Why so many physicians work on vacation days and what can be done

Vacation time is supposed to be a restorative activity, but many physicians are not able to take the vacation days they have earned or are not able to fully detach from work while on vacation. This contributes to emotional exhaustion and depersonalization, lowers their professional fulfillment, and increases their odds of burnout, according to a recent study published in JAMA Network Open.¹

The cross-sectional study of 3,024 U.S. physicians found that more than half (59.6%) took 15 or fewer vacation days per year, with 19.9% taking five or fewer vacation days. The majority of physicians (70.4%) worked on a typical vacation day, with 33.1% working 30 minutes or more.

Vacation days varied by specialty. Among specialties with more than 30 respondents, anesthesiology (75.6%), radiology (74.8%), radiation oncology (62.5), and pathology (56.2%) had the highest percentage of physicians taking more than three weeks of vacation per year. The lowest percentages were in family medicine (34.4%), physical medicine and rehabilitation (32.8%), general internal medicine (27.2%), and emergency medicine (23.8%).

Factors associated with working on vacation included female gender, working in an academic medical center, age 55 to 64 years, and age of youngest child 5 to 12 years. In addition, physicians who worked more hours per week had greater odds of working on vacation.

Physicians’ barriers to taking vacation days included difficulty finding someone to cover their clinical responsibilities, the financial impact on their professional compensation (e.g., not being able to meet productivity targets or continued overhead costs), and the volume of EHR inbox work they would face upon their return from vacation.

The authors concluded, “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. … Our results suggest that ensuring physicians take at least three 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.”

1. Sinsky CA, Trockel MT, Dyrbye LN, et al. Vacation days taken, work during vacation, and burnout among U.S. physicians. JAMA Netw Open. 2024;7(1):e2351635.

Posted on March 1, 2024 by FPM Editors