Wednesday, November 14, 2018

Why You Should Take A Sabbatical (And How to Make the Most of it)

By Sidney Roberts, MD
Lufkin Radiation Oncologist

This article originally appeared on Op-Med Doximity.

Earlier this year, I did something I had wanted to do (and needed to do) for a long time. I took a sabbatical.

I am a cancer doctor and hospice physician. Dealing with death and dying and end of life issues can be exhausting, not just physically, but emotionally and spiritually as well. Even though I love what I do, I was getting burned out. Not every patient is pleasant or easy to work with. Stress happens. We all need a break sometimes.

There are different ways to get away, and how we go about it may depend on where we are in life. During the routine work year, breaks can come in all shapes and sizes, from the afternoon off to a three day weekend or a more substantial week or more off for a vacation. These standard breaks rejuvenate us and help us stay focused when we are back at work.

A sabbatical is something altogether different.

The word sabbatical has at its root what we recognize as Sabbath – rest – which has a deeply spiritual meaning of both rest and worship in Judeo-Christian theology. The idea of an extended rest from work has a long history in the academic setting, where professors are given time off from teaching to travel, write a book, or study. But I never hear of doctors taking a sabbatical.

Doctors need it. Physician burnout is, according to some, is at epidemic levels. Others call it a crisis. Let's just say, burnout among physicians is far too common. The specialty of emergency medicine reportedly has rates of burnout at nearly 60% with many other specialties at 50% or higher. Burnout is basically severe, chronic stress characterized by emotional exhaustion and lack of empathy for patients along with a cynical or negative attitude and a sense that you are spinning your wheels in your career and not getting anywhere. Does that describe any physician(s) you know? I guarantee it does. I didn't want it to describe me.

Why physician burnout exists (and is increasing) is not the subject of this essay. But if you talk to doctors, government bureaucracy, electronic health records, insurance companies, and declining reimbursement despite longer work hours are almost always going to come up.

Doctors need a break. More than just a scheduled afternoon off or periodic vacation. I would argue that at some point in a physician's career – if they want to stay the course for the long haul – they need to take a sabbatical.

What does a sabbatical look like? It depends on the person. My advice for those considering a sabbatical is to keep in mind three key components: time, distance, and purpose.

Time is important in order to distinguish a sabbatical from a vacation. Two weeks, for example, is not long enough to truly get away from work. You spend the first week just beginning to unwind and the second week worrying about the hell you are going to pay when you get back to the office. Four weeks is a minimum for a true sabbatical.

Distance is important as well – certainly physical distance, in that you want to avoid the temptation to check in on work. Get out of town. Out of the country, even. In this digital age, electronic distance is also important. Are you still going to be tied to Facebook? Instagram? Twitter? Or worse, to your electronic health record? Emotional distance is key as well. Let go of the thought that only you can do what you do.

Finally, consider if there are things you've always wanted to do – books to read (or write), goals to accomplish – but you've never had the time to do them. Be creative; think outside the box.

Avoid the temptation simply to travel, where you feel obligated to visit every cathedral and museum from Athens to Zanzibar. A sabbatical is about you. Be careful, though, that you don't set unrealistic goals for your sabbatical, and that you don't come back feeling guilty that you didn't accomplish all that you set out to do. Remember, the definition of sabbatical is rest. Be still. Listen. Be open. Don't just "do"! Find out more about who you are apart from medicine.

Personally, I stayed four weeks in a seminary in Beatenberg, Switzerland where I translated German theologian and martyr Dietrich Bonhoeffer's thought-provoking book on discipleship and read a trio of books by Puritan writer John Owen. But I didn't feel guilty about whether or not I was meeting certain self-imposed goals. After all, a sabbatical is first and foremost about rest.

I am happy to report that I came back from my sabbatical not just refreshed and much less stressed, but more self-aware and ready for many more productive years of practice. Mission accomplished!

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