Here's an observation: most physicians in private practice don't take enough vacations. I am often (rightly) accused of this sin. My staff, colleagues, and even patients regularly encourage me to take time off; but still I find it hard.
Why is this? Is it that I love my job so much that I can't tear myself away from it? Is it that my self-worth is wrapped up in being "the man" for my patients, and being away from this makes me feel insecure? Is work my addiction - the one place that I have control of my circumstances and positive reinforcement?
But I think the reasons are more basic than that.
- Not only don't I get paid on my time off, I actually lose money.
- Coming home to a pile of work almost makes it not worth taking the time off.
If you are the main source of your income, then there is no such thing as a paid vacation. When you are not in the office, you are not generating revenue. This does not mean you don't take time off, but it does mean that any time you take away from the office comes at a cost. You have to balance your income with your need to take time off. It is natural, then, to err on the side of work.
Plus, when you are off your overhead does not stop. Your staff still needs to be paid, your bills continue coming in, and your rent does not stop. With the nature of most businesses requiring you to "zero out" the income at the end of the year (to avoid taxes), it is difficult to put money away for this.
Then there is the issue of coming back. The number of things on your desk when you get home can be astonishing, including:
- Phone calls from patients while you were away.
- Labs and tests you ordered that need to be reviewed.
- Forms patients need to have filled out.
- Consults and other phone calls.
- Crises that have occurred in your office among staff/patients.
There is one more thing: when you have taken time off, you usually owe other physicians for covering for you. You are usually on call and spending extra time in the hospital and/or office.
What's the point? I guess I am just answering those who suggest that I should take more time off. Yes, I feel guilty that I am not taking more, but the price I end up paying (both financial and non-financial) makes it hard.
I guess I am just griping.