Doctors still work while on vacation

Doctors still work while on vacation

Last week, I took a 6-day vacation.  Two days before and two days after, I put in a total of 32 unpaid hours of work which was cut short by a call from my daughter asking me why I am working during my time off.  While away with my family, I ran into people of different walks of life and noted that few understand what goes through the mind of a doctor when he or she takes time off.  Here’s a glimpse.

Doctors don’t take much time off.  We realize that disease and illness does not pay attention to our schedule, but our patients’.  I am now in my 18th year of practice and this is the second year that I am taking a week off at a time.  I work most weekends and holidays.

Doctors work while on vacation.  Because of the Internet and electronic health records, we steal time away from our family to connect and review labs, refill medications, answer emails while away.

Doctors put in hours alone in the office.  The workload doubles the week before and after the vacation.   So much work is done in the absence of patients on behalf of patients, such as reviewing lab results and discussing care with other consultants and writing letters to insurance companies to get necessary treatments approved.

Doctors pray a lot that patients don’t get sick. We are true patient advocates; we win when our patients win. When we are away, we pray that no one gets sick, so we can be there in their time of need.

Doctors feel guilty all the time.  We feel guilty that we have limited time for our patients.  We feel guilty that we don’t have time to attend to our growing children who will be at that special age only once.  We feel guilty that we forget anniversaries because we were too busy worrying about our patients.  We feel guilty that we cannot do more for our patients with difficult diagnoses or limited resources.  There is tremendous pressure from every angle that we impose on ourselves.  And, yet, we feel guilty for taking time off from our practices.

Doctors study during vacation time.  With the rapid development in medicine and science as well as the requirements of keeping up with continuing medical education and required board certifications, many doctors schedule their family vacations at the same time that they are attending conferences.

Doctors worry about costs of taking time off more than others.  There is the issue of paying someone to cover the practice.  The overhead continues to mount without incoming revenue, unlike other businesses.  And employees must be paid while we are off.

Doctors don’t know how to relax.  Knowing how to let go is an art most of us have not mastered. We are worry freaks.  We worry what if there is an emergency and I am not there?  What if a long term patient dies and I cannot be there for the last days?  What if an important fax comes in and I review it late?

Doctors are socially awkward and end abruptly.  We attend a party and spend half of it away from people on our phones, not buying and selling stocks, not trading, not even making any money — just trying to take care of the after hour calls from the hospitals and sick patients begging for help.  When we return to an unfinished conversation, we seem dazed, as part of us is still thinking what we could do for the patient that was on the phone, why the nurse could not understand our simple orders, which consultant we should call.  We carry this personality into our vacations.

Sorry, the hospital is calling.  I have to run.

Afshine Ash Emrani is a cardiologist and can be reached at Los Angeles Heart Specialists. This article originally appeared in the Jewish Journal.

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  • Lisa

    I find this article a bit irritating. All of my doctors go on vacations; they take time off for personal reasons. Their partners cover their patients or they hire another doctor to cover their patients. No one, even a doctor, irreplaceable.

    I went on vacation last week. I started preparing for the vacation a week before hand, working extra hours to make sure that I would meet my deadlines. I worked the Saturday before I left, writing detailed emails to the person who would be covering for me. While I was on vacation, I worried about the proposals she would be submitting and hopped things went smoothly. I will be working tomorrow to catch up.

    Like the articles on how doctors are being squeezed financially, my response is doctors are not unique, but are suffering from the same pressures that everyone else in the middle class is suffering from.

    The only relief for not working on vacation is to go somewhere with out cell phone coverage and to leave your portable computing devices at home.

    • Afshine Emrani MD FACC

      Wow irritated so easily…I recommend you take a vacatio from reading my irritating articles…lol

    • Sara Stein MD

      Sorry Lisa, this is well detailed example of what it is like to be a physician these days. The best I can tell you is that at times, your doctor was thinking about you while on semi-vacation.

