Vacation: Struggling with guilt
Rob Hill Sr. wrote, “My goal is to build a life I don’t need a vacation from.” Most Direct Primary Care physicians would agree that we have achieved this in our practices. I know that I look forward to coming to my office, which is a cozy space filled with natural light, fuzzy pillows, ocean sounds, and the light beachy scent of a resort hotel. I specifically created this oasis so that I would be excited to come to work and so my patients would feel comfortable and relaxed despite the inherent vulnerability of being a patient.
It’s only natural to gravitate toward spaces which are not only physically comfortable but emotionally comfortable due to a sense of ownership and control, as well as a sense of expertise and purpose. If anything, it’s difficult to leave this space, this physician archetype, only to enter a more chaotic space and step into the murkier roles of mother and wife, crushed by the Sisyphean weight of daily life.
That’s the funny thing about boundaries. It’s not so much that others are trying to get in; it’s that we’re trying to escape. There’s a desire to grab a quick hit of dopamine by sending in a quick prescription refill after hours and maybe fold that laundry tomorrow. When you feel more successful as your work self than your home self, there’s a tendency to let work bleed into home until you’re not really home at all. I’ve had to do a lot of boundary work on myself for this reason. After all, my main purpose in starting my DPC practice was so that I could be there for my family.
Although I’m proud of the boundaries I’ve created between work and home, I still struggle a lot with the concept of vacation. When I worked in the system, I worked on commission, taking a percentage of collections from my appointments, so my vacations, maternity leaves, and sick days were all unpaid. With any time off, there were loud complaints: from the practice manager, from covering physicians, and from patients, often grumbling about yet another vacation at their appointment months later. I rarely took time off, especially since I had to save up my vacation time in order to be allowed a six-week maternity leave, but when I did, I was punished for it.
I still feel guilty “leaving” my patients, even though I typically address urgent matters during vacations. My patients are so lovely, always wishing me well, insisting that I deserve some time off. However, I continue to carry that guilt, which was instilled throughout my training, that good doctors sacrifice everything for their patients and never take a vacation.
Great read! So relatable