FMLA To Help Modify Your Schedule When You’re Feeling Burnt Out
This post is a little about the state of being burnt out in medicine and how to make sense of the FMLA law in regards to this. I am sure that I am not the only physician to experience feeling burnt out and had I known what I know now I would have addressed it differently when I first started feeling this way.
Take A ‘Burn-Out Test’
There are a lot of different sources you can consult to figure out if what you’re experiencing is feeling ‘burnt out’ or simple apathy to your work, depression or poor work-life balance etc. These 2 states are quite different, one is debilitating and the others just sucks.
When burnt out you likely are getting minimal pleasure from your work, your patients are getting short-changed and your mood/anxiety level is likely affected greatly. It doesn’t have to be a fiery eruption of emotions, it might be a subtle undertone, it might creep up on you without you realizing it and it might be hiding under the surface and break out amidst other personal/life situation.
Diagnosis: Burn-Out, Now What?
Let’s say enough people have suggested or told you that you’re burnt out. You’ve looked into it and determined reluctantly that shit, yea, you’re probably burnt out. It’ll take you a while to admit it and then comes the decision of what the next step should be.
You might opt to take a long vacation, or not pick up as many shifts, maybe decrease your personal stresses or you might start calling in sick more often. If there is a sabbatical you might apply for that or just float along and make yourself numb towards your emotions.
Here is where FMLA, Family & Medical Leave Act, comes in. Let’s not get into the details of FMLA, I’m working on a more detailed post about it which is interesting and expansive. If you suffer a serious health condition then you qualify under this federal law to get a change in your hours or time off. There is no way that I could have overcome my pride the first time I started feeling burnt out to even admit that I needed external help much less pursue a change in my schedule with help of FMLA.
A quick word about a ‘serious health condition‘. Take it from a person who has filled out a fuck-load of FMLA’s for patients, there is no such thing as a serious medical condition. It could be something as serious as cancer, it could be taking care of a family member and it could be bilateral wrist pain.
Bargain With Management First Before FMLA-ing
You may never need to use FMLA if you can convince management to make a change to your schedule that accommodates your current mental/emotional state. You may want to stop working by 8pm or you may want to not work on weekends. The likelihood of that is low however, so back to FMLA.
Let me say that now that I’ve done my stint in admin I never thought any clinician I was supervising was particular taking advantage of FMLA. I won’t mention the details but these individuals used it, if anything, way too little and slightly too late.
Do I know providers who have taken advantage of it? Absolutely. Unfortunately, they sealed their fate among their peers. The medical group has very little they can do about such claims but your peers will hang you long before your boss can, so be sure you are legit about it.
How the FMLA Process works
If you are part of a large medical group then you would fill out the paperwork through HR. Your boss wouldn’t have any rights to know why you are taking leave because it could be for a personal health condition such as cancer, or paternity, or taking care of a close family member etc. If your regular doctor is willing (most are) to fill out your FMLA paperwork for you then the hardest part is to figure out what accommodations would help you with your burnout.
For some having shorter work-days, getting home earlier in the evenings might be what’s needed. Spending less time in the clinic might be all you need to not feel so overwhelmed. Perhaps getting out of the weekend shifts so that you have more time with friends and family might be the cure. There may be tasks you are assigned which are particularly stressful at your job, getting out of that might be restorative. For you surgeons FMLA could get you out of clinic, rounding or out of the OR.
FMLA Protects Your Job And Current Position
You may have requested to go to part-time just to be denied this by your employer. FMLA could simply state that you can work a part-time schedule without any retaliation. Your boss couldn’t demote you during FMLA use, they wouldn’t be allowed to move you to a different department or change your position in any way unless you agree to it.
The great thing about FMLA is that you would be dealing with HR and usually a specific person that’s assigned to you. You wouldn’t have to deal with your boss regarding this. Your HR person could certainly ask for ‘proof’ that you are under the care of a clinician regularly but that doesn’t mean that you have to constantly be seen by a doctor or go to therapy sessions unless you choose to do so.
If I could go back to about 2 years ago I would have used FMLA to work only 4-hour shifts. Of course, at first I would have asked my medical group for a short work-day but they would have likely steered me in the FMLA direction to get that particular schedule. Not all groups are that way, mine was enlightened in that sense.
This would mean that my workday would start at 1pm and end at 5pm. I would have chosen something like this because it would have caused the least disruption for my group and my peers. And that’s the advantage of FMLA, you can come up with something equitable that helps you and doesn’t hurt your workplace. I did end up burning out – in a way I am responsible for not having taken more aggressive measures to prevent this.
Better To FMLA Than To Lose Your Job From Burn-Out
I encourage you to look into FMLA if you are suffering from any emotional state of feeling overwhelmed at work, feeling like you’re drowning or feeling burnt out. There is a small chance that your boss or peers might give you shit for it and yes your ego might be a bit affected. But recognize that you’re doing something bigger for yourself, your patients and your family. Because if you’re in a shitty mood all the time then you aren’t just a drain on yourself but you’re also messing with everyone else’s mojo.
I assure you that if you tell your boss that you’ve had it, you can’t take it no more and that you’re quitting when it’s too late for you to turn things around then your boss would have wished to at least keep you around with a smaller work schedule. Most of us docs won’t know we’re being adversely affected by our jobs until it’s too late.
It’s sort of surreal when you talk to your boss, who in my case is a great friend, and tell them how burnt out you feel. They will usually have no idea and you will be dumbfounded because you thought you were sending all the right signals.
The words tired, exhausted and needing a break aren’t the same as saying “I’m burnt the fuck out, my emotional bank is empty and I am using every bit of energy at work just to keep it together. I sometimes wish that I get hit by a car to be fucked up enough to need bed rest but not too fucked up to die. A severe case of influenza with reversible cardiomyopathy has also sounded appealing recently.”
You Don’t Get Paid For Un-worked Time
It’s important to point out that under FMLA the time you don’t work is unpaid. Your employer may and will likely have you use up all your vacation, educational and sick time to fill in the holes the FMLA creates. There are circumstances where you might be paid for your full shift but only have to work the first few hours of it and perhaps do some message-management work for the rest of the time. I guess the point I’m making is that there is a lot of room for creativity. And if you’re reading this then most likely you’re a valued employee, they are gonna wanna keep you.
Filing for partial or full disability is the next step in this process and I would think that both the employee and the employer would want to avoid that. The advantage to this option is that there is partial pay for un-worked time.
Your HR can be very helpful in helping you navigate this, choosing between unpaid leave, FMLA, disability or even admin-leave. They generally don’t have any selfish reasons for you to choose one thing over another, they want to do it right so as to not get the medical group into trouble. You may or may not even have an ombudsman who can be of great help.