{"id":1082,"date":"2017-07-20T20:21:44","date_gmt":"2017-07-20T20:21:44","guid":{"rendered":"http:\/\/blogs.nejm.org\/frontlines-clinical-medicine\/?p=1082"},"modified":"2017-07-20T20:21:44","modified_gmt":"2017-07-20T20:21:44","slug":"needing-vacation-vacation-primary-care-providers-feel","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/frontlines-clinical-medicine\/2017\/07\/20\/needing-vacation-vacation-primary-care-providers-feel\/","title":{"rendered":"Needing a Vacation after your Vacation?  Primary Care Providers Feel the Same!"},"content":{"rendered":"<div id=\"attachment_680\" style=\"width: 135px\" class=\"wp-caption alignright\"><a href=\"http:\/\/blogs.nejm.org\/frontlines-clinical-medicine\/wp-content\/uploads\/sites\/8\/2016\/08\/AU000_edonahue.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-680\" class=\"size-full wp-image-680\" src=\"http:\/\/blogs.nejm.org\/frontlines-clinical-medicine\/wp-content\/uploads\/sites\/8\/2016\/08\/AU000_edonahue.jpg\" alt=\"\" width=\"125\" height=\"150\" \/><\/a><p id=\"caption-attachment-680\" class=\"wp-caption-text\">Elizabeth Donahue, RN, MSN, NP-C, practices adult primary care medicine in Boston, MA.<\/p><\/div>\n<p>I just finished a week of vacation and, truth be told, I\u2019m seated at a bar on this particular Sunday night seriously considering early retirement. Small problem being, at the tender age of 34, it\u2019s probably a little too soon for this to be a feasible option. I\u2019m trying to figure out how to make retirement work because I\u2019m seated at this bar because of its excellent internet connectivity and not because of the attractive cocktail list. I have a salad and a glass of water and my laptop before me. I\u2019m checking messages, prescription requests, and lab results from the last week \u2014 preparing to return to work tomorrow, hoping to reduce the to-do list before I\u2019m physically back in action and actively adding to it.<\/p>\n<p>I know that I\u2019m not alone in this experience. A physician colleague returned from her own vacation about two weeks ago and since we she was in Europe (where she was less able to dock in remotely), she was completely overwhelmed on her first day back in the office. A full clinic day scheduled, with the backlog of messages and requests, and just one really sick patient to manage can leave even the most competent and experienced provider flummoxed. And all of this occurs despite having in-office coverage by a colleague for \u201curgent\u201d requests and likely several hours of advance work put in by the provider in the week before vacation. It\u2019s leading me to be a little more inquisitive about vacation practices in healthcare settings.<\/p>\n<div id=\"attachment_1085\" style=\"width: 310px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/blogs.nejm.org\/frontlines-clinical-medicine\/wp-content\/uploads\/sites\/8\/2017\/07\/lake-champlain_edonahue-vacation-photo.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-1085\" class=\"wp-image-1085 size-medium\" src=\"http:\/\/blogs.nejm.org\/frontlines-clinical-medicine\/wp-content\/uploads\/sites\/8\/2017\/07\/lake-champlain_edonahue-vacation-photo-300x225.jpg\" alt=\"\" width=\"300\" height=\"225\" srcset=\"https:\/\/blogs.nejm.org\/frontlines-clinical-medicine\/wp-content\/uploads\/sites\/8\/2017\/07\/lake-champlain_edonahue-vacation-photo-300x225.jpg 300w, https:\/\/blogs.nejm.org\/frontlines-clinical-medicine\/wp-content\/uploads\/sites\/8\/2017\/07\/lake-champlain_edonahue-vacation-photo-768x576.jpg 768w, https:\/\/blogs.nejm.org\/frontlines-clinical-medicine\/wp-content\/uploads\/sites\/8\/2017\/07\/lake-champlain_edonahue-vacation-photo-1024x768.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><p id=\"caption-attachment-1085\" class=\"wp-caption-text\">A photo from my recent vacation in Burlington, Vermont (Lake Champlain in background)<\/p><\/div>\n<p>How much vacation do most providers take? Are there specialties that find it easier to take a vacation than others (perhaps some that have less continuity of care burden)? What is the impact of all of the technology we have in 2017? Electronic health records make accessing messages and records outside the office quite easy, smartphones connect our work email instantly, almost unavoidably keeping us tied to work? Why do providers struggle with completely \u201csigning out,\u201d and are patients willing to accept that providers need time off too?