes required, prevention of the need for recovery is a much-preferred option.
Indeed, we clinicians are notorious for taking little if any vacation, and in many groups, the importance of taking regular vacation has not been role-modeled or encouraged. Our reasons for not doing so are many, and on the surface seem rational, including patient care commitments and our sense of dedication, staffing shortages, financial considerations, poorly coordinated coverage, the inability to truly unplug, and the dread of returning to all the work that has piled up while we were gone.
The challenge, however, is that numerous studies have shown that taking a vacation can have important and necessary physical and mental health benefits, including lower stress, a better outlook on life, and more motivation to achieve goals. Adding to that body of research is a recent study published in JAMA Open Network. The authors found that 60% of physicians who responded to a national survey took 3 or less weeks of vacation per year including 20% who took 1 week or less. Additionally, 70% of those who did get away worked on a typical vacation day. They concluded that taking more than 3 weeks of vacation per year and having full EHR inbox coverage while on vacation were associated with lower rates of burnout, whereas spending 30 minutes or longer per vacation day on patient-related work was associated with higher rates of burnout. This, of course, is not good news.
As a response in the health system where I work, our department has begun to provide centralized inbox coverage during vacations, focusing initially on smaller practices. For some colleagues, having this coverage has resulted in their first fully “unplugged” vacation of their career. And while the process is evolving and there are some glitches to be worked out, the stories of true rest, vital connection, and returning with a fresh perspective have been heartening. In talking with one of those “never unplugged before colleagues,” she shared, “That was incredible. I feel like a new person, and we’re like an entirely different family with me feeling a part of it rather than a perpetually distracted appendage.” For those of you who don’t have such coverage, consider having a “vacation buddy” who can cover for you and you for them. That’s what I’ve done for many years and still do (our central coverage does not yet cover my group).
So, back to my original questions: When’s your next vacation, and the one after that? If you already have them scheduled, kudos to you! If not, there’s no better time than now to add “taking regular extended time for rest, restoration, recreation, and relationships” to your professional toolkit. And by making plans now, you can leave plenty of time to be more intentional about schedules and coverage. Remember, based on the data, taking at least 3 weeks of vacation this year is not simply an important break from your responsibilities but is also an integral part of your professional commitment to health - both your patients' and your own. And if anyone asks, just tell them it was doctor’s orders … then ask them when their next vacation is ….