There’s growing awareness of a counterintuitive healthcare problem: many doctors don’t use their vacation time.
About half of doctors experience burnout, citing long hours and too many bureaucratic tasks as key reasons. Most physicians get three to four weeks of paid time off—so why don’t they use it? It would seem like a few well-deserved vacation days are just what the doctor called for, but physicians aren’t cashing in.
Let’s examine the research and what changes can help doctors use their much-needed vacation time.
Vacation time reduces burnout, but doctors don’t use it
A recent study published in JAMA Network Open set out to quantify how doctors use their vacation time, and any connections to burnout. Researchers surveyed a cohort of 3,000 physicians that is roughly representative of the American physician workforce and asked questions about vacation days taken, work during vacation, and burnout.
Here’s what they found:
- About 60% of physicians take 3 weeks of vacation or less
- 20% of doctors took five or fewer days off in the last 12 months
- While on vacation, 70% of respondents still did some work
- Physicians who took less vacation or worked on vacation reported higher rates of burnout than their colleagues
“Like other workers, physicians have a human need to periodically truly unplug from work and recharge,” lead study author, Christine Sinsky, MD, MACP, said in an interview. “Health system leaders who want to reduce burnout, and thereby also anticipate reducing turnover and improving quality, can make tangible changes to support physicians taking full vacation.”
Why don’t doctors take vacation time?
Sinsky’s findings are supported by AMA survey data showing that about half of doctors took just three weeks or less vacation in 2023. In that survey, doctors cited three barriers to using vacation days:
- the volume of inbox work faced on return (36%),
- the financial impact on professional compensation (23%),
- and finding someone to cover clinical responsibilities while away (22%).
Doctors’ high workload likely explains why many providers don’t take PTO. If taking a week off puts you behind for several weeks following–even if you spend 30 minutes a day in the EHR inbox while on vacation–what’s the point?
Compensation is another important variable. Over half of doctors have compensation packages that link personal productivity to pay. For these professionals, using paid time off can take money off the table.
Finally, the medical work culture normalizes workaholism. Even Sinsky, the physician publishing about the benefits of vacation to reduce burnout, admits to working on vacation. When everyone around you works long hours most weeks, it’s easy to assume this is just how things are.
Medicine’s unhealthy work culture is evident in thoughts like, “I don’t want to make more work for my colleagues,” or “Who will get this done if I’m not in the office?” Others posit that doctors are just too interested in their work and should pick up other hobbies, which they often let go of during years of grueling medical education.
Whatever the causes of doctors’ tendency to skimp on vacation time, physician burnout has real consequences. Doctors and employers would benefit from changes that make healthy vacations a normal part of the medical profession.
Workplace policies should incentivize vacation days
Occupational burnout negatively impacts healthcare professionals, but it’s also a threat to wellbeing and health system goals. Physician burnout is associated with higher rates of medical errors, longer hospital stays, lower patient satisfaction rates, higher turnover, and excess healthcare costs.
In short, policies that encourage doctors to use allocated vacation days pay off. Employers should ensure doctors have the incentives and support to take time off and disconnect from work while on vacation.
Here are some workplace changes that could help doctors use their vacation days:
- Full coverage while away for clinical responsibilities, including the EHR inbox
- More flexible vacation scheduling policies
- Practively blocking off vacation time in physician schedules
- Compensation packages untethered from productivity
- Ensuring realistic workload expectations and hiring additional staff when necessary
- Efforts to explicitly track, normalize, and model taking vacation days
As Sinsky’s team writes, “The fact that two-thirds of physicians are obligated to continue to provide clinical care to their patients while on vacation should be considered a marker of poorly designed systems of teamwork, inadequate clinical staffing, and poorly designed cross-coverage systems.”
Small but targeted workplace changes can make a big difference in encouraging doctors to use vacation time, leading to tangible improvements in physician wellbeing.