Managing Your Dermatology Practice: Work Less

Year’s end is a good time to do your annual maintenance evaluation. Check all of your equipment for malfunctions. Have your curettes and scissors resharpened. Back up your computer files and upgrade software as necessary. And above all, take a good look at the status of your most important asset: yourself.

I write this reminder every couple of years because it’s so easy to lose sight of the big picture among the pressures of our daily routines. Sooner or later, no matter how dedicated we are, the grind gets to all of us, leading to fatigue, irritability, and a progressive decline in motivation. And we are too busy to sit down and think about what we might do to break that vicious cycle. This is detrimental to our own well-being, as well as that of our patients.

There are many ways to maintain your intellectual and emotional health, but here’s how I do it: I work less. Yes, less. I take individual days off (average of one a month) to catch up on journals, take a CME course, or to try something new – something I’ve been thinking about doing "someday, when there is time" – such as a piano or sailing lessons, or a long weekend away with my wife. And I take no less than 4 weeks’ vacation per year.

I know how some of you feel about "wasting" a workday. Vacations are even worse because patients might go elsewhere while you’re gone, and every day the office is idle, we "lose money."

That whole paradigm is wrong. Stop thinking day to day; think year to year instead. You bring in a given amount of revenue per year – more on some days, less on others, and none on weekends and vacation days. It all averages out in the end.

Besides, this is much more important than money. This is breaking the routine, clearing the cobwebs, living your life. And trust me, your practice will still be there when you return.

I am writing this month’s column from Greece. Yesterday, my wife and I, and two of my kids, hiked to the top of the Byzantine ruins of Mystra on the Peloponnese Peninsula; tomorrow we will climb the sanctuary at Delfi. As I huff and puff up the trails, I don’t have the time – or the slightest inclination – to worry about the office. After these 10 days, I will return ready to take on the world, and my practice, anew.

And I will have jotted down some great ideas – practical, medical, and literary. Original thoughts are hard to come by during the daily grind, but they often appear, unannounced, in a new and refreshing environment.

Creative people have long recognized the value of working less. A classic example is the oft-told story of Swiss research scientists Alex Müller and J. Georg Bednorz. In 1986 they reached a major impasse in their superconductivity research; it appeared two decades of work might be for naught. The harder they pressed, the more elusive the answer became. So Müller decided to take time off, put aside his troubles, and research a subject that had always interested him: ceramics.

Nothing could have been further from his research field, of course, since ceramics are among the poorest conductors known. Yet as he relaxed, it occurred to Müller that a unique property of ceramics might apply to their project. Back in the lab, the team created a ceramic compound that became the first successful "high-temperature" superconductor.

The rest, as they say, is history; Müller and Bednorz won a Nobel Prize and triggered an explosion of research leading to breakthroughs in computing, electricity transmission, magnetically-elevated trains, and many other applications that are still being realized.

By working less, you may not change the world, but you will change you; any nudge out of your comfort zone will give you fresh ideas and help you look at the same old problems in completely new ways.

And to those who still can’t bear the thought of taking time off, remember Eastern’s Second Law: Your last words will NOT be, "I wish I had spent more time in the office!"

Year’s end is a good time to do your annual maintenance evaluation. Check all of your equipment for malfunctions. Have your curettes and scissors resharpened. Back up your computer files and upgrade software as necessary. And above all, take a good look at the status of your most important asset: yourself.

I write this reminder every couple of years because it’s so easy to lose sight of the big picture among the pressures of our daily routines. Sooner or later, no matter how dedicated we are, the grind gets to all of us, leading to fatigue, irritability, and a progressive decline in motivation. And we are too busy to sit down and think about what we might do to break that vicious cycle. This is detrimental to our own well-being, as well as that of our patients.

There are many ways to maintain your intellectual and emotional health, but here’s how I do it: I work less. Yes, less. I take individual days off (average of one a month) to catch up on journals, take a CME course, or to try something new – something I’ve been thinking about doing "someday, when there is time" – such as a piano or sailing lessons, or a long weekend away with my wife. And I take no less than 4 weeks’ vacation per year.

I know how some of you feel about "wasting" a workday. Vacations are even worse because patients might go elsewhere while you’re gone, and every day the office is idle, we "lose money."

That whole paradigm is wrong. Stop thinking day to day; think year to year instead. You bring in a given amount of revenue per year – more on some days, less on others, and none on weekends and vacation days. It all averages out in the end.

Besides, this is much more important than money. This is breaking the routine, clearing the cobwebs, living your life. And trust me, your practice will still be there when you return.

