Having boundaries and work-life integration can be elusive, especially for physicians. Thinking about work when not at work or falling prey to the idea that some things are a waste of time… thoughts like these are all too common. However, there is a truth that revolves around needing time to be restored. Without it, you aren’t able to present your best self to the world.
For many of us, I believe the issue isn’t as much in making time to get away but the difficulty in actually getting away. That is, being able to remove yourself, to unplug not just physically from work but emotionally and mentalIy. Without this ability, we can find ourselves with time off but unable to relax into it. That’s why, as odd as it may sound, we need to intentionally learn how to enjoy time off work.
“If you look at nature, you look at the human body – rest and having sort of a restorative time is a critical component of how life thrives and how life is sustained.” – Dr. Sara Dill
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I’m Dr. Sara Dill, and this is the Stress-Less Physician Podcast, episode number 17. Welcome to the Stress-Less Physician podcast. I’m your host, Dr. Sara Dill, MD. Using my unique combination of coaching and mindfulness tools, I will teach you practical ways to reduce your stress level, feel happier at work, and create a better balance between your medical career and personal life. If you are a busy practicing physician who wants to design a life and medical career that feel good to you, you are in the right place.
Hey everyone, so good to talk to you. It actually feels like it’s been a while. And I guess that’s probably because it has been for me, at least. I recorded a few podcasts in advance because I was taking vacation. And I actually just got back from vacation. And that’s why I wanted to do this podcast episode, which is really on “How to Enjoy Time off More.” It sounds silly sometimes, but it’s something that when I talk to other physicians, we all get it.
In general, as a group, I would say that we are not always the best at taking time off at resting, and enjoying vacations, weekends, evenings off, without work showing up, without work working its way into it. In general, just to generalize, I think that physicians are often not that good at having boundaries, with work versus the rest of their life. I coach a lot of doctors on work-life balance or just work-life integration. But how do you keep work at work and enjoy your work. But part of that is also about encouraging and enjoying time off from work.trip out of the country since:
So, I just wanted to start by talking about this concept that we have of rest, of time off, of downtime. And maybe that looks like nights off or weekends off depending on how you work. Perhaps you work part time, vacation time, all sorts of ways that we structure our non-work life. And it doesn’t mean that that time isn’t full of other people, perhaps other obligations. And yet, how much time do you spend not working? And just notice if you spend a lot of time even when you’re not at work, thinking about work. This is super common. So, again, I really want this podcast episode to go over how we can start to enjoy our time off more, if that’s something you’re not particularly good at. And that might include enjoying weekends, vacations, evening time, and really getting better about structuring your work life and the rest of your life.
So, how do you spend your free time? Are you someone who worries about wasting time? And what is wasting time mean to you? How do you know if you’re wasting time? That’s an interesting question. What is wasting time? Is it actually even possible to waste time? That might be a question to ask yourself? Are you someone who likes to be busy? Do you like to be busy all the time? Or are you someone who likes to have downtime? Are you good with free time? Is that a strength of yours? Are you someone who considers not being productive, the same thing as being lazy? Is being lazy a bad thing? Why or why not? These are questions you can start to notice.
So, let’s talk about how you can start to enjoy vacation time or weekends more or just generally enjoy time off from work. How do you enjoy not working all the time? And maybe even just how to stop thinking about work when you aren’t at work. So, time off, whether it’s a little bit or a lot, brief or long, regular, or comes in bursts, really can be restorative and essential to one’s mental and physical wellbeing. If you can manage your mind and actually allow yourself to be restored, I don’t know how many of us have taken a vacation and it doesn’t really feel like a vacation. You might mentally be at work or worrying about things, and missing out on your vacation while you’re still on vacation. Sometimes it takes a few days to sort of settle into vacation mode.
Doing this work ahead of time and practicing, enjoying time off and being able to sort of turn off your work brain will let you not waste those days of vacation settling into vacation mode. I would even encourage you to wonder if it’s possible to have vacation mode, even when you’re not always on vacation, to not be thinking about work or in that work mode when you aren’t working. So, if this describes you, someone who has a hard time turning their mind off thinking about work a lot, taking a vacation only to spend a lot of it thinking about work, worrying about work, or being otherwise distracted until you realize that you’re actually missing out on your vacation. This is something to start practicing now.