      • Lisa

        Quite frankly, I doubt it.

        Here is a story about my first oncologist: He called me to give me some test results before he left on a vacation. Coincidentally, I had just gotten the results from a round of biopsies (very long involved story) and had been told by that I would need to have a mastectomy. As my oncologist had not ordered the MRI that led to the biopsy and further an additional diagnosis, I filled him in and said I would be seeing my surgeon soon. We talked a bit about the surgery and I mentioned that I was inclined to have a bilateral mastectomy, for symmetry. After a short silence, my oncologist confessed that he could not remember if I was large or small busted. At this point, I had seen him repeatedly, both before and after my initial surgery, and part of his routine during every visit was a breast exam. So, no I don’t think he would be thinking of me while on his vacation, except hopefully to be a bit embarrassed.

        • SarahJ89

          I agree that good coverage can allow anyone to relax and put work out of his/her mind.

          As for not remembering… my guess is he remembered you, but as we so often don’t connect names with faces, he didn’t connect the breasts with the person. He probably sees lots of them in a given day and if he’s really focused on them during an exam he might not be focused on you as a person at the same time. In fact, separating the person from the body part may well be a means of maintaining objectivity.

          • Lisa

            I had to laugh when my oncologist asked me that question. Since puberty, my defining physical characteristic was that I was very, very busty. I read my surgeons notes and believe me, he mentioned that fact (in medical terms of course).

            I think my oncologist had my chart in front of him and he reviewed it quickly before calling me. But I honestly think he didn’t remember who I was, at that moment. And I still don’t think he thought about me while he was on vacation, which was as it should be.

  • Reese

    “…why the nurse couldn’t understand our simple orders.” Nice. Perhaps your orders aren’t understood because you are on vacation and are distracted. Perhaps the orders lack clarity.

    I’m not sure what the point of this post was other than to portray doctors as martyred souls who can’t even take a week of vacation. Of course things are busy the week before and after your vacation; it’s no picnic for the staff who aren’t going on vacation and need to care for more patients before and after you’ve been away.

    Physicians aren’t the only ones who wind up doing work while on vacation. Business people do it, heck, even my nurse manager has had to deal with issues while she took time off.

    No one would dispute that doctors work hard, but they’re not the only profession to do so.

  • QQQ

    Physicians aren’t the only ones that bring their work on vacation! Last year I was doing more paperwork than I was enjoying myself on my time off! This is nothing out of the ordinary!

  • James O’Brien, M.D.

    I thought all doctors did was play endless rounds of golf while the world burns! Oh wait, that’s another job…

    • Ncmedic


      • James O’Brien, M.D.

        Raise your hands if you’ve had time to work in 183 rounds of golf in the past six years…

  • Lisa

    There are many places without cell phone coverage. We just got back from four days in the High Sierras. No cell phone, no news, no work; it was wonderful!

    I think GPS works in many places where there isn’t cell phone coverage, because it is satellite based. That said, I don’t rely on GPS, but paper maps. I don’t have to worry about the battery running low.

    • Eric Strong

      A GPS receiver should theoretically work anywhere in the world. When it seems to be getting bad signal, it’s typically a result of the immediate topography (i.e. you’re located in a deep canyon), rather than a result of being too far away from something.

      • Lisa

        I confess to being a luddite; I just haven’t felt the need to learn how to use a GPS.

        • SarahJ89

          Oh, I miss the free gas station maps of my youth. I much prefer maps.

          • Lisa

            I belong to AAA for the maps.

          • SarahJ89

            Du-uh. Forgot about them. Great mappage.

    • annette ciotti

      Here, here. I foolishly forgot to put the paper map in my shorts’ pocket on that one hike. I’ll never forget again.

  • Afshine Emrani MD FACC

    Amusing…why are the comments so bitter and hostile? This was not meant to be a commentary on othe professions but a simple sharing of some doctors life… many doctors and their families can identify.

    • DeceasedMD

      Now there’s a good question.

