Showing posts with label Work/Life Balance. Show all posts
Showing posts with label Work/Life Balance. Show all posts

Friday, February 21, 2025

Pajama time severance: How to leave work at work

The Apple TV+ series "Severance" follows Mark Scout, a man grieving the loss of his wife outside of the office and who is unaware he has a wife inside the office. The protagonist submits himself to a "severance" procedure, splitting himself into two people. When severed people enter the office, they have no memory of their life outside of work. However, when they are out of office, they have no memory of their 9-5 day.

It is difficult for physicians to leave work at the end of the day and not take it home. We have coined a term for this called pajama time. Pajama time is a term used to describe doctors working outside of regular hours, often at home. Pajama time includes completing EMR records, billing, and creating prior authorizations to obtain permission for patients' medications, tests, or procedures. These pajama-time tasks are uncompensated and may require 1-2 hours of work each evening.

The causes of pajama time include:
  • Administrative tasks may require doctors to complete these tasks outside of work hours.
  • Completing electronic health records (EHRs) at the end of the day.
  • Responding to emails and phone calls that can't done during office hours is done outside of work hours.
  • Staying current on reading journals and publications cannot be accomplished during work hours; it must be done outside of work hours.

Consequences of pajama time?
  • Pajama time can affect doctors' job satisfaction and impact patient care.
  • Pajama time contributes to physician burnout at epidemic proportions, impacting nearly 50% of all physicians.
  • Deterioration in patient satisfaction impacts our online reputation.
  • Pajama time can lead to doctors sacrificing personal and family time and deteriorating relationships with family and friends.

To successfully have severance and leave work at work and avoid bringing it home, focus on creating clear boundaries, establishing routines, and practicing self-care techniques.

1. Set clear boundaries:

  • Define work hours and stick to them, or at least make a commitment that when you leave the office, you will not work at home and will take only emergency calls or emails.
  • Try to start and end your workday at designated times and resist the urge to check emails or work outside these hours.
  • Communicate your boundaries: Let your colleagues know you're unavailable after work hours, and avoid taking work-related calls or responding to emails outside your designated work time.

2. Establish routines:

  • Create a closing ritual: Develop a routine to signal the end of your workday, such as tidying up your workspace, reviewing your to-do list, or planning for the next day.
  • Use your commute to transition: Utilize your commute time to mentally detach from work and shift your focus to personal activities or relaxation.
  • Schedule after-work activities: Plan enjoyable activities to look forward to after work, such as exercise, hobbies, or spending time with family and friends.

3. Practice Self-Care:

  • Prioritize exercise and relaxation: Incorporate physical activity and mindfulness techniques like meditation or yoga to manage stress and improve mental well-being.

4. Limit work-related discussions:Try to avoid work-related conversations at home.

5. Manage your stress:Practice mindfulness: 

  • Engage in mindfulness exercises to help you manage stress, reduce overthinking, and promote mental clarity.
  • Seek professional support: If you're struggling with work-related stress, consider seeking support from a therapist or life coach.

6. Consider an unplugged hour or, better yet, a day where you do not respond to cell phone\internet. Most of us are tethered to the Internet and iPhone seven days a week and even on vacation. We have become slaves of social media, Email, texting, and apps.

A solution to this enslavement is getting unplugged or having an "electronic" Sabbatical" when you are totally unplugged from the Internet, mobile phone, computer, iPad, and other electronic devices for just a few hours in the evening. After going without the computer umbilical cord in the evening, when you are free from the digital world, you will notice dramatic changes within yourself. You will think differently, act differently, and see things from a new perspective.

Bottom Line: It is not easy to be severed from our work when we go home at the end of the day. However, by implementing a few of these recommendations, you can effectively separate work from personal life, reduce stress, create a healthier work-life balance, and maybe use your pajama time for family and friends and have time to pour yourself a glass of wine and watch an episode of "Severance."
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Thursday, December 22, 2022

Falling back in love with medicine

“So, you want to be a doctor?” my pre-med preceptor asked, cocking an eyebrow. “My advice, kid? Don’t do it. Go to business school instead — anything else.” But I was 18, and like most teenagers, I knew better. “He’s just jaded,” I thought. “It won’t be like that for me.”



