The doctor is out: How much vacation time do physicians need?

The practice of medicine is both time-consuming and mentally challenging. In the past few years, many stories of physician burnout have been in the news as well as articles on how ideas of work-life balance are changing. But is there any data to guide us to where the sweet spot of vacation really is?

Recent investigations have focused on the differences between on-the-job mental and physical stressors. There have also been discussions on how Gen X and Millennial workers focus on maintaining more boundaries on the job to the point that the workforce of physicians is making more demands of their employers.

Job flexibility and time off have played a bigger part in job negotiation in competitive areas with a shortage of physicians. Work-life balance is now not just a thing, it is THE thing on our new physicians’ minds while looking for a position.

COVID showed physicians the joy of extra time at home

Burnout among physicians has had a real impact on the health care workforce. COVID made changes in people’s professional lives—where they work, the method of communication, the hours of commuting, increased use of emails, etc. It made physicians question the need to work such long hours, as they were able to enjoy their families and home life more.

This led to what has been called in business “The Great Retirement,” which is the phenomena of medical professionals over 50 years old making a conscious choice to not go back to the demands of our profession.

The term FIRE (financially independent, retire early) is also used as an explanation of why we are having physician shortages compared to prior to COVID.

Vacation has long been considered just optional time off for many physicians. Now the focus is coming back around to self-care and taking time off as a way to stay mentally and physically healthy. One-fifth of all physicians surveyed in Medscape’s 2022 Physician Lifestyle & Happiness Report take five or more weeks of vacations each year, and 40% take three to four weeks annually.

Finding a healthy balance

Reasons to not take vacation included primarily financial constraints, but also workplace issues such as the inability to find replacements for our positions while we are gone. The reality of the situation is that we all must be replaceable, and health care organizations need to develop more resiliency in their staffing in order to maintain a healthy, engaged workforce. It is more cost-effective to create a happy workforce than recruit and rehire a health care professional.

Leaving for a week of vacation is hardly attractive when the price you pay is double the work when you return. As inflation looms and housing costs rise, physicians taking their PTO as pay sounds like a good strategy, but you may then pay the price via mental exhaustion.

When speaking to other physicians, the most common answer I received when I asked colleagues how much vacation we should take had some amusing comebacks—I really loved the answers, including “the patients told me I looked tired and needed a vacation,” “my office staff said that I was cranky all the time” and “you are always so frustrated.” 

Our families also complain that we don’t spend enough time with them. When our families go on vacation without us, you should think that they need you there as much as you need to go. These are some social clues that time away from the job is needed for you to decompress.

Physicians are affected by micro-trauma-induced PTSD from difficult patient care and career issues. Loss of empathy and feeling undervalued are the primary reasons physicians cited as ways to assess burnout—career coaches can help you work through these issues as well.

How physicians can recharge

According to a poll conducted by Insider, 13 vacation days per year seems to be a good amount of time off for most working Americans. When speaking with my colleagues, I found that most tend to take time off every two months. Many of these vacations include a mini/local staycation, with Friday to Monday off to allow for a local trip.

On a larger scale, it is recommended that you take the majority of a week off at least every six months in order to fully disengage, as it takes a day on either side to relax; two weekends with the intervening week gives you the most bang for your buck. When it comes to optimal time to recharge and relieve burnout, 33% of physicians believe that seven to nine days is best.

Working to live

When you plan to take time off, whether it be for a family trip, to explore new places or to visit family out of the country, it makes it easier to focus on work knowing you are working toward a reward and a life-enhancing experience. Choosing a holiday plan in advance makes it easier to see that vacation time is equitable.

It is not enough to work only for others. We must work for ourselves, and our non-monetary life goals as well. When we went to medical school, we had high hopes for our lives. As Henry David Thoreau said, “Go confidently in the direction of your dreams, and live the life which you have imagined.”

Take this advice and go live your life—your patients and family will appreciate it just as much as you will.

Related reading:

A candid approach to improving resident and physician mental health

Physician and medical student mental health update: Has the situation improved as the pandemic comes to an end?