  • William Viner

    Doctors read and write blogs about doctor stuff when they should be either spending time with family or working.

  • buzzkillerjsmith

    Add to the list:

    Some doctors, like the alleged lady doctor in the photo, have ridiculously good posture.

    • SarahJ89

      I love the picture, don’t know why. It’s well composed, with a hint of absurdity.

  • Patient Kit

    LOL! Between this OP and the recent “Secret Lives of Doctors” piece, the next time I’m at the hospital for a checkup, I may find myself looking to see whether all the docs are carrying personal portable urinal bottles around with them. ;-)

    Seriously though….In general, I have a lot of respect for doctors and I think my personal doc is awesome. I’m sure a lot of this stuff in both these OPs is true about doctors’ lives. Some of the frustrated feedback on this piece is because a lot of it is true for non-docs too. The working on vacation, no time for lunch, working long hours, relentless push to do more with less to increase productivity and efficiency, the working harder and harder for less and less money, the missing kids’ birthdays and other milestone events — many Americans, both doctors and many others who are not doctors, are feeling those pressures. The frustrated reaction is coming from an accumulated sense from numerous OPs and comments on KMD that sometimes suggest that some doctors think they are unique and alone in this. You are not. We should all be able to empathize with each other about these kinds of things. There is really nothing to be gained by competing for who has it the worst. Everybody just wants acknowledgement that it’s the world many of us live in and we all need to vent about it sometimes.

    That said, I think there are some unique pressures on doctors. Some of it can’t be avoided. Some of it is beyond your control. But I think all of us, docs and non-docs, who may have some workaholic and martyr tendencies, need to step back, take a deep breath and change some of this stuff where we can. Definitely ditch the portable urinal bottles! Insist on taking time for bathroom breaks! ;-)

  • Sara Stein MD

    Yep. That’s exactly what it’s like. Thanks for explaining it so well.

  • Sara Stein MD

    This is my life. Thanks for explaining it so well.

  • Afshine Emrani MD FACC

    Thank you for your kind true words and understanding.

  • Dr. Cap

    There’s a tad too much wailing and gnashing of teeth here. And that’s coming from a surgeon. There is no upside for anyone involved in living this way!

    On a personal note, my first truly disconnected experience was on a cruise. No wifi anywhere to be found. The shakes eventually subsided and by day 6 I didn’t even access the hotspot at the last port. Nothing I could do about a darn thing at that point anyway. And I lived to tell the tale. Even better? So did everyone else. And my son will never forget it.

  • SarahJ89

    “I put in a total of 32 unpaid hours of work which was cut short by a
    call from my daughter asking me why I am working during my time off.”
    I’m a workaholic married to a workaholic. He “retired” in March, but has a private accounting practice. Plus, accountants are like Border collies–they can always find work to do.
    I suggest you pay close attention to your daughter. You might consider needle pointing the above quote onto a pillow as a reminder.
    It’s not a whole lot of fun trying to put the brakes on in retirement so don’t wait. At the moment we’re both working on limiting our work to M-F and forcing ourselves to take the weekends off entirely.
    Most doctors I know have some sort of coverage for when they’re gone. When we had a medical crisis the doctor covering for our regular PCP took the call. He was a huge, huge help. Your patients will be in good hands without you and fare much better when you come back fresh and rested.

  • EmilyAnon

    I had a doctor that signed on as a cruise doctor every year. I don’t know if he was paid, but he was able to take his family with him. That’s a nice way to combine work and vacation, for the family anyway. He said he mostly dealt with sea sickness.

    • Patient Kit

      That sounds like too much of a busman’s holiday to me and not a real break from work that a vacation should be.

      • Lisa

        Consistent with a lot of professions and academic disciplines though. Ever notice how many conferences are held in very nice locations? Work and play can be combined.