Thirty years and a global pandemic later, I find myself reflecting more than ever on that conversation. I feel privileged to be a physician, and I love my relationships with my patients (most of the time), but the daily aggravations often feel like death by a thousand paper cuts. And even though I’ve escaped much of the reimbursement rat race by converting to direct primary care, I still find myself frustrated daily by nonsensical demands, such as prior authorizations for generic medications and prolonged peer-to-peer phone calls to get necessary tests approved.



And, of course, add COVID-19 into the equation. Even before the pandemic, doctors were reporting high rates of burnout, with almost half making active plans to leave the profession. Tack on more than a year of full hospitals, social isolation and emotional angst, and some doctors have simply had enough.



But at our first in-person county medical society meeting in nearly two years, I found a balm for my jaded thinking, and it came straight from the Collier County Medical Society’s Physician of the Year, nephrologist, Mark Russo, M.D. His words of wisdom were just what I needed to hear.


Remember where you started



Before he became a physician, Russo started working at the bottom rung of the hospital system. “I was a patient transporter, nurses’ aide and psychiatric attendant, and one of my jobs was to walk around and light the patients’ cigarettes,” he said.



This made me think about my own days of volunteering in hospitals and clinics to boost my medical school application. I remember how excited I was when a nurse let me check a patient’s blood sugar—I even wrote about it my diary. That pre-med student would be thrilled to know she would one day not only routinely check blood sugars but help patients manage their diabetes.



Take a moment to consider who you were before you started medical school. What motivated you to want to become a physician? What did you write on your medical school application personal statement? Most likely, you talked about wanting to help, to heal and to make a difference in someone’s life. I bet you’re doing exactly that.

Take stock in how far we’ve come



Russo obtained a doctorate in molecular biology but found himself urged to attend medical school by his research mentor and discoverer of the Philadelphia chromosome, Peter C. Nowell, M.D.. Recollecting the early days of his medical career, he pointed out how much medicine has improved in the past 20 to 30 years. “Isn’t it great to be practicing medicine now?” he asked. “We have been blessed with improved treatments for cancers, hepatitis C, immunosuppressants [and] mRNA vaccines. We have better diagnostic tools.”

As a nephrologist, he is ecstatic about research on xenograft transplants. “We may even put dialysis out of business in our lifetime,” Russo said. This outlook resonated with me. Although we’ve struggled with COVID-19, the mRNA technology perfected to prevent the disease may change the trajectory of vaccines for many diseases and even cancer. Although it’s often automatic to think about the negatives when we are dealing with disease, practicing cognitive reframing to focus on how far we’ve come can change your outlook.


It’s not all about doctoring



As physicians, we truly do make a difference in the lives of our patients, but we make an impact in other ways, too. Russo talked about the three years he spent working as a wrestling coach before medical school, and he recalls this as one of his favorite jobs. “I was able to help kids become outstanding citizens in their respective communities by instilling the discipline they needed, and they still call or write me, thanking me for teaching them,” he said.



It’s easy to focus on our shortcomings. Instead, take a moment to think about all the people you have helped and inspired over the years. Maybe it was through your work as a doctor, but maybe it was just through a kind word or deed. Know that you make a positive impact on the lives of others every single day.



Oftentimes, just being there for someone is enough. “Sometimes we cannot cure or treat. All we may have is our human touch.” Russo said, noting that medicine has been moving away from touch over time. “It’s OK to hug. It’s OK to just hold their hand and comfort them.”


Focus on your friends and family



An entourage of family members accompanied Russo to celebrate his award, and his family’s pride truly touched me. “Mark is the smartest person I know,” his older brother said. “The kid always had his head in a book. I remember the rest of us had to be quiet because he was always studying for some kind of test.”



Rather than focusing on people who don’t matter, such as social media trolls or anonymous reviewers, let’s give our attention to the people who really matter. Remember that we all have our own cheering section of friends and family who want to see us succeed and will be proud of us no matter what.


