Tempus Monetæ

Work-life balance in healthcare? It's possible (really).

I’m not a big “art” person. I know what I like, but I’m also very much aware of what I don’t. I’m unafraid to opine that a particular item just isn’t art in my eyes. Randomly splashing paint on a canvas, for instance, is unimpressive, whether done by me or some guy whose name demands adulation and millions of dollars for his mess.

And yet, some would argue, sufficient previous achievements in the art-world by that guy serve to put his slop on a level far beyond anything I could create—even if I just happened to create identical paint-splashes. Is it fair? No, but regular readers of this column will know what I think of that particular F-word.

Similarly, when Elon Musk says something that anybody else could (and, indeed, many have), rightly or wrongly it gets a lot of attention. Early this month, for instance, he tweeted “Time is the ultimate currency.” To date, that got well over 468,000 “likes,” 76,000 retweets, and 32,300-something comments.

Now, some of that was fueled by his involvement with cryptocurrency. When your mere words can make intangible things like Bitcoin and Dogecoin soar or plummet in value, people pay attention to those words. Maybe even hope to ride on your coat-tails to their own fame and fortune.

Nevertheless, quips like “time is money” are far from new. The actual phrase is credited to Benjamin Franklin, but a brief online search on the matter turned up Antiphon, a Greek orator who wrote “the most costly outlay is time” somewhere around 430 BC.

It’s surely older than that, because it seems like most people personally reach that conclusion sooner or later in their lives (whether or not they sum it up in a pithy way that gets others’ attention). You can spend your limited time to earn potentially-unlimited money…not so much the other way around.

Which is, really, one of the reasons you have to pay (or otherwise coerce) most people if you want them to work for you. You are “compensating” them for the time they’re spending on your behalf, time they might have preferred to use on other things.

There’s no small amount of mental gymnastics that goes on as people try to convince themselves and one another that arranging the time they spend working in certain ways will be better than others. Healthcare is no exception, and in radiology (especially telerad) we get particularly creative.

Most consider a “good” work schedule to be the inverse of when they’d like to be free to do other things. That is, they want to sleep at night, they want to have weekends and holidays off so they can see friends and family that have similar schedules, and they’d prefer not to have to wake too early or stay up too late. Presto: Monday through Friday, 9-5 is what a lot of people consider “normal.”

Some fields, like healthcare, make that a nigh-unobtainable Holy Grail. People get sick and injured 24-7, 365. So we find ways to cover those numerous other hours and days using rotating call-schedules, eniority schemes where folks work progressively less of the hours they dislike as time goes on, and shift-differentials, which pay better for less-desired times so people self-select to fill them.

As mentioned above, teleradiology has been particularly clever about all of this; once you stop depending on your workforce physically showing up, or indeed living in the area at all, your options greatly increase.

Firstly, when you’ve got a roster of hundreds of rads rather than a handful, there’s much more potential for redundancy and schedule overlap. Let’s say, for example, that 1 in 10 rads are willing to work purely nocturnally: If your radgroup is only 10 strong, that’s one guy you might have to cover all the nights. But if your group numbers 400, now there are 40 to provide coverage.

Second, when there’s a nation- (or world-) wide pool of remote telerads to draw from, the chances increase that just about any schedule you offer will have takers. Nobody local wants overnights? Somebody on the other side of the globe could cover those hours as daytime work. 7-on, 7-off nights? 7-on, 14-off? Weekends only? Name your scheme…or, alternatively, be receptive when telerads come out of the woodwork proposing things you haven’t thought of that might work for you.

Naysayers will turn up, too: In our social-media world, the “stop liking what I don’t like” crowd is far from shy about decrying the opinions and preferences of others. Want to work 9-5, M-F without nights or weekends? Expect others to call you things like “selfish” and “unrealistic,” even if you’ve already baked in the notion that this might lower your comp and exclude you from partnership tracks. Decided that 7-on, 7-off nights works for you? Be prepared for criticism that you are feeding the Evil Corporate Forces of teleradiology, and that you’ll be burned out in a couple of years.

The fact remains that only you can really know what working-schedule would best suit you…and that might change over time. My first job, working in a psych clinic during summers in college, had a 1-9pm routine. That was perfect for me; I could stay up late with friends every day after work, and then sleep in the next morning without consequence. Or I could go running at night after work was done, when it was cooler and there were fewer cars on the road.

But if you offered me those hours now? Ugh, no thanks. I’d never be able to have dinner at a normal hour with friends/fam, or indeed do much of anything with my evenings.

When I joined a corporate telerad in 2011, their 7-on, 7-off nocturnal schedule was fine for me: I lived alone, and had a million ideas about how I’d use the 26 weeks of time off each year. Fast-forward a few years, however, and I came to hate having half of my holidays and weekends spoken for. My current job, with comparatively-few weeks off per year but most weekends/holidays free, was a change I eagerly made.

For rads on the job-seeking end of things, I’d suggest regularly (re)visiting this subject in honest introspection. What schedule do you really want, versus what you can tolerate? How’s that likely to change in the visible future? Does the job you’re considering really suit you, now or in a couple of years? If you find yourself thinking, “I can put up with it because…” that’s a warning-sign.

And for would-be employers, it’s worth remembering that your scheduling needs don’t exist in a vacuum. The less flexible you’re willing to be in getting it filled, the fewer candidates you’ll have to choose from.