Get Coached on the Most Effective Way Doctors can use Vacations effectively to Recharge their Batteries, with Dr. Victoria Silas
“Physicians feel guilt when they take time for themselves. And it’s super important to remember that by taking time for yourself, you’re actually likely increasing your ability to serve others when you get home. And, increasing your likelihood of having a longer and healthier career and life. “
- Dr. Victoria Silas, Certified Coach and Orthopedic Surgeon
It’s time for Vacation 101 For Physicians. Today, Cohost of the podcast Master Certified Coach Jill Farmer talks with Certified Coach Dr. Victoria Silas about how to approach taking time off from your medical practice. Sparked by hearing from struggling physician clients, as well as their own experiences, Dr. Silas talks with Jill about how we can change our mindset towards vacations. Acknowledging the presence of workaholism in the US, Jill and Dr. Silas encourage you to let go of any guilt you may feel about taking time off. Together, they emphasize that a vacation is not just being absent from the workplace, but rather that vacation is most importantly a time for you to best prioritize your wants and needs, regardless of your location. In today’s conversation, Dr. Silas and Jill offer you advice on how to create an individualized vacation plan to help you avoid burnout, be more effective in the workplace, and prioritize your own health and well-being as a physician.
Victoria Silas, MD is a board-certified Orthopedic Surgeon and certified coach with 21 years experience in practicing medicine and 10 years experience in coaching. Now retired from medicine, Victoria helps other physicians cultivate a sense of calm and control in their personal and professional lives, as they regain their love for medicine and rekindle their sense of purpose and professional excitement. She can be found at DocWorking and at www.medicalmindsconsulting.com.
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Please enjoy the full transcript below
Victoria: Physicians feel guilt when they take time for themselves. And it’s super important to remember that by taking time for yourself, you’re actually, likely increasing your ability to serve others when you get home and increasing your likelihood of having a longer and healthier career and life.
Jill: Hello, and welcome to DocWorking: The Whole Physician Podcast. I’m Jill Farmer, one of the cohosts of the podcast and lead coach at DocWorking. And we are so glad you’re here. As always, this episode is brought to you by DocWorking Thrive, where you can get coaching, peer support, and everything you need to move from burnout to being more balanced in your life.
Today, we’re talking about vacation and how sometimes, if you’re not intentional, you may not be getting what you actually need for your work and life, in terms of a recharge to your batteries from your vacations. And here to have this conversation with me is one of my favorite people to have conversations with about all things related to thriving, and to coaching yourself, and to getting coached towards the life and work that you want to live. And that is Victoria Silas, MD. Victoria is a retired pediatric orthopedic surgeon turned coach and a traveler extraordinaire, who, as a very busy and overworked surgeon had to learn how to let vacations make her work and life more balanced and help sustain her very challenging work. So, Victoria, as always, thank you so much for being with us here today.
Victoria: Thanks, Jill. I love talking with you about all of these topics that come up so frequently for our physician clients.
Jill: Yeah, and it is a funny one, right? People say to me, “Well, how does somebody have to learn how to do vacation?” I’ve had physician clients say that to me. It’s like, “I feel somehow, I don’t know how to do vacation, because I end up feeling tired or I avoid it because it feels it takes so much planning ahead of time that it’s easier if I just don’t even bother to take all my vacation days,” things like that that I see as red alerts because I know that in order for the very, very challenging work of being a physician or a healthcare professional, you have to take breaks, you have to change the channel in your brain, and give both your body and brain a chance to do something different in order to make this sustainable.
Victoria: I totally agree, Jill. There are any number of studies now that look at how vacation actually increases productivity. It increases creativity. It also decreases stress. There are health implications as well as mental health implications. We’re actually finding that people who don’t take vacation actually increase their risk of stroke and heart attacks, because they’re not giving themselves that opportunity to destress. So, vacation is that, not just a fun thing, it’s not just, “Oh, well, get away from work for a little while.” It’s actually good for your wellbeing both mentally and physically. I think a lot of people aren’t aware of that.
