Working in the healthcare industry is hard. Stress hits you in all levels. Burnout rates are high. Job satisfaction has slowly declined over the past 20 years due to a number of external factors beyond the practice of medicine.
Take, for instance, the daily work of an intensive care unit (ICU) nurse. Patients in the ICU are sick. Many of them die. The nurse is responsible for monitoring these patients for health changes. He is responsible for changing the bed sheets, cleaning ventilator tubing, cleaning the patient, and changing dressings. This job is physically demanding and tough on your feet, back, and arms. It is emotionally and psychologically draining due to the degree of illness you are surrounded by. It is demoralizing when you make mistakes or are yelled at. The fluorescent lights in the hospital are depressing. They do burnout. For the level of shit that nurses deal with, I am grateful that nurses are available to help us out.
However, nurses are almost always contracted on a hourly rate. A standard work week is 40 hours, which can consist of four 10-hour shifts. I have seen options for three 12-hours shifts per week. Yes, shifts can last longer than you expect due to sign-outs and ten-hour shifts can become 11 or even 12 hours. That is the reality of medicine. You want to deliver good care. If you were the patient, you would be thankful that your healthcare worker stays longer to make sure appropriate care is handed off.
Doctors Are Likely To Burnout Even More
The one perk of being an hourly worker is that if you end up taking additional shifts beyond your designated time, you can potentially receive overtime pay. That’s right. Time and a half. You might argue that cleaning up an incontinent patient’s shit is worth more than time and a half, but at least there is additional compensation. Some doctors are paid according to shifts like Hospitalists and Emergency Room Physicians, but they are unlikely to receive a higher hourly rate for extra shifts.
Most doctors are compensated by the amount of care they deliver. That is stratified by the number of patients they care for, and the acuity of the diseases treated. It doesn’t matter how long it takes a doctor to care of the patient; they still get paid the same amount.* With the evolution of the American healthcare system, doctors are compensated less while having to deal with ever increasing regulations that are often not even pertinent to healthcare. Sermo is a good reference forum for doctors to bitch about their problems. It is depressing to see what our profession now has to deal with.
In addition to decreasing compensation, doctors still have to deal with the usual stresses of the workplace. We deal with sick patients who sometimes die. We deal with family members and overbearing parents whose children are in the hospital. We deal with questionable lawyers who advertise on late night television who promise to sue doctors when modern medicine fails to prolong lives or cure all ailments.
Keeping a Sane Work Week May Be A Solution for Doctors
While financial independence may be the ultimate solution to eliminate physician burnout, restricting the number of hours you spend with work may be a temporary solution. One of the best advice I’ve received from several retired doctors was that keeping a four day workweek was one of the best lifestyle decisions they’ve made. Yes, some employers don’t allow this. You might not make as much money. Sometimes working less will prevent you from advancing your career.
But it can make you much happier. I recently experimented with taking one day off a week at the expense of a slightly lower income. I am much happier now. The typical day in the hospital is stressful. Patients, no matter how informed, have questions. Patients are sick. Some misinformed patients are hostile. It is amazing how many personalities exist, and no matter how nice you are, you will be verbally abused by unreasonable patients.
Having a four-day week gives me a break from those stresses. I can actually take care of chores at home and run errands. I avoid losing an hour of my life commuting to and from work. Again, I do have a lower income than the majority of my peers and nearly all of my colleagues in the same field, but I still have enough to sustain a reasonable lifestyle. It will likely take me longer to achieve my F-You Money stash, but it is a sane balance.
Do you cut back on your hours at work to allow for more time with your family? What has your experience been at work? Sound out below!
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*This is true for the most part, although some billing methods allow for doctors to bill for the amount of time spent to care for a patient to account for those complex cases that require additional discussion. I do find that time-based billing to be somewhat impractical since you end up having to spend a very long time before you can code for high level cases.
(Photo courtesy of Flickr)