During rounds, in between seeing patients, the medical student pulls out his phone and scans a dating app for new matches. In the team room, a resident opens Facebook before responding to a non-urgent page. Each of these instances may seem trivial enough, but I’ve seen both lead to poor evaluations, reprimands, or others whispering terms like “unprofessional.”
In the medical world, there’s an implicit understanding that while you’re at work, you should only engage in behavior that’s directly related to patient care or learning medicine. Using “work time” for anything besides these activities is not only considered a poor use of time but somehow just wrong. The idea of only using work time for work-related activity sounds good in theory, but the current model of medical training allows for 80-hour work weeks and 30-hour shifts without designated breaks. Waiting until you’re not on “work time” may, therefore, mean putting your outside life on hold for almost every waking minute.
Using time in the hospital for personal connections isn’t universally panned. I’ve often seen attending physicians stop bedside rounds to check in with their spouses. Part of why this is deemed acceptable is the deeply ingrained medical hierarchy, where those at the bottom of the totem pole must pledge unwavering interest and dedication to learning over everything else. Only those at the top of the totem pole are allowed to even approximate the normal desires and wants of a typical human. Only the attending physician can reasonably expect to take a call from outside of the hospital when others are present without getting grief or risking a poor evaluation.
There’s a clear paradox here. Everyone seeks well-rounded medical applicants with diverse extracurricular interests and strong relationships with friends and family. Of course, we want our doctors to have good people skills. Despite this, we dismiss or even punish attempts by trainees to maintain their connections to people outside the hospital.
For one reason or another, we tend to view time spent on a dating app or social media as less valuable than a phone call to a spouse. Yes, there are valid criticisms of social media and dating apps as time sinks, and too much use may be harmful in other ways. Still, these tools can also help people create and maintain meaningful relationships. More importantly, this may be the only way that medical trainees can retain some semblance of an outside life when they’re obligated to be in the hospital for nearly every moment of the day. For example, it can be nearly impossible to meet potential dates through traditional channels when you’re working 80+ hours a week.
The real issue here is simple: When medical trainees are living their lives in the hospital, they should be encouraged to tend to their outside relationships during their shifts, not in the little breaks they have to steal throughout the day. Application of this concept doesn’t have to cut into the quality of patient care. Designated time for personal activities like checking in with friends and family should be incorporated into the framework of the trainee’s day so as not to compromise workflow. Instead, our current model induces guilt when medical trainees must awkwardly excuse themselves to tend to something personal or furtively sneak contact with the outside world on a smartphone or computer screen. When 27 percent of medical students and 28 percent of medical residents suffer from symptoms of depression, interventions at maintaining their relationships are an investment, not a liability.
Yes, there is always something we could be doing for our patients or to improve our medical knowledge. But let’s not just assume that time spent on pursuits outside medicine is wasted. Certainly, I’m not suggesting we condone social media and dating app use in the hospital at the expense of patient care. However, if we want to retain any hope at producing sociable, relatable and emotionally sound physicians, we shouldn’t be so quick to judge hospital time spent on outside relationships as inferior or wasted.
Austin Perlmutter is an internal medicine physician.
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