Jill: In the culture that we have in the United States, which tends to aggrandize overworking and to even sometimes try to, I don’t want to say we totally are trying to push people toward workaholism, but we don’t push people away from workaholism, either.
Jill: And in that culture here, there tends to be this pat on the back for people who do overwork and maybe don’t take that time. And so, that’s always fascinated me as somebody who loves to look at productivity and how to make work sustainable for the long haul and not this thing that fries us to a crisp that we give our all and then leave with great resentment. I, for a long time looked into what other countries do and there’s a lot of productivity studies around the world that show that in countries, which is pretty much all of Europe and other parts of the world as well, the people tend to work far fewer days per year. Take vacation more often. It’s much more normalized to take a few days off and then also to take longer breaks than a lot of times we allow or that people are used to taking in healthcare. And they still have higher productivity rates working far fewer days per year and far fewer hours in the day. I think it’s something that we just have to really begin to normalize from a big picture in our country as well.
Victoria: Yeah, I completely agree with that. I know for myself when I was working. One year, and this was earlyish on. It was a while back and I ran the call schedule. And so, frequently, I wouldn’t choose my vacation time until I saw where my windows were. This was also back before I started traveling with others so much. And one summer, I just didn’t take any vacation time. Summer is really nice time in the Pacific Northwest. So, I don’t usually go away. I like to be here. But I found that not taking any vacation days over the summer was a complete disaster, for me, personally.
Nothing actually happened, except I was miserable and exhausted. That’s when I realized that I really needed a week off every two months just to remain normal. Not even recharged, but to get back to a normal mental health state. That’s what I required and that’s when I started making a rule for myself that I am going to take a week every two months. So, I’m going to mark it out in the calendar. It might not be completely exact, but I really tried to stick with that and it made a big difference.
Jill: What did you notice when you gave yourself permission, first of all, and then secondly, created some routine around it, so that it wasn’t such a disruption to your day-to-day work? What was the benefit of that for you?
Victoria: Well, there’re several benefits. One of them is, we weren’t supposed to cancel clinic within six weeks because they have to reschedule all the patients. It was a rule, but frequently, not followed. Then there’s a lot of angst if you don’t take vacation well enough ahead of time about when are you going to take it, and who’s going to be canceled, and what sort of disruption is that going to cause, if you mark out your vacation in the calendar ahead of time, then you get to bypass all that additional stress about where are we going to put the patients and what are we going to do? So, that is a big reason I think that planning out your vacation a year ahead if you can, but at least, several months is ideal, because it cuts down on your stress, it cuts down on the clinic’s stress.
And then because sometimes vacations do take some planning, that gives you lots of time to plan all the things. I think some physicians are not aware of tours, or groups, or vacations that are essentially planned for you. I like to do Rick Steves’ tours. Those have been great. And I’ve done tours, when I went to Greece and when I went to Egypt. And so, all you have to do is figure out, “Okay, what time am I going to be gone?” And then you can find a tour company that has a tour already set up in areas that you’re interested in going to and then all you have to do is plan you’re flying in and flying out. So, a lot of that planning is actually taken away from you when you use this kind of system, if that’s the thing that you enjoy.
I’m also someone who really enjoys learning about where I’m going and planning out what experiences I want to have ahead of time. And for me, part of the de-stress component of vacation isn’t just being on the vacation and being away from my job. It was also being away from my job mentally before I even left by watching shows, and reading books, and figuring out where I’m going to stay, and how I’m going to craft my day. And so, it gives me that outside of work creative playing field. So, that actually to me is part of the vacation. You can have a little vacation from where you are while you’re planning your vacation ahead of time. It doesn’t have to be a super stressful experience like you mentioned. It can just be part of the process that makes the vacation fun is planning ahead of time and daydreaming about what it’s going to be like and watching videos about beautiful places you’re going to go explore.