So, again, I actually recommend practicing and join time off in small doses all the time, maybe daily, or at least weekly, rather than waiting for a big vacation, or a bigger chunk of time off. Small things, small habits practiced often will typically help rewire the brain more than the occasional big gesture, I find this is true of most habits.
So, how to start enjoying time off and how to maybe take more of it, or why you aren’t taking more of it. So, the first step, or the first thing to look at is to check in with whether you need to disassociate your self-worth with how productive you are or how hard you work. So, what are your thoughts about work and productivity? Are you someone who has this unconscious or subconscious, I would say cultural belief in the moral value of hard work? That somehow working hard and being productive, is innately virtuous, or that it makes us a good person. That somehow our self-worth and our value as a person is dependent in any way on how productive we are, how hard we work, how much good we do in the world, how much we sacrifice, any of that. I would start by saying that in my experience, this can very much drive our tendency to indulge in overworking. And when you add this very pervasive cultural, puritanical value set, and that also comes from our traditions of capitalism as well.
So, when you add that to our medical training, and the emphasis there on putting patients first on, always being available, never asking to go home, being a good part of the team. Add that to the fact as well that most of us who are attracted to medicine, really feel this deep, strong desire to be of service and to help others. And to in some sense, even try to help the world. You can see why so many of us have a hard time not overworking. We have this hard work idea that somehow makes us a good person, a valuable person, a moral person. And we have all of this training and indoctrination into why that’s also critical as a physician.t work with swine flu back in:
And of course, then we had new rules and a new understanding that working sick was no longer acceptable, or something to be pursued. And so it’s been so interesting to watch that shift. But I still think and especially during COVID, with people out sick and understaffing, those of us who are seeing patients have really been asked to work more and work harder and work longer. And it requires a lot of us to be able to say, no, if we need to do that for our own health and our own well-being.
And I want to be clear here that I’m not saying that you can’t enjoy working hard. I love the feeling of working hard and being very efficient with my time, with seeing a lot of patients and taking good care of them and accomplishing a lot and being productive. I think it’s an amazing feeling and I love it. I also coach a lot of my clients on how to be more efficient, and more productive with the time that they work, how to close charts efficiently, how to get work done. But I don’t associate my worth or value as a person with how hard I work any longer.
I certainly did that, although I would say it was maybe a little bit more unconscious, it wasn’t necessarily something that was a big thing in my family, although I certainly have a lot of coaching clients, and friends who come from families where hard work is really seen as a moral imperative. But these days, although I like being efficient and getting a lot done, I also don’t have that association with it making me a better person, or somehow in alignment at all with morality or virtue. Or conversely, that somehow my worth or value is decreased by taking time off or not working as much as someone else. So, you can look at whether you have any of those beliefs, because those are going to drive you to really emphasize work at the expense of perhaps other areas in your life that are important to you, or over emphasize work at the expense of your mental and physical well-being.
Another thing to look at if you want to get better at enjoying time off, whether that’s evenings or vacation time, or weekends, and not bringing work into those other times when you aren’t at work and aren’t needing to work is to stop people pleasing. So, it’s really imperative to stop caring so much about what other people are thinking or doing or wanting you to do. So, you can ask yourself, are you someone who worries a lot about what patients or maybe your boss or your chairperson, or your colleagues think of you or what they will think of you if you don’t pick up an extra shift, or you don’t take as much call? Or you don’t check in on your days off or your time off? Or your vacation time?
Do you compare yourself to other people, to your colleagues, or to friends in medicine, and their work hours and work ethic? It’s important to run your own race to compare yourself to you, not to other people. And also you can notice, do you tend to catastrophize or go to worst case scenario of the result of taking time off or maybe not always being available for work or for extra work? For not being the person that responds first, to a text message or to an email or to a patient phone call even. Does your brain go to worst case scenario about losing your job or not being considered a team player or any of that? That whole tendency to worry more about what other people think about us and to please them at our own expense can also make it very difficult to enjoy time off and to overwork, bring work home and have a hard time saying no to additional work.
The next thing I want to talk about too is that really, and this can be a little bit hard, because we are used to thinking it about this way, but is to take 100% responsibility for how much you are choosing to work. I hear it a lot, that, “I have to work, or I can’t work part time or I can’t take vacation.” And then a whole variety of reasons that we think that’s true. And I’m not saying there are not consequences, or ramifications of working part time, or taking vacation, or deciding not to check in on charts when you aren’t at work. But it is a choice, we are able to make those decisions, we might need to solve for potential problems.
