 "I
just snapped," recalls a 42-year-old family doctor who
works in a three-physician group in Ottawa. "I told
the receptionist to cancel the rest of the appointments
and then I just sat in an exam room and had a good cry.
I was thinking about quitting medicine." The tipping
point had come the day before when an overflow patient
load caused her to miss her son's little league pitching
debut. She vowed that never again would she take on
too much.
It dawned
on her that working hard and working smart have their
limits and that sometimes there just aren't enough hours
in a week. She realized too that keeping up with her
group partners would have to take back seat to her own
sanity.
All it took
to restore the spring in this doctor's step was five
fewer hours work per week — roughly 55 hours down
from 60 — plus actually eating during that 30-minute
lunch break that she always had — in theory —
but felt too guilty to take. She barely notices the
pay cut but she feels like she's a better doctor to
the patients she now sees and a better mother to boot.
KNOW
YOUR LIMITS
If you too think you're working yourself too hard ask
yourself the following questions:
- Am I getting angry or
resentful towards some patients?
- Do I often eat
on the run?
- Do I ever second-guess
the wisdom of choosing a medical career?
- Am I drinking more
than I'd like to?
- Have I become a
more cynical person than I'd care to be?
Answering
"yes" to any of those questions should set off alarm
bells in your mind.
TREATING
#1
If you decide that you are in fact overburdened it's
of utmost importance that you don't feel guilty scaling
back your workload. Remember: you're doing a disservice
to your family, your patients and even to a smaller
extent the nation when you're an unhappy physician.
Making your patients wait a wee while longer for appointments
is a small price to pay for scaling back on an onerous
workload. And if you still feel guilty — remember
that in our age of high worker mobility a number of
your patients are bound to move away in any given year,
so if you just keep your remaining patients on roster
the extended delay for appointments should correct itself
in no time.
The Ottawa
MD had another thing to be concerned about — her
practice partners' response to her decision to let up
a bit. Fortunately, her colleagues were very understanding.
She assured them that she wasn't being selfish, and
that her current schedule was truly unsustainable. Letting
partners know your motivation for reducing your workload
will go a long way towards defusing any tension or resentment
that could potentially crop up. Make sure you don't
have a cavalier attitude about it and reassure the other
doctors that you didn't come to this decision easily.
THE
MULTITASKING MYTH
In some cases, it's not the cumulative workload that
overwhelms doctors, it's the amount they try to do at
the same time. Multitasking is overrated. In a 2003
study published in the journal Neuroimage researchers
found that tackling two mental tasks at once diminishes
the brainpower available for either task. In the study,
subjects were asked to listen to speech and look at
two rotating objects at the same time. MRI scans indicated
that the brain activity allotted to listening dropped
a staggering 53% when subjects were trying to watch
something at the same time
FALSE
PROPHETS
Part of a pressure to do ever more in ever less time
comes from the supposed panacea of productivity —
technology. Doctors are constantly being pressured to
use PDAs, go paperless, switch over to an EHR. But it's
rare that the many failings of technology go reported.
Too often we fail to account for the downtime caused
by glitches, bad design and the training required to
use newfangled gadgets. As a rule of thumb, you should
never count on technology's promises that it will let
you do more in less time.
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PATIENTS & PRACTICE