Jill: So, Victoria, I think one of the things too that comes up with physician clients is, sometimes, they’re expecting vacation to do a little bit too much of the heavy lifting in life, because they’re overworking so much and having that contaminated time where time that should be off like weekends and nights. Work is bleeding into that and contaminating that time as well, so, then the vacation is supposed to be all the relaxing time, all of the rejuvenating time, it’s supposed to do all the work to refill the tanks when it’s so darn depleted there’s just no way to refill it in that one week’s time. What are your thoughts on that?
Victoria: I would totally agree, Jill. And it speaks to what you often mention about the need to change the mental channel, so that the mental channel is not always tuned to work even when you’re at home to make an effort to protect some of your time for yourself, so that you aren’t that depleted when you get on the vacation, because you haven’t been working nonstop. I know for some people because of the position they’re in with family or jobs that can be a really challenging idea, because there’s constantly more to do. But the reality is, there’s constantly more to do. And so, you can either do it and still have more to do or you cannot do it and still have more to do. But having taken, at least, some time for yourself, so that you’re not quite so depleted when you leave work and step into that vacation time.
And then we’re just also building that muscle of changing the channel in our brain, not just from work to not work, but changing the channel from everybody else’s needs are more important than my needs to my needs are also important. For me to take the best care of other people including my patients, I have to take care of me. Otherwise, I am not going to be at my best.
Jill: Yes, beautifully said. One of the challenges I hear, though, from some of my clients and so, I think would be fun to workshop this with you to see your thoughts on it. They get into that there are so many places they want to go and that sometimes, tendency of the physicians to be perfectionistic. It’s like, “Well, but how do I find the perfect place to go, and the perfect way to do that place, and learn all the things about that?” And so, those tendencies lead them to analysis paralysis, where they’re just not doing anything and then will convince themselves, “Well, I’ll just go ahead and do a stay-at-home vacation,” which a lot of times there’s code for, “Beat myself up for all the stuff I didn’t get to at home. And so, I’ll work then.” And then there’s resentment and the lack of the benefits and the stress relief and the changing of the channel in your brain, and the new neural pathways that come from doing something different. So, what do you say to somebody that’s like, “It’s just so overwhelming to try to plan that trip and the planning isn’t part of the fun for me, it makes me feel stressed out and overwhelmed?”
Victoria: Well, I think the great coaching tip for too many choices is to just pick a direction and go in that direction and then you’ll get feedback. Say, you’ve got a week off in June and you’re thinking, “Oh, maybe this is the year I go to Egypt.” And then you look at the weather in Egypt in June and you go, “No, it’s not Egypt this year because that’s not when you want to go to Egypt.” And so, I think there are ways of narrowing your focus down to, “Where have I always wanted to go?” and, “Is that a good time of year to visit there?” and, “What tours are available or not available?” and, “What is the airfare like?” because this year–
All of those things can help with your decision making, as long as you make a decision to head in this direction and then you get feedback about, “Is this what I want to do right now or not?” Actually, I’ve always wanted to tour Egypt and then I thought, “Well, I’ll do Egypt, and then the next year I’ll do Greece, and then the next year I’ll do Rome” kind of following what we consider the development of Western civilization, if you will or European civilization. And so, I made my decision based on, “I want to go to all of these places. Where do I go first?” and I did it chronologically. It’s less important what you choose and more important that you choose something. And then if it looks like that’s not going to work out, then you can choose something else. Maybe something will come up. But you have to start moving in a direction.
Jill: I might even start a little further back at the very beginning, “What do I need right now?” If you’re exhausted and overwhelmed, if what you need is rest and the fewest decisions possible, then this might be the time to think about giving yourself permission to go do the all-inclusive trip somewhere, or the cruise, or something where there’s a lot fewer decisions, or even– If it’s a tour, great. But something where you get to just be and not be the arbiter of all the planning and the decisions or and listening to what your needs are. A lot of times the physician clients will say, “Well, I should go do this or that. The kids haven’t been to national parks” but if what you need right now is to go to someplace where you sit by the beach and read books, and somebody brings you beverages that’s okay, too. There’s no “shoulds” around this.