I am writing this month’s column from Greece. Yesterday, my wife and I, and two of my kids, hiked to the top of the Byzantine ruins of Mystra on the Peloponnese Peninsula; tomorrow we will climb the sanctuary at Delfi. As I huff and puff up the trails, I don’t have the time – or the slightest inclination – to worry about the office. After these 10 days, I will return ready to take on the world, and my practice, anew.

And I will have jotted down some great ideas – practical, medical, and literary. Original thoughts are hard to come by during the daily grind, but they often appear, unannounced, in a new and refreshing environment.

Creative people have long recognized the value of working less. A classic example is the oft-told story of Swiss research scientists Alex Müller and J. Georg Bednorz. In 1986 they reached a major impasse in their superconductivity research; it appeared two decades of work might be for naught. The harder they pressed, the more elusive the answer became. So Müller decided to take time off, put aside his troubles, and research a subject that had always interested him: ceramics.

Nothing could have been further from his research field, of course, since ceramics are among the poorest conductors known. Yet as he relaxed, it occurred to Müller that a unique property of ceramics might apply to their project. Back in the lab, the team created a ceramic compound that became the first successful "high-temperature" superconductor.

The rest, as they say, is history; Müller and Bednorz won a Nobel Prize and triggered an explosion of research leading to breakthroughs in computing, electricity transmission, magnetically-elevated trains, and many other applications that are still being realized.

By working less, you may not change the world, but you will change you; any nudge out of your comfort zone will give you fresh ideas and help you look at the same old problems in completely new ways.

And to those who still can’t bear the thought of taking time off, remember Eastern’s Second Law: Your last words will NOT be, "I wish I had spent more time in the office!"

Year’s end is a good time to do your annual maintenance evaluation. Check all of your equipment for malfunctions. Have your curettes and scissors resharpened. Back up your computer files and upgrade software as necessary. And above all, take a good look at the status of your most important asset: yourself.

I write this reminder every couple of years because it’s so easy to lose sight of the big picture among the pressures of our daily routines. Sooner or later, no matter how dedicated we are, the grind gets to all of us, leading to fatigue, irritability, and a progressive decline in motivation. And we are too busy to sit down and think about what we might do to break that vicious cycle. This is detrimental to our own well-being, as well as that of our patients.

There are many ways to maintain your intellectual and emotional health, but here’s how I do it: I work less. Yes, less. I take individual days off (average of one a month) to catch up on journals, take a CME course, or to try something new – something I’ve been thinking about doing "someday, when there is time" – such as a piano or sailing lessons, or a long weekend away with my wife. And I take no less than 4 weeks’ vacation per year.

I know how some of you feel about "wasting" a workday. Vacations are even worse because patients might go elsewhere while you’re gone, and every day the office is idle, we "lose money."

That whole paradigm is wrong. Stop thinking day to day; think year to year instead. You bring in a given amount of revenue per year – more on some days, less on others, and none on weekends and vacation days. It all averages out in the end.

Besides, this is much more important than money. This is breaking the routine, clearing the cobwebs, living your life. And trust me, your practice will still be there when you return.

I am writing this month’s column from Greece. Yesterday, my wife and I, and two of my kids, hiked to the top of the Byzantine ruins of Mystra on the Peloponnese Peninsula; tomorrow we will climb the sanctuary at Delfi. As I huff and puff up the trails, I don’t have the time – or the slightest inclination – to worry about the office. After these 10 days, I will return ready to take on the world, and my practice, anew.

And I will have jotted down some great ideas – practical, medical, and literary. Original thoughts are hard to come by during the daily grind, but they often appear, unannounced, in a new and refreshing environment.

Creative people have long recognized the value of working less. A classic example is the oft-told story of Swiss research scientists Alex Müller and J. Georg Bednorz. In 1986 they reached a major impasse in their superconductivity research; it appeared two decades of work might be for naught. The harder they pressed, the more elusive the answer became. So Müller decided to take time off, put aside his troubles, and research a subject that had always interested him: ceramics.

Nothing could have been further from his research field, of course, since ceramics are among the poorest conductors known. Yet as he relaxed, it occurred to Müller that a unique property of ceramics might apply to their project. Back in the lab, the team created a ceramic compound that became the first successful "high-temperature" superconductor.

The rest, as they say, is history; Müller and Bednorz won a Nobel Prize and triggered an explosion of research leading to breakthroughs in computing, electricity transmission, magnetically-elevated trains, and many other applications that are still being realized.

By working less, you may not change the world, but you will change you; any nudge out of your comfort zone will give you fresh ideas and help you look at the same old problems in completely new ways.

And to those who still can’t bear the thought of taking time off, remember Eastern’s Second Law: Your last words will NOT be, "I wish I had spent more time in the office!"