Valerie Brooke, MD
Doctors Don't Do Lunch
As part of my research on physician burnout, I have been reading books by other physicians who suggest multiple different strategies for treating and preventing burnout. These books have a lot of wisdom and certainly have made me change how I think about my work environment, where I have control, where I can make changes, and what things I can let go of.
I recently read this excerpt from a book “Remedy for Burnout” written by Starla Fitch, MD. In it she explains seven different ways doctors can rediscover meaning in their work. With all due respect, there was one story from her book that I’d like to challenge. In the chapter on Encouraging Connection, she wrote:
Friday, I was in the break room at the hospital scarfing down a power bar between three-hour cases. The truth was, I was multi-tasking: eating, writing on a chart and checking my email in my phone.
I had received an email from a businesswoman, whom I have known for a few years. She wanted to know if I wanted to join her for lunch, this week.
I laughed out loud.
The rest of the staff, who were busy also grabbing a quick bite in between cases, looked up. I read the email out loud.
"Lunch?!" they all asked.
We laughed and shook our heads.
Doctors don't do lunch.
Even when I am in the office for the day, not the O.R., taking a break and actually leaving the office for lunch is out of the question. On those super busy days, I bring something slightly more like real food to eat than my usual power bar. And I heat up hot water for some tea.
But always, as the water warms for my tea, I complete the morning's charts, fill out paperwork for surgery the next day, and answer questions from my staff on patient concerns.
So no, I wouldn't exactly call that a true "lunch hour."
I totally agree with Dr. Fitch that doctors don’t do lunch. We sit at our computers while woofing down something from the cafeteria or some food we brought in from home. Recently my medical director shared with us the exciting news that a pulmonologist would start being able to see patients at our rehabilitation hospital, before and after their outpatient clinic schedule. He then remarked they could also pop over on their lunch breaks, to which I responded, “Well then that’s not a lunch break.” He looked at me, smiled and jotted off urgently to his next meeting.
Two years ago, right before the pandemic hit for the first time, I remember going outside to have a quick lunch with a therapist friend. I was lamenting to her how exhausted I was, how I felt like I never had any mental space, as I was constantly being interrupted all day long. How I couldn’t ever leave for a real lunch break or go very far as I had to be available in case one of my patients started to decline. The therapist was on her scheduled 30-minute lunch break, and like other salaried employees in our hospital, she also had two 15-minute breaks, as determined by labor law. These laws don’t apply to physicians, but I wondered why not? Maybe we would deliver better health care if we did take breaks at work.
Since that time, and ever since I recognized my own burnout, I have started to challenge the assumption that doctors don’t do lunch. Why not? Who is standing over me telling me that I cannot take a lunch break? Absolutely no one. While it’s true that I may need to stay a bit later in the day to finish up my documentation, no one is holding a gun to my head to make me eat my wrap while typing notes on the computer. And while it’s also true that I cannot leave the hospital grounds, unless I want my colleagues to be responsible for my patients, I can take breaks. If I really make it a priority.
I first started to change this no lunch break habit by closing my office door for 20 minutes, with a sign on it that said, “do not disturb unless it’s a patient emergency.” But I would still eat while staring at my computer. The closed door just meant no interruptions to my note writing. Then I realized it was probably healthier for my digestion if I didn’t do any medical work while eating, so I moved over to another chair and small desk in my office, where I would open up my personal computer to follow up on emails. Still multi-tasking. Next step was to realize there wasn’t much difference between the medical and personal “work,” so I stopped looking at any computer while eating my lunch.
This was a step in the right direction, though eating alone by myself in my office with the door shut was incredibly isolating. Then I realized I needed connection. Before the pandemic the physicians and leadership staff used to eat together in a small room off the cafeteria. It was a wonderful way to socialize, get to know one another and talk about non-work things. Since that was no longer an option due to pandemic social distancing rules, I recently started to have lunch with a good friend at work, just her and I in her office. Our relationship has improved, and we are able to support one another with both work and personal life challenges.
The greatest change to my lunch hour however came when I realized that I could also meditate for 20 minutes in the quiet room every day, before I have lunch with my friend. Gasp!!! That means I am taking a 40-45-minute lunch break. Every single day. How dare me. And yes, it’s true that I leave about an hour later every day, but this reset in the middle of the day makes it so much easier to continue to take care of patients in the afternoons.
So, I wonder how many of us believe we cannot take a lunch break, when we actually can. We are powerful as physicians. We can set boundaries and close our doors, eat lunch in a quiet place, and lunch doesn’t have to be 40 minutes long. It can be 10 minutes. I have realized how often as a physician I have complained about things in a prideful way: “I don’t have time for lunch; I have three more new patients to admit: I have to work 12 days in a row when I am on call.” I have challenged myself with these statements as they are based on inaccurate assumptions. I can take a break for lunch. I can say no to another admission. I can take the last two days off during my call stretch so that I only work 10 days in a row. I actually do have some control over my work environment. These changes have made me happier to go to work every day. And happy doctor equals happy patients, which means happy administration. Spread the happy. Take a lunch break.