Victoria: [laughs] That’s a really good point, Jill. That is something I have also done is, what kind of vacation do I want to take next? Do I want a vacation where I lie on the beach and I don’t do much of anything else? And I can tell you that some of my workaholic physician friends hate those types of vacation. To them, that’s not relaxing. They need to be doing something to feel they’ve spent their time well. But that’s not me. I love relaxing on the beach. But sometimes, I’m not in the mood to relax or I really want to delve into a specific area or specifics history and so, I do that.
The other thing I would say, you and I have talked about this several times. You say, all-inclusive and people think about beach destinations. One of my favorite destinations that’s all inclusive is going on safari. Those are usually an all-inclusive situation. You don’t make any decisions about activities, where you’re going to eat or you might have to decide exactly what you’re going to eat. But again, that’s a place where you go and there really are no more decisions, except do I want to stay in bed or do I want to go out on a game drive?
Jill: I love that. My husband and I’ve done a biking trip and are going to do another one that’s run by a company that again it’s all inclusive. Everything is taken care of.
Jill: They bring your bikes, they haul your stuff to the lovely hotels. If you’re tired the afternoon, you don’t want to ride with the rest of the group, you ride in the van back to where you want to go. So, there’s a lot of just care that I think goes into it. I think what’s interesting and what’s fun, but also back to those deeper needs. What do you need right now? In most cases, for overworked physicians in this season of COVID, continuing post-COVID, however you want to label it, it’s really important that you set that intention for yourself ahead of time of who do you want to be, how do you want to feel in this experience and when you’re done?
Our producer, Amanda brought up a point that a lot of times people will talk about needing a vacation from the vacation and that can be a tendency. If you’re somebody who tends to cram things in, you may want to pay attention to whether you try to do that to yourself in vacation time as well. Whether the result of that is that you end up recharging your batteries and getting the break from the stress and overwhelm during your vacation or whether it’s just changing the flavor of the same kind of stuff that you’re choking down that isn’t really working for you. What do you think about that?
Victoria: I think those are great points. I think the answer is going to be different for different people. As I mentioned, I know people who do not find relaxing as an activity relaxing. They like to go do things in their spare time that I would consider hard work like deep sea fishing or shrimping. But they get a tremendous amount of satisfaction from doing those activities. Even though, someone might say, “Well, that doesn’t seem relaxing.” To them, it is. It would be much less relaxing for them to go to a more traditional relaxing vacation, because they don’t enjoy it.
The important thing there is to make a plan, take the vacation, and then spend some time reflecting after the vacation on, “Did that vacation do what I wanted it to do? Did it give me the feeling I wanted to get?” And if not, okay, well, maybe I need to schedule less activities or maybe I need to schedule more activities. So, paying attention to your own experience gives you important feedback about what are the things that really refresh you as opposed to giving you additional stress when you’re supposed to be having a good time.
Jill: Yeah, beautifully said. And for those of you who are parents of children, we know that can be wonderful to have that family time together, and the change of schedule, and it can also be exhausting. And so, I often will tell people, “It’s okay to take the four- or five-day trip with the family and then give yourself a day or two to just be home and rest and recover.” And again, it’s giving yourself permission to play with, “Can I make more space in this experience? Can I change the pace, the intensity from which I do things on a daily, weekly, or monthly basis in my work?” And notice if that is part of the rejuvenation and the things that feel good and helpful about being on a vacation. Being a little bit experimental and playful with it, I think can be really helpful as well.
Just because it’s just easy to carry out the patterns of the way we do things in that day-to-day work life and impose it into that vacation life. I guess, that’s my fun challenge I want to give people is, “Can you play with what it looks like to really let yourself get into a different pace?” Like you said, you’re learning stuff at work and you’re working hard at work, but the way you learn things on vacation is really fun, and invigorating, and interesting for you. So, it’s not that you’re completely turning yourself into a different person, but you’re really changing the pace, and the path, and the pleasure that you’re allowing to move in to that space. Is that a fair way to say it?