<\/p>\n<p>A quick internet search shows that general vacation policies in the U.S. are widely varied. Ours is one of the only developed countries that does not have labor laws dictating that employers MUST provide paid vacation time to employees. Other developed countries are required to give employees an average of 2 to 4 weeks of vacation per year. Small U.S. employers are unlikely to give any paid vacation while other companies have recently begun to provide unlimited vacation time (most are startups and technology companies but this has also been seen with more traditional companies like Grant Thornton and General Electric). I\u2019m not sure unlimited vacation time would get any legs here in the healthcare industry! Like U.S. vacation policies and practices in general, those among healthcare providers also seem to vary; one survey in 2012 showed that anesthesiologists and radiologists reported taking nearly twice as much vacation time as their colleagues in family and internal medicine.<\/p>\n<div id=\"attachment_1087\" style=\"width: 310px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/blogs.nejm.org\/frontlines-clinical-medicine\/wp-content\/uploads\/sites\/8\/2017\/07\/wareham_edonahue-vacation-photo.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-1087\" class=\"size-medium wp-image-1087\" src=\"http:\/\/blogs.nejm.org\/frontlines-clinical-medicine\/wp-content\/uploads\/sites\/8\/2017\/07\/wareham_edonahue-vacation-photo-300x225.jpg\" alt=\"\" width=\"300\" height=\"225\" srcset=\"https:\/\/blogs.nejm.org\/frontlines-clinical-medicine\/wp-content\/uploads\/sites\/8\/2017\/07\/wareham_edonahue-vacation-photo-300x225.jpg 300w, https:\/\/blogs.nejm.org\/frontlines-clinical-medicine\/wp-content\/uploads\/sites\/8\/2017\/07\/wareham_edonahue-vacation-photo-768x576.jpg 768w, https:\/\/blogs.nejm.org\/frontlines-clinical-medicine\/wp-content\/uploads\/sites\/8\/2017\/07\/wareham_edonahue-vacation-photo-1024x768.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><p id=\"caption-attachment-1087\" class=\"wp-caption-text\">Wareham, MA<\/p><\/div>\n<p>How do you manage your vacation time? How often do you find yourself checking in when you\u2019re not in the office, and how do you support your colleagues when they are on vacation? I\u2019d love to hear about your experiences.<\/p>\n<p>All early (OK, <em>really<\/em> early) retirement dreams aside, I will likely work until the average primary care provider retirement age of 65. Until then (actually, until my next vacation), back to that to-do list!\u201d<\/p>\n<p>&nbsp;<\/p>\n<p><a href=\"https:\/\/secure.jwatch.org\/registerm?cpc=JWATCH&amp;promo=OJFOBLOG&amp;step=1\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-925\" src=\"https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2017\/03\/hivJWAd540x250.jpg\" alt=\"Register Now for more NEJM Journal Watch Content\" width=\"540\" height=\"250\" \/><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>I just finished a week of vacation and, truth be told, I\u2019m seated at a bar on this particular Sunday night seriously considering early retirement. Small problem being, at the tender age of 34, it\u2019s probably a little too soon for this to be a feasible option. I\u2019m trying to figure out how to make [&hellip;]<\/p>\n","protected":false},"author":1265,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[26,38],"tags":[426,313,425],"class_list":["post-1082","post","type-post","status-publish","format-standard","hentry","category-nurse-practitioner","category-work-life-balance","tag-primary-care-practice","tag-retirement","tag-vacation-policies"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/frontlines-clinical-medicine\/wp-json\/wp\/v2\/posts\/1082","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/frontlines-clinical-medicine\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/frontlines-clinical-medicine\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/frontlines-clinical-medicine\/wp-json\/wp\/v2\/users\/1265"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/frontlines-clinical-medicine\/wp-json\/wp\/v2\/comments?post=1082"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/frontlines-clinical-medicine\/wp-json\/wp\/v2\/posts\/1082\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/frontlines-clinical-medicine\/wp-json\/wp\/v2\/media?parent=1082"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/frontlines-clinical-medicine\/wp-json\/wp\/v2\/categories?post=1082"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/frontlines-clinical-medicine\/wp-json\/wp\/v2\/tags?post=1082"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}