The current era of health care delivery has been aptly compared with going to war against an invisible enemy that can attack anywhere, at any time and with novel means. This invisible enemy was attacking the civilians as well as the “front line” with vigor. We have attempted to learn on the fly and use our intelligence to develop a defensive strategy against the enemy’s ever-changing tactics and learn from prior battlefronts. This has been an exhausting 18-month war that has resulted in 3.54 million casualties. As leaders, watching the bodies pile up, and our resources become scarce has unsurprisingly resulted in low morale, fear and frustration. In an actual deployment, our soldiers and leaders get a “leave” (even as the battle rages, remember poor Radar O’Reilly trying to regulate this in M*A*S*H?). The military historically had 12-18 month deployments; now the usual time away is six-nine months. After a six-month deployment, the leave is at least two weeks (in addition to usual vacation/PTO), regardless of position: cook, infantry, strategy or logistics. Due to COVID impairing usual leave, the Secretary of Defense signed authorization in April 2020 that service members could accrue and retain a balance of up to 120 days (normal leave is 30 accrued days per year with a carrying over of 60 days annually). But in medicine, this was not the case. When we served an exhausting six months, nine months or 12 months, we were not given “leave.” Instead, we were literally asked to produce at 120% to “make up” for lost visits during the lockdowns. We were limited on when we could take leave. We had to stay in the war zone- no “going home” — yes, you could have the weekend “off,” but you had to stay hearing the artillery bombs going off all around you. The texts, DMs, calls from personal friends and family who were scared and wanted information to direct care of their loved ones or ask your opinion regarding policy or possible “miracle cures” were relentless. You cannot escape your friends and family. Meanwhile, other industries plan on their employees possibly wanting time off to recharge and explore other passions. This is otherwise known as sabbatical leave: Several companies which offer paid sabbaticals include: The Cheesecake Factory (three weeks after five years of service) McDonald’s (eight weeks for every ten years of service) Charles Schwab (four weeks after five years of employment) REI (four weeks after 15 years of service) QuikTrip ( four weeks after 25 years and then every five years thereafter) Genentech is the only health-related company I could locate that offers six weeks after six years of full-time employment. I know of no such program for physicians, nurses or health care professionals. Traditionally, a sabbatical is found in university settings one year for every seven worked and focused on rest, travel and research. This is founded on agricultural and religious recommendations of letting the field “rest” every seven years in order to keep the soil nourished for the best crops. When a sabbatical is taken, the academic idea is to build new individual skills and experiences. Suppose a hospital system were to be bold enough to offer a sabbatical pilot program. In that case, they could request that the person apply for this program and show how they will benefit from healing themselves, rejuvenating themselves and creating. Offering the possibility of a sabbatical could be part of the remedy for burnout. Remember the pre-COVID delight of simply planning a vacation? The brain changes and dopamine surges of imagining and planning an experience can sometimes be as rewarding as the actual experience. This can be a market differentiator and will require one year of advanced planning of the entire team involved. If we can transplant a heart into a living person, we can probably figure out how to cover responsibilities for a few weeks of a key person being unavailable. Harvard Business Review highlighted in 2017 that companies with sabbatical offerings (much less disruptive than sudden leaves or absence or FMLA announcements) experienced increased productivity, increased talent building, improved retention and grew an amazing recruitment tool. Four weeks of a physician or nurse being absent from the clinic or floor and remaining employed by the same hospital for the next seven years is a no-brainer. As I am six weeks into my 12-week “career pause,” I have completed my certification in executive coaching, started a YouTube channel, birthed a new company, grown peaches and green beans, spent time celebrating with my children, done much writing and creating, returned to the gym after a six-year absence and have had lunch dates with more friends in the last month than the entire 2000s! This year, many of us have been uncomfortable with the idea of being hailed as “heroes.” We all did our job and kept doing our jobs. Just as soldiers probably don’t need a parade as much as they would like permission to rest and appreciation for what they have done, we are the same. We are begging for a “leave of absence” and time to heal from our own wars. Can we imagine a world where we could start treating ourselves in health care like we treat our patients and soldiers? We can normalize rest, leave and sabbaticals so we can safely get back on the battlefront. Leaders in the military do not wait for the soldiers to ask for time off; many would not ask for such a thing out of duty and obligation (sound familiar?). Sometimes when you are coming out of a traumatic environment, you are the worst person to decide what you need. We challenge strong leaders to begin entertaining sabbaticals as a possible benefit for health care organizations. After 20+ years practicing medicine, I believe in 6 more weeks I will be ready to return to the front line. Source
