So….it’s been almost TWO YEARS since I last posted. (No, I don’t count the intro blurb I wrote to Fiona Scott’s kind guest post more recently.) Part of me feels pretty bad about that. I enjoy writing immensely, but I have enjoyed even more hearing from readers who have chosen to share their own experiences, and being constantly reminded that as alone as physicians burnout feels, we are in (shockingly) good company.
But at the same time, there is a part of me that is admittedly quite pleased I haven’t posted, for the simple reason that I have been BUSY. And not busy-work busy, or toxic miserable crazy busy. I have been busy with really, really good and satisfying work that I am extremely passionate about. So at least I have a somewhat decent excuse for my lapse in blogging.
Lately, I have found myself perusing other blogs that focus on physician burnout. I’m not completely sure why, but I know that I have a definite sense of having escaped something, and I feel like in some way I need to remind myself of how bad things were, so that I don’t let the edges get fuzzy with the passage of time and become complacent about how good I have it now. One thing is for certain though: I am absolutely, positively convinced that my current happiness and job satisfaction have a tremendous amount to do with the fact that I work part time.
Now let’s be totally clear about one thing: the physical rules of the time-space continuum simply do not apply to those practicing in the medical field. I suspect there are other career paths that also suffer from this wormhole phenomena, but medical practice is the one I am intimately familiar with. It is very important to make the critical distinction between a part time contract, and part time work. Take my contract for example. On paper, I am contracted and paid for 60% of an FTE (Full Time Employment) position, which constitutes 5 clinical sessions a week plus one half day for “administration”. This amounts to 24 contract hours a week. In actuality, I work much, much more than that.
For one, my admin time (as I suspect is the case for most other practicing physicians) is a nice euphemism for “anything that is not direct clinical patient care”. This includes reviewing charts for my upcoming consultations for the week, teaching medical students and residents, chairing committees, writing and publishing articles, completing charts on my finished patient visits, answering barrages of emails, training, etc etc etc. Does that fit nicely into a 4 hour block every week? F**k no it absolutely does not. Then add on when patient care becomes more complex than predicted, and you have a setup for potential disaster.
Except that, until recently, I have never had an issue with the spillover for two reasons. One, I have built in buffer in that I don’t work 40 hours a week, so if I have a particularly demanding week, I have some wiggle room. Two, I simply ADORE what I do, and the people I work with. So when a week is hard, or long, or maybe even just sad, I can still step back and not lose sight of what an absolute privilege it is to hold the position that I do.
This was how things were chugging along anyway, until a few months ago.
I managed to catch whatever hellish upper respiratory infection was floating around, and I got sick. Like SSSSIIIIIIIIIICCCCCCCKKKKK. Like febrile and coughing so hard I thought my uterus was going to fall out on the floor. The kind of sick where I actually had to CANCEL THREE DAYS OF WORK.
Unfortunately, this also went down the week before I had already scheduled a makeup clinic for when I had been out of town at a conference. I didn’t really pay attention to this small fact when I rescheduled all my missed clinics from being out sick for the following week when I got back.
What this ended up translating to was a regular work week, with four full makeup clinics scheduled on top of it. Essentially, I had scheduled the equivalent of shoving 20 pounds of crap into a 10 pound bag.
And as you can imagine, it absolutely SUCKED.
My admin day was doubled since I had to chart review twice what I normally do in a week. I ended up staying until about 8 or 8:30 each night finishing my charts since I had seen twice my normal patient volume. For the first time in three years, I found myself at the end of the day feeling utterly sapped and not at all looking forward to coming back to work.
But the effects went beyond work. Absolutely nothing got done that week. NOTHING. No laundry, no food shopping, no workouts, zero. My husband and I ate out five nights in a row because there was simply no time or energy for anything else, and by the end of the week that wasn’t enjoyable either.
I don’t mean to be melodramatic. I totally survived the week. But that’s pretty much because it was one week, and I knew it wouldn’t last.
Most importantly, that week was looking an awful lot like the first job that I eventually walked away from. It was a great reminder of how I did not want my career, or my life, to look anymore.
My contract may say part time, but my work life is quite full. Physicians by the very nature of their mission are vulnerable to the threat of becoming “overfull”. And when we are unable to take care of ourselves, it becomes virtually impossible to take care of others.