Own yourself



“My entrepreneurial spirit began when I was around 13 years old,” Russo said. “Everyone in the neighborhood was getting an allowance of $2 to $3 per week, so I asked my dad if I could have an allowance, too. My dad thought about it for a while and finally answered, ‘Yes. I’ve decided I’m going to allow you to continue to live here.’”



So Russo started his own business with his friends, mowing lawns and making $20 to $30 per week. He continued his entrepreneurship as a physician, opening a solo practice, Naples Nephrology, in 2002. In 2007, he added a partner “who is like a sister to me.”



Russo encourages physicians to take a chance on self-ownership, and I couldn’t agree more. After 15 years of employment, opening my own practice was the best thing I ever did. I never thought I could run a business but having physician mentors like Russo helped me realize I could—and you can, too. Talk to colleagues who have opened practices or check your state medical society for resources. As Russo says, “Follow your dreams!”


Don’t be afraid to speak out



“During the pandemic, I was saddened to see mostly politicians speaking about the illness. I yearned to see more physicians,” Russo said. “Many of us answered the call and educated our citizens, leading us to have a strong response to [COVID-19], but when we tried to stand up and guide our leaders, we were pushed aside.” In addition, doctors who tried to speak up were harassed, heckled, and even threatened and abused, which I experienced firsthand when I attended county commissioner and school board meetings on behalf of our medical society.



“What I learned is that we need more voices. We need to be louder. We need to be tougher and stronger,” Russo said, offering to get out his wrestling whistle to motivate physicians. “We need to take back control. This is our lane. This is our automobile. We know how to drive it, not the politicians.”


Give back to your community



Russo reminds us that as physicians, we all trained at top-notch, highly competitive universities. “We bring special skills and experience from these tertiary centers into our own communities. We must continue to recruit new physicians to meet the needs of the community,” he said. Consider precepting medical students or residents and taking newer doctors under your wing to show them the ropes and provide support. Russo also challenges physicians to serve the community outside of medicine. Volunteer work has been shown to lead to improved physical and mental health, and also allows us to be a part of molding the community we want to live in. “If we don’t do it, someone less qualified will,” Russo said.


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Friday, July 15, 2022

Three keys to ease provider tension

Being a physician comes with certain baseline stressors. For most, the culprits are pretty familiar: patient care responsibilities, high debt loads that compel long working hours, system complexities, and mounting administrative chores. COVID-19 has added yet another layer to the burdens that already contribute to physician burnout.

As an emergency physician, walking into work every day for the last 12 months has felt like a roll of the dice. It’s been difficult to witness the effects of a disease that at times seems to affect people randomly. Despite what we know about COVID-19 risk factors, there are perplexing cases of severe disease with no apparent reasons. It’s a bit unsettling, especially given the realization that you may be putting yourself and others at risk.

Although we’re now, hopefully, turning the corner on COVID-19, many providers have endured significant mental health pressure trying to manage the pandemic’s challenges 24/7—both at work and home.


Whether the problem of physician burnout gets better or worse in the coming months will be driven largely by the provider community. The correlation between mental wellness, job satisfaction, and burnout has come to the forefront, but many physicians will tell you they don’t need wellness support. After all, we’re the ones trained to keep people well. That’s one reason practices sometimes see low engagement with programs designed to improve wellness.

In addition to wellness programs, another way for practices to reduce physician burnout is to lessen systemic stressors. In other words, to create a working environment where physicians are more likely to feel satisfied and less likely to burn out. While there’s not much practices can do about patient care responsibilities or debt loads, one powerful solution is to reduce administrative burdens and restore a degree of autonomy over physicians’ work/life balance.


Restore efficiency and balance


Taking care of patients is what gets physicians up in the morning, not dealing with complex technologies and administrative tasks. Over time, however, both have increasingly shifted onto physicians’ shoulders. Electronic health records (EHRs) and payment paperwork are just two examples. In many ways, tasks like those feel like death by a thousand paper cuts.

There are huge advantages to technology in healthcare, of course. But just like anything, if a tool isn’t used properly, it can do more damage than it does good. Technology must improve the functionality of physicians and practices without increasing physician workload.

