Physicians aren't 'off' on PTO: Study

The majority of physicians struggle to unplug from work even when taking paid time off, contributing to higher burnout rates, according to a new study published by JAMA Network Open.

Researchers affiliated with the American Medical Association; Palo Alto, Calif.-based Stanford University School of Medicine; Rochester, Minn.-based Mayo Clinic; and the Aurora-based University of Colorado Anschutz Medical Campus conducted a cross-sectional survey of 3,024 U.S. physicians between November 2020 and March 2021, inquiring about their PTO usage and behavior while on PTO. They also measured physicians' burnout levels using the Maslach Burnout Index and professional fulfillment using the Stanford Professional Fulfillment Index. 

They found that many physicians are hesitant to use all of their vacation days, citing financial concerns and the inability to find someone to cover clinical responsibilities. Of the respondents, 19.9% took five or fewer vacation days in a given year, while 59.6% took three weeks or less. 

Even those who do take time "off" are likely to work during the day. More than 70% of physicians said they work on a typical vacation day; 37.3% spend up to 30 minutes on work-related tasks, 18.3% work 30 to 60 minutes, and 14.7% work more than one hour on the average PTO day. 

The results varied by specialty: Urology, neurology and surgery subspecialties were most likely to perform at least 30 minutes of work on PTO, while emergency medicine, radiology and pathology subspecialties were least likely to do the same. 

However, the effects of always being "on" were consistent. Those who worked on PTO days and took less time off showed higher exhaustion and depersonalization scores, according to the report. 

There is hope, the authors offered. Although less than half of physicians report that they have full EHR inbox coverage on their days off, this service was associated with improved ability to disconnect from work — lowering rates of PTO work and thus lowering rates of burnout. 

"Our results suggest that ensuring physicians take at least 3 weeks of vacation per year and providing coverage for clinical work, including full EHR inbox coverage while physicians are on vacation, may be tangible and pragmatic organizational actions to mitigate burnout risk," the authors concluded. 

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