Work Life Boundaries for Physicians

I want to take a moment to celebrate the Family Doctors today as it is World Family Doctor Day, May 19th, 2021, and the pivots that you have taken in your stride in the last 14 months.

Fourteen months ago, in our clinic at least, we did not have worklists of patient requests. There were strict rules about which patients could leave us phone messages. They arrived on paper, clipped to cardboard and placed in our inboxes. We never called patients with our cell phones. In fact, we had to google the prefix to use before calling our patients with our cell phones in order to block our numbers. There were posts about it on Facebook. Eventually, we all blocked our numbers so we didn’t even know when we were calling each other!

We never worked from home. That’s not entirely true - of course we did, but it was in our pj’s after dark doing our charting and inboxes, but it wasn’t seeing scheduled patients by phone. We had to figure out how to get a script from the computer to the pharmacy from home. We had to install eFax workarounds to make it possible to work from home. We had to have conversations with pharmacists that scripts would not be physically signed any longer, an electronic signature would suffice.

We started comparing notes on what was acceptable to see virtually and without a physical exam. How to be safe and thorough without making yourself crazy. We had to gain consent for virtual calls and deal with the complaint of the day and the questions about covid, all within the constraints of the visit booking length.

We stopped doing pap smears, mammograms and other screenings as directed by our population health directive and started creating systems and processes to find these patients “later”. 

We sourced PPE and collaborated with other physicians around the country about how to see patients safely, what to do for our personal protection and to keep our patients safe. We moved to compulsory masking, wider chair spacing and hand sanitizer.

We stopped accepting hugs, handshakes, homemade cakes and communal lunches. I haven’t seen a drug rep for 12 months. 

We see fewer patients in person, but our hours of work have expanded. 

There is no work-home boundary unless we fiercely maintain it. 

You can start “seeing” patients at midnight by answering emails, pick up phone calls with your morning coffee, get to the clinic to see patients in person and then spend hours doing phone consultations, empty your inbox into the email portal. 

It’s a true 24/7 experience if you want it to be.

You might think I am celebrating this. I am not. Just to be clear.

Here is what I want to celebrate: you are innovative, adaptable and remarkable.

You have taken change after change and figured it out. Pivoting like a trained ballerina.

You have advocated for your patients and kept health care for our population ongoing despite a global pandemic.

The downside is that your boundaries are blurred. Inboxes no longer empty as patients can fill them 24/7. You are accessible in a way that has never been available before.

So take a moment today to celebrate the amazing accomplishments you have created resourcefully this year. 

Then take a moment to acknowledge where your boundaries have been crossed and the cost. 

What do you need to prioritize again to help you rest and recover?

You are an exceptional Family Physician and also a human!

This is worth figuring out now as virtual care and patient portals aren’t going anywhere.

Go after the amazing life you want, despite medicine and the demands of your day job.