Taking vacations and paid time off (PTO) are key restorative activities in the general population. The same can be said for physicians. But the problem is many physicians think of PTO as “pretend time off” and face too many barriers to taking that much-needed vacation. While the share of physicians taking four weeks or more of vacation inched up in 2023, an exclusive AMA survey showed that nearly half—48.9%—took three weeks or less, with 5% reporting that they took no vacation days in the previous 12 months.
And even while they are on vacation, many doctors are spending 30 minutes or more catching up on overloaded EHR inboxes and work email, which contributes to—and worsens—physician burnout.
More than 12,400 responses from physicians and nonphysician providers across 30 states were received from more than 80 health systems that participated in the AMA Organizational Biopsy®. The AMA national physician comparison report—which is exclusive data to the AMA that is not published anywhere else—reflects 2023 trends in six key performance indicators: job satisfaction, job stress, burnout, intent to leave an organization, feeling valued by an organization, and total hours spent per week on work-related activities (known as “time spend”).
The purpose of the aggregated data is to provide a national summary of organizational well-being and to serve as a comparison for other health care organizations. The results may be limited by the number of health systems that choose to participate.
In 2023, the physician burnout rate dropped to 48.2%. This is the first time in four years that the physician burnout rate has fallen below 50%. And while burnout dropped, it still hits these six physician specialties most.
For 2023, physicians were asked how many vacation days they had taken in the last 12 months. Of those who responded, physicians reported taking this many days off:
- 20–plus: 23.4%, up from 20.5%.
- 16–20: 27.6%, up from 26.7%.
- 11–15: 24.5%, up from 24.1%.
- 6–10: 13.7%, down from 17.2%.
- 1–5: 5.7%, down from 6.9%.
- Zero: 5%, up from 4.7%.
Physicians are not taking time away from work because of too many barriers. For 2023, the most-cited barriers to taking vacation were:
- The volume of inbox work faced on return—36.1%.
- Financial impact on professional compensation—23.4%.
- Finding someone to cover clinical responsibilities—22.1%.
Meanwhile, more than 70% of physicians reported spending at least some time—with some 90 minutes or more per day—attending to work demands while on vacation. Physicians spent the following amounts of time tending to patient-related phone calls and inbox messages in the EHR and other work-related email while on vacation each day:
- None: 27.9%.
- 1–30 minutes: 30.6%.
- 31–60 minutes: 20.8%.
- 61–90 minutes: 14.3%.
- More than 90 minutes: 6.3%.
As the leader in physician well-being, the AMA is reducing physician burnout by removing administrative burdens and providing real-world solutions to help doctors rediscover the Joy in Medicine™.
At Confluence Health in Wenatchee, Washington, 50% of physicians take four weeks or more of vacation per year and the health system also boasts high job satisfaction rates. Confluence Health is a member of the AMA Health System Program, which provides enterprise solutions to equip leadership, physicians, and care teams with resources to help drive the future of medicine.
Here is how Confluence Health reduces barriers to physicians taking the time off they need and deserve to unlock a restful vacation.
Provide help while away
James Murray, MD, a hospitalist and chief medical officer with Confluence Health, says it’s vital to take responsibilities off a vacationing physician’s plate.
“In one of our primary care departments, when a physician is out of town or off, messages and results get pooled. Physician partners in the department either rotate responsibility for the pool or are assigned someone’s messages and results,” Dr. Murray said. “The goal is to have physicians return to an inbox of zero messages and results, something they have done quite well. We intend to spread this workflow through other departments within the organization.”
He said he recently returned from a 15-day trip in Italy and found the support invaluable.
“Although I spent some time keeping up on email, I relied on three physician leaders to carry on operations,” he said. “Having physicians and physician leaders who can fill in in your absence is extremely important.”
Taking more vacation time—and having the vacation time be truly restful and distraction-free—can help prevent physician burnout.
Keep time off flexible
Jennifer Jorgensen, MD, a gastroenterologist with Confluence Health and the president of the Wenatchee Valley Medical Group (WVMG), said that WVMG—the largest medical group affiliated with Confluence Health—created a highly flexible time off policy.
She said physicians working five days a week need to work 205 days a year and those who work four days a week need to work 184 days per year. The remaining days are not paid but can be used for CME, holidays, personal or vacation time. Most physicians do not use all of their time off, which is not paid, but they can if they choose to.
“Physicians are generally hard-working overachievers, and ours are no different, but I do think our group attracts people who enjoy a wide variety of activities, especially outdoor activities due to our location, and prioritize time away from work to do the things that rejuvenate them,” Dr. Jorgensen said. “As an organization, we talk about provider and employee wellness and prioritize it.”
Dr. Murray said there are clear rewards to the patients, physicians, and healthcare system when burnout is avoided or treated when it arises.
“Physicians who have a better work-life balance tend to be more productive when they are at work and tend to be more engaged with their patients and with the system, so it benefits all,” he said.
Dr. Murray also emphasized that though vacation time may seem like a luxury to driven and busy physicians, it’s a vital part of performing at one’s highest possible level.
“Fatigue is real,” he said. “Finding ways to decompress, relax, and enjoy life outside of work will likely lead to a better, more productive, and more energetic self. You, but also your patients, will benefit from that.”
Learn more from an AMA STEPS Forward® toolkit about reducing barriers to taking time off. AMA STEPS Forward open-access toolkits offer innovative strategies that allow physicians and their staff to thrive in the new health care environment. These resources can help you prevent burnout, create the organizational foundation for joy in medicine and improve practice efficiency.
The standard of care in physician well-being recognition
Institutions in this article have been honored by the Joy in Medicine™ Health System Recognition Program.
