Note: This post was written in 2012. We’ve written more content with new research since then, including the Software Needs Cycle for Medical: Must-Have Functionality for Small Practices.
It’s hard enough for any of us to consider taking a vacation in the current economic climate, let alone those of us responsible for the health of others. If you’re anything like the doctors I spoke with, you might actually be afraid to take a vacation.
So, how do you do it, especially if you work alone?
It comes down to facing up to the realities of the profession, doing some planning, and a certain amount of letting go. I spoke with several health professionals to understand what their struggles and solutions have been when planning time away from work.
1. Walk Before You Run
When you’re going solo, it can take a few years before you’re able to plan a big trip, but that doesn’t mean you can’t take a vacation. Instead of aiming for two weeks off, start small and perhaps give yourself a Friday off every other week.
Dr. Debra Jaliman, a New York City-based dermatologist and author of Skin Rules: Trade Secrets From a Top New York Dermatologist, didn’t take a vacation for the first two years after she set up her practice 27 years ago.
“If you’re afraid to take a whole week off because you’ll lose patients, you could take long weekends,” Dr. Jaliman says. “That’s a way you don’t really lose patients, I find, because they can get you during the week.”
2. Call in Reinforcements
You might be concerned that if you call in a covering physician, some patients will leave your care for theirs. There’s of course a chance of that, but don’t let that stop you. It will be better for all of your patients–not to mention your own well being–if you take time off and don’t get burned out.
As Dr. Jaliman explains, solo-practitioners need to “take their vacation, because you’re of no use to anybody if you overwork. I think you need to come back refreshed; it’s good to take time off.”
Dr. Jaliman leaves her full staff of 10 in the office when she’s vacationing, staying on call to back them up, with a registered covering physician as a last resort.
Dr. Travis Dierenfeldt is a GI doctor who lives in a small community in Kansas where he has solo-practiced for 12 years. He was able to vacation in his first year—but found himself fielding phone calls in airports.
His patients know when he goes on vacation–the office sends out a letter informing them ahead of time–and he has developed a kind of “informal cross-coverage” with the other GI specialist in town. (He concedes that this approach might not work as well in a larger community, however.) He also has a physician’s assistant, and the State of Kansas requires a registered covering doctor to be on record for his patients when he leaves.
Dr. Joshua Charles, a solo-practice chiropractor based in Toronto, is three years out of school and into his practice, and has only taken one vacation during that time. He hopes to hire a physician’s assistant as his practice grows, but in the meantime has two full-time receptionists in his office to field calls and schedule appointments while he’s away.
Choose the option that works best for your particular practice, your patients, and your personality.
3. Establish Boundaries with Patients
You’re either going to have to work to set boundaries with your patients or end up never being able to feel like you’re fully away from work. Implementing this rule will vary, depending on what branch of medicine you’re in and on your personality.
Dr. Jaliman admits that she has probably made herself too available to her patients:
“A lot of people have my cell phone number and they text me, they email me; people have access to me. I never really have a full vacation where I can say, ‘I’m totally away from it all.’ Even when I was having my daughter, people were calling me in labor. From the time I became a dermatologist, I’ve always had some interaction with my office or my practice or my patients.”
Dr. Dierenfeldt, in addition to informing his patients ahead of time about his vacations, chooses vacations that tend to render him unavailable–such as on cruise ships don’t get great wireless reception.
However as technology advances, there’s soon to be no place that you’re completely out of contact with the world. So with medicine as your calling you’ve got to decide: are you willing to be unavailable for someone’s inevitable emergency?
4. Plan for the Financial Impact
Dr. Charles took his first vacation this year: a 20-day trip to South America. But it did sting a little. As he explains:
“Because I’m in private practice I only get paid when I treat a patient, so I found that not only did I lose 20 days of potential earning income where I literally made $0, but I found that it was also slow one week before I left, and when I came back things were slow for about 5-10 days. So, really, my income was essentially decreased for about 30 days.”
When planning to take a trip, you need to factor in the cost of the trip, the loss in income while you’re away, the cost of paying your staff and ongoing practice expenses in your absence, and the chance of things being slow to pick up again once you return.
Until he hires assistants, Dr. Charles has a new strategy for future trips: long weekends. He plans to “take three days off, maybe add another two days and go somewhere not too far, versus taking 20 days off—that was really tough.”
5. Unplug Yourself
If you really want to get away from it all and relax, you’re going to have to be at least partially disconnected from technology when on vacation.
Dr. Dierenfeldt relates the story of a colleague who was “on his honeymoon on the beach in Australia answering his cell phone.” With his physician assistant and covering physician, Dr. Dierenfeldt feels more comfortable leaving for vacation with the family now than when he first started.
“I think it depends on your personality, on how much you’re able to let go. But for me, now that I’ve got a little bit of a backup when I’m gone, it’s made it easier,” Dr. Dierenfeldt says.
Create policies for yourself on how often and under what circumstances you’ll stay connected. For instance, you might commit to checking email and voicemail only in the mornings. Tell your staff or patients to text you only in the case of an emergency that you’ll be capable of addressing long-distance. Then turn off your phone, or leave it in the room.
And go have a drink on the beach.