So, for example, if you’re in the habit of checking in on charts and callbacks, and to-do’s on days, you aren’t in clinic, you may need to have a conversation with colleagues, or with nursing staff or with patients, or something to set an expectation about timeliness of returns or whether someone else needs to be on call, or whoever that is. I’m not saying we live in a vacuum at all, but taking 100% responsibility for your choice on bringing work home, or being mentally present at work when you’re home. And of course, the first step is always to build awareness. So, we need that awareness, muscle that attention so that when you start noticing that your thoughts are drifting to work or thinking about that patient encounter or anything like that, we can interrupt that pattern, and redirect.
So, here I would just notice, if you often tell yourself that you have to write that you have to work weekends, or you have to work nights or you have to take call, I would question all of that, if that’s something you don’t want to do. I would also notice what you think about again, doing nothing, or not being productive. Do you think that not working somehow equals being lazy, being unproductive or wasting time? Those are some thoughts to clean up. That’s a little bit of mind management that needs to happen because otherwise, it’s going to be very difficult to be in your own integrity.
And then the fourth thing I’ll mention is that you might notice that one reason we often spend a lot of time at work, thinking about work, checking in on work, or bringing work home, is whether you are good company to yourself. Do you enjoy spending time with you? Is your mind in your own company, something that is pleasant for you? Or do you work and stay busy, because you don’t like being alone with yourself, with your thoughts or your inner dialogue, your inner self talk and with your own brain? There’s a quote from a writer that I like, Anne Lamont, she has a quote that says, “My mind is a bad neighborhood that I try not to go into alone.” And I love that because sometimes it is a bad neighborhood.
That’s one thing that we work on in coaching all the time, is to go in there with someone else, sometimes like a coach or therapist or a friend, so you can start to notice, is your mind a bad neighborhood that you don’t want to go into alone? Or can you start to explore it? Maybe you can gentrify your own mind, so, that it becomes a pleasant neighborhood, a neighborhood you want to go hang out in. It is so important. I would also argue that we all need time off and rest. I think as physicians, we know this, right? We talk to patients about this. We understand this intellectually. But having time off and rest and the ability to recharge, and restore will actually make you a better doctor. It actually makes you more productive in the end, more efficient. And it will create a more sustainable career in life when you have time off and you enjoy that time off. Whether that looks like just downtime during the week, or taking vacation time, or whatever that looks like.
I think it’s also clear there’s more to life than work. Even for those of us who are passionate and love what we do. There’s so much more out there to explore. I often work with people who maybe over identify with their career and their work and then when they cut back or they retire or anything like that. It becomes very much a crisis of identity. So, you’re a physician, yes. And you might be a wife, a mother, a spouse, you might be a daughter, a sister and you’re just your own person.
You might be someone who enjoys taking walks or playing tennis or reading. Can you flesh out your full self, and make sure that you have the bandwidth and the time and the space to enjoy, not only work but the rest of your life. And also, we can’t function at max capacity all the time. We can’t be 100% productive, work, work, work, getting stuff done all the time, the opposite is also true. Trying to be at 100% all the time, in my opinion, often leads to burnout, to injury, to mistakes, to career and to life dissatisfaction. If you look at nature, look at the human body rest and having a restorative time is a critical component of how life thrives and how life is sustained. I would say the same is true for us.
So, let’s talk about how to start enjoying time off, if this is something that is challenging for you. So, the first thing to do is to start small. So, I would say be intentional and do one thing at a time, when you are sort of enjoying downtime. So, perhaps tonight or this weekend, decide to take some time off from your to do list or from checking email or doing charts, or staying busy. Maybe pick an hour, two hours or half a day, maybe pick a whole day. And I want you to come up with a mental list of things you can do. I would suggest things like taking a walk outside. And when you take a walk outside, don’t listen to an audiobook, don’t listen to a podcast, don’t do anything else, but take a walk and look around you.
