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With the author of today's blog post, and several commenters also mentioning full- or part-time work, with some alluding to the topic of burnout -OR- just a desire to cut back clinical hours from full time to part time in order to have time enough to pursue other interests (e.g., blogging, travel, volunteer work/medical missions, etc.), it made me wonder about the time we spend doing work and how we define full- or part-time clinical jobs. Obviously, some people who have their own private practices will get to define it however they want. Many of us are employed physicians. Also, it's July, and some residents/fellows are starting their final year of training, and the end of the program is more tangible; some may have either started looking for jobs or are just about to do so.
I've worked for two academic institutions.
One job: 1.0 FTE was defined in the contract as 50 hours per week (typically five days per week, and you are generally expected to be present at work during more typical "business" hours) including clinical work, teaching (students and residents on rotation), more formal teaching (lectures), and administrative (meetings) and research time, unless you had a "director" type of role (such as medical director, director of medical student rotations, program director, etc.), in which case it was defined as 60 hours per week. In my experience, I would find myself spending 2-3 hours almost every night at home on documentation--usually waiting for resident notes to finish so I could finish the work. I felt the burnout; it was stressful to never feel like I have time to turn work off in my life until the weekends. Night/weekend call coverage was above the typical 1.0 FTE of 50 or 60 hours, and it was optional (because enough people wanted to participate in call) and was paid.
Another job: 1.0 FTE includes typical M-F "business" hours with clinic part of the day seeing outpatients, with rounds for inpatients and consults during the other part of the day. Minimal time to get administrative/documentation work done, with minimal idle time during the day and no dedicated time for other academic activities such as research (though it is a clinical position and research isn't built in to the job description), and it seems like more nights than not (particularly if rounding on inpatients), some documentation work needs to be done at home in order for it to be completed. Night/weekend coverage is not compensated separately, and an attending will find him/herself on call every other week, or sometimes is on call one week out of three or four.
The biggest aspect for me in contributing to burnout is the setup of the clinical load being such that I can't ever feel rested if I know that the workload is such that I have a couple of hours of work to do after I get home. I was wondering whether this is common, to be in an employed position and not be able to finish work at work. It seems to be one of the reasons people cite for wanting to be FI--so that they can pick and choose how much they want to work (i.e., avoid doing things they wouldn't want to do).
I've worked for two academic institutions.
One job: 1.0 FTE was defined in the contract as 50 hours per week (typically five days per week, and you are generally expected to be present at work during more typical "business" hours) including clinical work, teaching (students and residents on rotation), more formal teaching (lectures), and administrative (meetings) and research time, unless you had a "director" type of role (such as medical director, director of medical student rotations, program director, etc.), in which case it was defined as 60 hours per week. In my experience, I would find myself spending 2-3 hours almost every night at home on documentation--usually waiting for resident notes to finish so I could finish the work. I felt the burnout; it was stressful to never feel like I have time to turn work off in my life until the weekends. Night/weekend call coverage was above the typical 1.0 FTE of 50 or 60 hours, and it was optional (because enough people wanted to participate in call) and was paid.
Another job: 1.0 FTE includes typical M-F "business" hours with clinic part of the day seeing outpatients, with rounds for inpatients and consults during the other part of the day. Minimal time to get administrative/documentation work done, with minimal idle time during the day and no dedicated time for other academic activities such as research (though it is a clinical position and research isn't built in to the job description), and it seems like more nights than not (particularly if rounding on inpatients), some documentation work needs to be done at home in order for it to be completed. Night/weekend coverage is not compensated separately, and an attending will find him/herself on call every other week, or sometimes is on call one week out of three or four.
The biggest aspect for me in contributing to burnout is the setup of the clinical load being such that I can't ever feel rested if I know that the workload is such that I have a couple of hours of work to do after I get home. I was wondering whether this is common, to be in an employed position and not be able to finish work at work. It seems to be one of the reasons people cite for wanting to be FI--so that they can pick and choose how much they want to work (i.e., avoid doing things they wouldn't want to do).
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