  • Afshine Emrani MD FACC

    Here is the original article and original photo- but I think KevinMD did a great job of picking anothere:)

  • Sherene

    “Doctors worry about the costs of taking time off more than others…” – I doubt that. All business owners have similar worries about the costs of taking time off. Most still have to pay employees and cover overhead costs when on vacation.

    Also had an issue with the condescending tone of why the nurse couldn’t understand your simple instructions. Maybe you don’t explain them well.

  • Afshine Emrani MD FACC

    There are topics that need to brought to the attention of the public as well as help us doctors cope with our challenges while we tend to our patients. Sometimes they seem like whining and other times callous, but as Chrisk Rock says “That’s right- someone’s gotta say it- it had to be said!” Thanks for reading and communicating. Another one I wrote was-

    Twenty-One Topics Your Doctor Doesn’t Want to Discuss with You!

    1. I just signed up for Obamacare. Can you write off the $2000 deductible? Can you accept insurance only?

    2. I did a Google search and I strongly disagree with your treatment.

    3. I subscribe to a letter that comes from Harvard which says Statins are poison. Can you read it and see if you will change your mind?

    4. My friend is visiting from Germany and does not have insurance. Can you order some tests for him under mine? And some antibiotics?

    5. My family hates doctors. We don’t take medicine. I’m here just for a checkup.

    6. My last doctor was a jerk. He would not refill my Valium without seeing me. That’s why I fired him.

    7. I don’t like the patients in your waiting room- too many foreigners.

    8. Can I get your cell phone number? I don’t like the answering service.

    9. My wife’s friend wanted me to ask you if the medication her doctor is prescribing for her has any bad side effects.

    10. Can I record our visit for my YouTube channel?

    11. Can I drop by once a month to pick up samples of my medications?

    12. Are the diplomas on the wall real?

    13. Sorry about my bad Yelp review. I was having a bad day. I really like you.

    14. I brought a couple of cousins with me. They just have a quick question each.

    15. Sorry if I smell like garlic. I just heard it’s good for you. What do you think?

    16. Hang on a minute. I am just updating my Facebook status. Can I request you?

    17. I don’t smoke too much. Just enough to keep my appetite low so I don’t gain weight.

    18. According to Dr. Oz…

  • Patient Kit

    Let me see if I’m understanding what you’re saying correctly: Are you an ED doc who has trouble getting in touch with your patients’ primary care docs after 6pm on a weekday? And on weekends?

  • Afshine Emrani MD FACC

    Six Thousand Shares!!!! I am now even more amused as all of those comments saying that this was nothing special…it obviously hit a chord!

  • Lisa

    Depends, I think….

  • Afshine Emrani MD FACC

    Wow- this one hit a chord with >8000 shares! Thanks. I wish other doctors would express their personal experiences!

    • Lisa

      How many of those shares are you generating? Just curious….

      • Afshine Emrani MD FACC

        Lisa- thank you for commenting. Each person gets a “share” but even a doctor on vacation does not have enough time to share 8600 times! Much love:)

  • Suzi Q 38

    I was fairly angry at a certain doctor who had made the unfortunate error of not listening to me. The result of such was that I worsened under his care. I had sent him not one, but TWO emails regarding my condition, plus asked his nurse if she sent my emails to him. She emailed me back and said “yes.”

    I figured that since he did not answer me, I was better off than I thought.
    After all, he was the doctor. I went ahead with our 31st Anniversary European vacation.

    Unfortunately, I overexerted myself while on vacation, and got so weak that I at times had to use a wheelchair. I had complaints of weakness in my legs, after my hysterectomy for about a year prior to my vacation.
    My hands and feet tingled and were numb. My lower back “burned”.

    You can probably guess what was wrong with me even though 5-6 specialists could not.

    Anyway, when the doctor I emailed initially finally called me with sadness and resignation in his voice, I yelled at him for two hours.

    At the end of it all, he said that he had a lot to think about that weekend.

    I reminded him that while it is hard to have a nice weekend after a “near miss” during a “perfect storm” of unfortunate medical events, try.

    Your kids deserve more.

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