When I was an OB/GYN intern, I made the mistake of admitting that I was able to get a short nap during my night shift. I was immediately met with comments that made it clear that rest during downtime was not something to be proud of. I felt so ashamed that once I became an attending, I was always afraid to admit when I had a relatively “easy” call shift because I didn’t want my colleagues to think I was lazy.
Over the years as an attending and after hundreds of hours coaching other physicians, I now realize that there are several things that doctors are trained to feel proud of and even brag about that are actually harming us. These things make it clear that we have been conditioned to believe that our value is directly related to how others perceive our work ethic and our productivity.
Exhaustion. Handling a tough call, long clinic days, taking weeks of back-up call are worn as a badge of honor to prove we work hard enough. Many physicians even feel guilty when we are well-rested or have free time during our days because these things can feel threatening if we believe that our worth is correlated with how many hours a day we spend working.
Being busy. If we aren’t busy, we worry that people might think we are lazy. Because of this fear, we don’t take breaks or allow ourselves downtime. Instead, we read more journals, volunteer for more committees, or tack on more research projects.
Time without a vacation. We don’t want to inconvenience our colleagues or abandon our patients, so we take less vacation time than we are allotted. We incorrectly believe this shows our dedication to medicine.
High patient volume. Physicians are taught to believe that the more patients we see, the more productive (and therefore valuable) we are. The toxic medical system encourages this with systems like RVU-dictated salaries and bonuses.
After years of conditioning through medical school and residency, we think that our ridiculous patient load, dangerous levels of exhaustion, and lack of true rest prove that we are “good doctors.” Beliefs like this are reinforced by our colleagues and work environments that take advantage of our compassion and the concern for our patients. Most physicians are left feeling like we can never do enough or give enough of ourselves to satisfy our employer or our patients.
Physicians who have truly created a sustainable medical career and enjoy their work are likely to be proud of things like:
- Spending quality time with fewer patients.
- Resting every day and using all vacation time.
- Not “catching up on work” during weekends or days off.
- Cutting back on their hours if they want to in order to enjoy life more.
- Getting a full night of sleep.
- Spending an entire day doing nothing.
Physicians who rebelliously pride themselves in these are the ones who don’t dread work, are confident in their skills and knowledge, are not held captive by their job, and get the best patient outcomes. More physicians must make this shift in order to combat the toxic medical system that abuses physicians across the country.
We think that our ridiculous patient load, dangerous levels of physical exhaustion, and lack of rest prove that we are “good doctors.” The more patients we see, the more productive (and therefore valuable) we are. The toxic medical system encourages this with systems like payment based on RVUs.
Kristin Yates is an obstetrics-gynecology physician.