Family Medicine Vital Signs

 By Mark Price, MD

After 4 years of college, 4 years of medical school, and 3 years of residency, I’m finally looking for my first real job. I’ve decided that after graduation and a much needed 3 month backpacking trip through Europe with my girlfriend, I’m going to go work in New Zealand for half the pay, fewer hours, and twice the epic scenery that I would get at a job here in the states. While I can’t say that making this choice with a mountain of student loan debt staring me in the face was easy, I can say that it’s the right choice for me.

Here was my day yesterday (which is probably pretty typical for a 3^rd year family medicine resident):

• 7:30-5:30 – See clinic patients, finish notes, and respond to patient calls/e-mails.
• 5:30-7 – Squeeze in a quick workout and eat dinner.
• 7:00-8:30 – Read whatever medical topic I was second-guessing myself on during clinic.
• 8:30-9 – Call my mom, which I’ve been promising to do for weeks.
• 9-10:30 – Study for my board exam.
• 10:30 -11 –Try to wind down before bed, keeping in mind all of those good sleep hygiene tips I tell my patients, like avoiding the bright computer screen I’m using to write this post.

Of course this doesn’t include the other countless requirements, including quality improvement projects, serving on various committees, giving lectures, looking for a job, and well you get the idea. I realize a surgical or OB-GYN resident, the intern version of myself, or any doc who trained “back in the day” would laugh at how easy this schedule looks. I also know that so far this post sounds like one of those annoying Facebook status updates attempting to gain sympathy from others, but that’s not my intention. The point I want to make is that we’re all busy. We all have required obligations in life and our jobs (like this blog post for instance). Indeed, more and more it feels like the line between obligation and option is becoming blurred. Whether you’re a resident, teacher, architect, nurse, or waiter, it’s almost becoming an unspoken expectation that we stay a few hours later, pick up an extra shift, or agree to help with an additional project.

As a family practice resident and travel addict, I’ve had the chance to see the difference in our collective attitude towards work as Americans compared to other parts of the world. It seems that at least once a clinic session, I’ll see a patient with fatigue, insomnia, anxiety, and depression who has a completely normal physical exam and lab work who just happens to work 60+ hours a week to afford their new 4-bedroom house. Seeing this is anything but surprising after 3 years of training in the outpatient setting. However, I still can’t believe that when I ask people like this about their schedule, there’s almost an attitude of pride about the little free time they have. On the other hand, when I try explaining my work schedule to families I’ve stayed with and travelers I’ve met abroad, I’m usually met with either shaking of heads, laughter, or an invitation to dinner.  I know the idea of living to work instead of working to live is not a novel concept. However, it seems like there’s an ever-widening gap between the American live to work lifestyle and the rest of the world. In fact, a study done by the U.S. Travel Association found that in 2013 there were 429 million paid vacation days that went unused in the United States and about 2/3’s of Americans do work while on vacation.

Throughout my education and medical training, I’ve been conditioned to say yes. Yes, I’ll join my 7^th volunteer organization to bolster my resume. Yes, I’ll stay late to help out with a last minute admission. Yes, I’ll read about septic shock for 2 hours tonight after a 13-hour shift. I’m not arguing for a shift in our medical education, and there have already been countless articles written about the recent resident duty hour restrictions, because I think we all agree that those in the medical community should undergo rigorous training. However, more and more I’m learning that it’s sometimes okay to take an evening off from studying, turn off my laptop, and say yes to an evening consisting of friends, dinner, and the newest episode of Game of Thrones.

Mark Price, MD is a third year Family Medicine Resident at the University of Utah School of Medicine.