You begin your day knowing that you have ten appointments in the morning and around 15 in the evening slot. When you walk into your clinic, however, you notice a lot more patients than you anticipated. The first thought that comes to the minds of most doctors is, “It’s manageable!”. By the time you wrap up the first half of your day, you realise that the number of patients you consulted is way more than you saw in the waiting room.
While this may sound like a one-off occurrence, most doctors and healthcare professionals attending to patients know – “It’s not!” Joining the healthcare workforce, we are somehow obligated to say ‘yes’ to every patient who walks through the doors or schedule an appointment for every call that comes our way. We are here for them, aren’t we? But, what about our personal time, family time or time to relax during the day to allow our minds and bodies to rejuvenate?
In many parts of the world, the 1st of May is observed as ‘May Day’, ‘worker’s say’ or ‘labour day’. Did you know that towards the end of the 19th century, the fight for an eight-hour work routine to ensure work-life balance ended in the observation of this day? Working long hours has become the norm, irrespective of the industry, age, gender or country. The modified saying “All work and no play makes Jack a dead boy” explains the consequences of working extra hours aptly. Believe it or not, working less is, in fact, a matter of life and death!
The COVID-19 pandemic exposed the crumbling health infrastructure in the country, including the overworked healthcare workers. In the second wave alone, we lost over 300 doctors and many more nurses, ward boys, technicians, and other frontline health workers.
Why are We Working More?
There are numerous reasons why people are working more. From ambition to financial needs, achieving their goals or making up for staff shortage in their respective fields, working more has become the predominant trend. As healthcare professionals, we are largely aware of the consequences of working more, but still, the number of doctors and nurses working overtime is only increasing by the day.
Some common reasons why healthcare workers are working more than required include:
- Shortage of staff leading to overload (India has just 9.3 doctors per 10,000 citizens)
- Job demands
- Targets related to productivity
- Professional, personal and financial commitments
- Increased documentation times
- The need for more money to make ends meet
- Established doctors tend to work more due to high patient load and addiction to their profession
- Lack of enough specialists in the country puts an excessive burden on the existing ones
Apart from these apparent reasons out there in the open, two key drivers that send healthcare professionals way overboard with their working hours each day are– guilt and obligation! As a healthcare professional, there is an innate feeling that we should not be saying a ‘no’ to any patient. That’s what we have been taught in medical school.
Not just in urban setups but even in the rural landscape with an even lower doctor: patient ratios, inadequate health infrastructure, shortage of nurses, ASHA and Anganwadi workers, everyone is under the same pressure– to work more to make more! Are we all losing sight of life in the pursuit?
As Indians, it’s ingrained in us to show that ‘we are working’. A person who works less is often looked down upon, especially a doctor who spends the day with just a few patients. Many young doctors work overtime, well-past midnight, to prove that they are always working. The same Indian workaholic mentality works when patients judge the doctor’s practice by the number of patients in their working room. “Idhar patients kam hai, doctor ki practice chalti nahi hogi shayad” is not an uncommon thought in the minds of patients.
For all these reasons and more, Indian healthcare professionals have set an unrealistic standard of working hours, which is slowly eating away into their lives.
Consequences of Working More
The red flags of overworking can be seen in one’s physical, mental, emotional and psychological health and wellbeing.
Multiple studies have been conducted on various cohorts of professionals across multiple industries. Fatigue, boredom, frequent illness, and reduced productivity are some of the signs and symptoms observed in most people who work overtime.
Working more has led to burnout, depression, and dissatisfaction in their careers among physicians and healthcare community members. It is ubiquitous to find healthcare workers taking shorter, less frequent vacations, sacrificing their sleep or leisure time to attend to their patients. With the integrated lifestyle that today’s generation is living, most of us have to play multiple roles in our daily lives and switch between them umpteen times.
Overworked healthcare workers are detrimental to a healthcare organisation as they result in lower quality of care more mistakes in diagnosis, treatment planning and surgical procedures– all of which can turn out to be expensive for the organisation and life-threatening to patients.
Burnout, the most common result of working too much, is characterised by the following cardiac signs and symptoms:
- Poor work-life balance
- Inefficient workflows
- Loss of control over the schedule
- Poor emotional resilience
Research conducted in Tamil Nadu in 2016 states that nearly 50% of doctors in India are prone to CVDs owing to their unhealthy lifestyle, poor eating habits and lack of adequate physical activity. As a healthcare professional, working less is good for you and improves your relationships with your patients and colleagues.
Can You Work Less?
In a hectic world, it is natural to wonder, “Can I work less?” and still achieve the same results? Is work-life balance a myth? You’ll be shocked to know that it is a possibility and a necessity. While baby boomers are beginning to retire, the millennials and Gen-Z realise the importance of a work-life balance. With most nuclear families being double-income-with-kids, it is vital to have a work-life balance to maintain healthy family dynamics.
Many younger healthcare professionals understand the importance of life outside their work and improve their existing quality of life. Creating clearly defined goals from each sector of life makes it possible to work less and live more!
How To Live: Tips to Work Less
As healthcare professionals wanting to work less, many of our wishes depend upon our government and the facility we are associated with. The government needs to address the heavy burden that the Indian healthcare workforce is shouldering on their backs. Increasing the number of medical, nursing and allied healthcare colleges, raising the number of seats available in post-graduation across all streams, increasing healthcare funding, improving healthcare infrastructure, adopting advanced tools and machines to support healthy workspaces for doctors– all this while ensuring patient care improves.
As a healthcare professional caught in the web of ‘work more but want to live more’ here’s how you can improve your quality of life:
- Prioritise work and focus on quality
- Take leaves whenever you can to relax and spend time doing something you love
- It’s okay to say ‘no’ when you don’t feel you are adding value to a job
- Schedule time for exercise at a time that is convenient for you every day
- Create a change at your workplace to benefit the work-life balance of all your colleagues
The first step to working less and living more is to accept that we are all working overtime. There is cut-throat competition between professionals in the healthcare sector, especially doctors. Competing with your peers and trying to prove you are the best by making more money, treating more patients, etc., can be your path to working more and living less. It’s time to acknowledge that we all have just one life, and it’s upto us whether we want to work more and live less or maintain balanced work and live more to enjoy life.