The 6 month strategy: Beating healthcare burnout
One of the reasons I started working as a travel OT- and recently went to my 6 months a year policy using geoarbitrage to cut my expenses - is because of a little talked about phenomenon: healthcare workers burn out very fast! Here’s some stats:
Doctors have a suicide rate over 2x the general population
Nurses have depression rates 2x the general population
Half of healthcare workers have signs of burnout
Over 25% of clinicians are considering switching careers.
When you spend day in and day out experiencing some of the limits of human suffering- experiencing people who’ve lost their limbs, been paralyzed after gunshots, dependent on oxygen tubing and drains, dealing with bodily fluids, people with severe developmental disabilities abandoned by their families, cracking somebody’s ribs giving them CPR, people with degenerative diseases or cancers...knowing they’re likely going to get worse- Yeah, it’s emotionally stressful!
In some ways, the more stressful part is dealing with the confused mess that is the U.S. health insurance industry. Here’s just a few stories of many (no personal patient info due to privacy concerns):
I had a patient who developed a mysterious condition whereby she lost control in all of her extremities, and was scheduled to have a neurologist consult at a hospital an hour away. So, her daughter had to take time off work in the middle of the day, get her mom down 2 flights of stairs, get her into and out of the car, drive 50 minutes, sign in with the staff, wait 1 hour...and guess what happened! Well, the hospital accepted their insurance, but the doctor did not. A couple days later, they found out an in-network specialist was less than a mile away.
I was sitting in my office finishing up my paperwork, and got a call from the daughter of a patient I had been seeing for a few weeks. The man in question fell and broke one of his kneecaps, needing an immobilizer (so he couldn’t bend the knee). Apparently, the insurance company said we told them that her father was safe to go back home. Remember, this is a man in his 80s and lives in a second story apartment who cannot bend his knee. I responded “Maam, nobody in this office recommended this”. Basically, the insurance company didn’t want to pay for more time in the facility, and put the blame on us. My boss was not happy with my answer.
It was the last day of a hospital contract and I was naturally in a good mood. Then, we get an all hands call for help. It seems a patient fell and one of my much smaller coworkers went to the ground with her. Luckily, the coworker was in her 20s and was able to break her fall without injury. My coworker was not so lucky...she ended up covered in liquidity stool. Let’s say it was a struggle for us to figure out how to get this patient off the ground. It involved pads, a lot of gloves and gowns, and a lot of teamwork. We cleaned up and got pizza like just another day in the office. No big deal, all of us have been covered in body fluids at some point.
A patient on his second or third stay at an inpatient rehab was doing well and looking forward to his discharge home in a few days. He was mobile, walking well, and his son was in town for the first time in years. Despite this, he had a sudden embolism and died nearly on the spot.
Part of my job is coordination orders for specialized equipment, especially custom wheelchairs. Seeing as they can cost as much as a new care, the insurance company wants you to jump through a lot of hoops to get it. The process can easily take 6 months of back and forth before delivery. Meanwhile, a person can be basically bedbound.
I have dozens of stories much more shocking than these, but the point is that it can take an emotional toll after a few years- many people feel it in their first years of practice, not being able to separate themselves from the situations they see everyday.
Knowing this, I came up with a strategy to avoid the compassion fatigue and burnout that plagues our industry-extended time off. Using Geoarbitrage, travel contracts, and relatively minimalist needs; I figured out a way to extend my time in the healthcare industry without the encroaching threat of burnout
Check out my desk before quitting…stacks of paperwork, schedules, meetings, florescent lights, no windows, recirculated air! Was that how I had to live for 40 more years?
It helps as I (generally) like what I do for a living, I just don’t think I can do it 50 weeks a year, every year until my mind and body give out. It’s not a “bullshit job” and produces value to society that I doubt I could find in some office job or blogging/Youtubing/consulting full time. So the plan was set: gradually wean my time as a therapist down to a more manageable workload.
50 weeks a year: 2012-2016- Quit my last full-time “permanent” job. It was the standard 2 weeks vacation a year, ask your boss for “permission” to take off, use your PTO time if you get sick (or patient load drops), dealing with office politics work situation, caring what “corporate
40 weeks a year x 3 2016-2019: I started my first travel Occupational Therapist contract. The pay was significantly higher- enough at the time that it was possible to make my previous year’s salary in around 30 weeks of work a year. The extra 8 weeks pay went to starting my investment journey, paying down interest bearing debts,
32 weeks a year 2020-2022: COVID inspired slowdown inspired a cut down of my work in 2020. To cope, I went to Mexico to cut my expenses until work reopened
26 weeks a year 2022-present. 6 months a year! After 6 years of downsizing, minimizing, debt paying, and learning about finance and investing; it was time to find the balance. I can still make a difference at my job, while still saving for the future, and saving my mind and back from the damage of long term healthcare work. How is this feasible?:
Minimalism: Moving a lot means owning too much stuff is more hassle than it’s worth. Less stuff=less money=less time spent at the office
Learning finance- Most of us don’t take the time to understand how money and finance actually work. How much do I really need to pay all my bills and debts, while saving for the future? How do I put my money to work for me? How do I insure myself?
Purging the consumerist mindset- What am I really working for? Do I really need a new car? Expensive shoes? Six figure mortgage? Expensive watch= don’t care, don’t buy. Playstation 5=something i enjoy, buy.
International Geoarbitrage- spending time off in cheaper countries. It’s possible to save thousands of dollars each month spent in a place like Mexico, Thailand, or the Philippines.
So with the 6 month on/off plan, I am able to reset my burnout meter by enjoying the winters in warm sunny climates, and return for the summers to perform my contribution to society.