The use of scribes is a good illustration. Scribes leverage technology in a way that makes it easier and faster for physicians to do what they love and were trained to do, without forcing them to sit in front of a keyboard.

Similarly, scheduling technology offers opportunities to help physicians achieve a better work/life balance. As noted in a recent perspective piece in The New England Journal of Medicine,
“…giving doctors flexibility in their schedule to allow for individual styles of practice and patient interaction was one of the few system solutions that reduced burnout. Flexibility in scheduling recognizes that both patients and doctors are individuals…”

Physician scheduling is a complex problem, with different wrinkles for different specialties. The right workload intensity varies from provider to provider; however, technology can be used to create fair and equitable schedules that honor physicians’ requests while maintaining parameters set by the practice and by each physician. The flexibility of such systems allows a more holistic approach to work/life balance than rigid, multi-week scheduling templates.

In fact, practices that use a single platform to optimize multiple resources—including clinical staff, non-clinical staff and room resources—can improve two important contributors to physician satisfaction: efficiency and balance. Providers able to efficiently move from room to room while at work can do more of what they enjoy—care for patients—with less frustration. Likewise, giving physicians the ability to easily view, accept, and trade shifts increases their efficiency while also allowing them to better balance time at work with time away.


Satisfy physicians, patients, and practices


It’s known that people who are happy and enjoy their jobs tend to do better at their jobs. Physicians are no different; we take better care of our patients when we’re in a better mood. Reducing burnout is the right thing to do to ensure physicians’ mental wellness and improve the quality of patient care.

Technology solutions can offer sizeable advantages for overcoming administrative burdens such as scheduling to reduce physician burnout. But technology must come with a caveat: that it makes processes better and doesn’t completely overburden physicians. Using technology to make it easier for physicians to feel a sense of autonomy over their work/life balance is one-way practices can make substantive strides toward easing provider tensions and reducing burnout.


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Wednesday, July 13, 2022

Balancing medical industry work with a healthy private life

Look, it’s an inescapable reality, feeling isolated in one’s private life. The often-time-consuming responsibilities that we face limit the amount of time we have to work on a healthy and fulfilling personal life. It is quite a common notion to think that a rich personal life is the price one has to pay to work in the healthcare industry.

It isn’t even just the physical hours you spend working, either. When one isn’t doing additional research within your field, you are most likely busy sorting out CPD revalidation. So, where can you start creating a meaningful private life in hopes of achieving an ideal work-life balance? These efforts will help you avoid having to overcome the turmoils of burnout.



Learn to switch off


You are very likely on call quite a lot, even when you are taking a personal day. Some things cannot be changed or avoided. Instead, your mindset becomes the most potent weapon in self-care. It would help if you mastered it.

In healthcare, we are dealing with people’s very wellbeing, and the stakes are often life or death scenarios. As a result, you will need to find ways to get your thoughts away from work and be present in your own life when you aren’t physically working. Just telling yourself to ‘relax’ may ironically cause more stress and anxiety. Our advice is to start practicing mindfulness meditation.


Set clear boundaries


Because other people won’t do it for you, in the medical fields, we frequently find that people seek out professional help and advice whenever we do have some time off from work. Random acquaintances will phone you at the most limited time to ask your opinion on a rash or some new medication they are thinking of taking. It would be best if you were firm, keeping in mind that your real patients suffer when you are exhausted.

If you are a physician, you should ask them to call you at the office and be sure to make it crystal clear that you will be charging for your time. Suppose you do not work in the traditional field of general practice. In that case, you are entitled and advised to tell anyone seeking medical advice that you are not permitted to offer a diagnosis or opinion.


Set personal goals


We understand and relate to the fact that time constraints limit your options. It is difficult to make plans too far in advance when it comes to any group activity, so one is usually bound to solo activities and hobbies. All the same, it is tremendously vital that you set some personal goals. You may not be able to do them all in one go, or practice whatever it might be every day, but putting in the effort when possible will help lend your life a sense of personal impetus.

Try to keep your hobbies to relaxing things to do. This doesn’t necessarily exclude stuff like going to the gym, but it is essential that whatever your interests may be, they do not become another source of stress.


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