Victoria: Yeah, I would agree with that. I think you’re also changing the challenges and potential stressors. And so, that’s a good thing to be aware of. What was challenging on your vacation? Maybe you don’t want to do so much of that on your next one, or what was stressful, or what stress did you bring with you, or did you create? At one point, one of my partners was on an extended vacation to Italy more than just a week. The staff would come ask me questions about his patients, which is, of course, I’m happy to deal with because that’s what you do. You cover for each other.
But then he kept checking the EMR from Italy and he would see the question in the EMR. And so, he would write back with another plan that was different from mine. Both plans were fine. We think about things a little differently. In both cases, the patient would have gotten the care that they needed. Well, now, the staff doesn’t know what to do. They don’t want to bother him in Italy, but they want to do the right thing by his patient, and maybe we’ve already reached out to the patient, and we changed the plan, and the patient starts wondering, “What’s going on?”
And I think that from his perspective, he thought he was being helpful by checking in that way. But when you’re checking in like that, you’re not really where you are now, which is in this case in another country. And although you perceive it as helping out, it actually was not something I experienced as helpful and not something the staff experienced as helpful. This idea that you need to check on all your patients while you’re on vacation, there may be some instances where you need to do that when the patient’s had a complication or obviously, solo practice is going to be a slightly different situation. But there needs to be a certain amount of trust that you’ve left your patients in the hands of your partners, they do know the super-secret ways of getting in touch with you, if it’s absolutely necessary. But I think one of the things in physician culture that is less healthy is this idea that you have to do everything yourself and that you’re the only one who can fix a particular situation. And oftentimes, that’s not true. There are other people that you can and should lean on in those instances, so that you get the most out of your vacation, they get the most out of the staff who’s left behind during the vacation, and the patients still get cared for.
Jill: Wow, that is so beautifully said. From that, I want to convert that into a permission slip for all of you that are listening to do exactly what she said. Let work be at work, so that you can get that break. Because that break is important and integral to you experiencing the benefits of the reboot that you can get from a vacation. In addition to that have fun if you can with playing and planning, but if it feels overwhelming, don’t be afraid to offload that to somebody else, to something that’s all inclusive and already planned, travel agent, a trusted friend who loves doing that kind of planning, anything like that that you can to make this experience of being on vacation, do what it can to help keep your tank full for the long term, so that you can keep doing the important work and living the life that you want to live while you’re doing that work as well. Any other final thoughts, Victoria?
Victoria: Well, I think that was really well said, Jill, as always. I would just reinforce this idea that physicians feel guilt when they take time for themselves. It’s super important to remember that by taking time for yourself, you’re actually likely increasing your ability to serve others when you get home and increasing your likelihood of having a longer and healthier career and life than if you don’t take vacation. Because there are some very good studies that demonstrate an increased risk of mortality and people who do not take as much vacation as their peers. And so, by taking that time for yourself now, you’re actually helping your patients in the future, because you’re more likely to be available for them both emotionally, and intellectually, and even physically.
Jill: That is really powerful and I hope everybody listening and all of us and you and I as well, Victoria, will take that to heart, because I think it’s an important change that needs to happen in the culture not only of medicine, but at large as well. So, Victoria Silas, MD, thanks so much for being with us. If people want to check out the work that you do in the world, where’s the best place to find you?
Victoria: The best place is at my website, medicalmindsconsulting.com.
Jill: Medical Minds Consulting. Also, if you sign up for any of our Thrive programs at DocWorking, Victoria is one of the lead coaches that along with me provides coaching kinda like what you heard today on the podcast to help you in your life and work to feel like you are thriving in all fronts. And we want you right now to go to docworking.com and take our burnout quiz. It only takes a minute or two and you’re going to have results to tell you where you are on the burnout to balance continuum. And then you’re going to get a free short webinar with tips to help you stay in that balanced state or help to move out of the burnout state, if that’s where it shows you are on the quiz. So, go there today. docworking.com, take the burnout quiz, and let us know how we can support you in your work and life. Until next time, I’m Jill Farmer on DocWorking: The Whole Physician Podcast.
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