Maybe you could take a walk with another person, right like a friend or your partner, talk to them. But I don’t want you to be multitasking. The point of this is to do something in a way where your attention and awareness is on what you’re doing. So, many of us are constantly trying to avoid being bored. Or being restless, we’re multitasking, we’re getting stuff done. That’s the opposite of learning how to enjoy downtime, or enjoy our time off. Maybe you want to watch Netflix or TV or watch a movie or a show. It’s totally fine. I love doing that. But can you do it without also being on your phone or email or Facebook or posting or all of those? If you’re going to do that, just do that. Just watch a movie, or a show.
Or maybe read a book. But again, just read the book. Don’t be also on your phone or checking email. Maybe put your phone in another room. Or you can garden or sit outside. Maybe hang out with a friend or your children are a pet. Can you do it without multitasking? Can you do it without your phone? Practice doing whatever you’re doing and being aware of it. Try to learn to inhabit the moment fully and appreciate it. And maybe notice your thoughts, notice if your thoughts wander towards work, and worry or thoughts about what you should be doing or if you’re feeling that you’re lazy or how unproductive you are or have so much to do.
Those are the thoughts that will constantly steal your enjoyment of time off, whether it’s an evening off, a weekend off or vacation time. This is going to give you an idea of where you need to start managing your mind. I have the thought that downtime is critical. It’s so important to not be working all the time. I 100% believe that.
And Step two, decide in advance whether you want to do some work at night or on the weekends or on vacation. So, sort of plan in advance. And if you don’t want to bring work home, set the intention. Be very specific about not checking work email, not responding to texts, not doing charts, not checking in on your To-do list or callbacks, or whatever it is however it is that work intrudes on your time off. However, you may decide that you do want to do a little work on some nights or weekends or even on vacation.
And if you’d like your reasons for it, always check in with your reasons. I would also say decide in advance how much and how long and what that might look like. Set some boundaries for yourself around how available you want to be in advance and practice only working during those times and however you decided to. So, that might look like spending half an hour on labs or charts on a weekend. Or maybe checking in on labs or urgent patient messages on days you aren’t in practice or not. I would definitely give yourself permission to consider not checking it, to consider also deciding to honor your time off, if it’s important to you and not check in with work and structure that in advance, make sure patients are taken care of and urgent things will be addressed. But how can they be addressed without you being the one to do it?
I would also say it’s equally important to not spend a lot of your mental time on work when you’re not physically at work. So, how often do you start thinking about work in the morning, maybe in the shower, when you’re still at home or maybe drinking coffee? Do you ever get on your email before you’re even fully awake? Is that a habit that you want to continue to do? Notice how work bleeds into a lot of your time not at work. That’s often where we lose a lot of that restorative nature of non-work time. So, is that something you want to continue or would you like to limit work, both mental and physical, to your work hours? So, you get to decide.
I’m not saying that your brain won’t keep trying to bring you back to thoughts about work or worries of work, or thoughts about patients etc. it happens. The key is to be aware and to redirect your brain, if you’ve decided that you don’t want to bring work home, both physical work and mental work. So, as soon as I start noticing that I’m thinking about work, I just redirect my mind, I remind myself, “No, I’m not at work, I don’t need to think about that. That’s not something that needs to get done right now.”
So, this really is a skill set, you can practice and get better at. I will say having just had two and a half weeks of vacation, I feel like such a different person in such an amazing way, I really needed this, it was definitely something overdue. And I would encourage you to check in with whether you need some vacation time, whether you are enjoying and appreciating and fully utilizing your time off, or whether this is something you need to and want to get better at. So, it certainly is.
It is so fun hanging out with you. Thanks for listening. I also just want to mention that I’m starting my next small group coaching program in a few weeks. So, if you are not on my email list, definitely sign up, you can go to www.saradill.com and get on my list and you will be the first to hear about it. So, it’s three months, small group, and physician only, no more than 10 people in a group. And this is some of the stuff that we work on and enjoin our own company, taking time off, setting good work-life boundaries. All the other things I’ve talked about in the podcast and so much more.
So, definitely check it out if it’s something you’re interested in or shoot me an email email@example.com. I answer all my own emails. So, again, feel free to reach out anytime. Alright, hope you have a wonderful week, and I will talk to you soon.
If you are a busy practicing physician ready to start feeling less stressed, enjoy work more, and learn how to create a more balanced and sustainable medical practice and life, sign up for a consult call with me at www.saradill.com. That’s S-A-R-A-D-I-L-L.com. It would be my privilege and pleasure to work with you.