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Finding time away for rads can be complicated – but, it’s necessary.

I haven’t gone on vacation since before COVID. It’s been about a year and a half, but I’m finally getting away for a bit.

That’s not to say I haven’t taken any days off. Relating to holidays, for instance, to facilitate familial or social meet-ups. Still, far fewer than I’m allowed by my contract…and that’s been my state of affairs since long before the pandemic. I just don’t take much vacay.

I used to. Back in my pre-teleradiology days, when I was salaried and the vacation-deal was “use it or lose it.” I would size up my calendar for a forthcoming year and, having squared away any must-be-free dates like weddings, I’d put in for every single day I had coming to me.

I had a standard approach, beginning with the rationale that my time off should be evenly spaced around the year; thus, I wouldn’t have any disproportionately-longer stretches of work between breaks. If, say, I had 6 weeks coming to me, I should use one every couple of months…

…except summertime was great right where I lived, and I could thoroughly enjoy every single weekend, right there. No need to take any time off between June and September. Suddenly, my calendar only had 8 months for those six weeks…and the notion of planning a getaway almost one week out of every month seemed unpleasantly hectic. It boggled my mind when I heard about rads who had 10-to-12 weeks off.

If I’d stayed in such a position, I probably would have gotten more sophisticated about it by now: Used some of my time to scatter some extended weekends around the year, etc. Instead, I moved on to vRad, where fulltime work necessitated at least a week-on, week-off schedule. Which, technically, gives 26 weeks of “vacation,” but I’ve described in other columns why it doesn’t really work out that way for most rads (one of the reasons I left vR).

Even after that, I’ve found that working via telerad changes the way I think about vacation. When you work from home, there’s less of a perceived need to vacate. Unless you don’t particularly like your home and want to get away from it. Heck, people take vacations to stay at home so commonly that the word “staycation” got invented.

The other thing that changed in my post-vRad tele-life was a different approach to comp in my current group, one I think isn’t as widely used as it should be. The group’s approach isn’t salaried or per-click, but rather based on how many hours one works. “Vacation” is just a certain number of weeks per year that one is allowed to not work…but when you’re not working, you’re not earning.

“Unpaid time off?!” came the cries of dismay from some folks in my life when I originally told them about it. As if it was some sort of crime against humanity. I tried explaining that it was just a matter of perspective; if it really matters to you, just divide your annual income by 52 weeks and consider your off-weeks paid at that rate. Some of them “got it,” then. Others still seemed to think I was being cheated and failing to recognize it.

The neat thing about this was that my vacay was no longer a “use it or lose it” affair. Gone was the annual almost-chore of figuring out how to allocate my time around the calendar to properly slice the intervals I’d be driving into an office. Now, I could just use the time I genuinely wanted/needed, and leave the rest over to feed my bank account a little more.

Any time I didn’t use as vacay just stayed on the schedule as “extra” time I’d be working at my normal hourly rate. If, during the year, I came up with some occasion that could use a day or two off, I had enough slack in my system to take those, too…rather than having to cannibalize a vacation week I’d scheduled months earlier.

Not only does that work for a telerad like myself (and probably more than a few onsite-working rads), it’s gravy for the rad group. They’re getting more of a return-on-investment for the rads they hired, and they’ve got that much more redundancy in their coverage.

Might there be too much of this good thing? Money-hungry rads taking less time off than their mental health needs, or consuming more RVUs that other rads were counting on to meet their productivity goals? Groups concerned about that might institute a hybrid system: 50 percent of your available vacation-time is “use it or lose it,” and the other half can be worked pro rata. Details of course can be played with: Make it 75 percent-25 percent, or 25-75 if that fits better.

I do think that some degree of unavoidable downtime is good for everyone involved. “All work and no play,” as the saying goes. Again, I took no formal vacations during the past 1.5 years, and felt fine with it…but maybe other rads or ancillary staff in my group noticed undesirable changes in my attitude. Or maybe some quiet disgruntlement has been bubbling up inside of me, stuff I won’t notice till it’s close to boiling over. Maybe I do need some of the vacation I haven’t been taking.

And that doesn’t just go for full-time work. If one or more readers perceived that this column had some less-than chapters relative to years gone by, it wouldn’t be unreasonable to suggest that maybe I’d have done better if I’d had an occasional week away in which I didn’t have a chance to do any writing.

It would be sufficiently reasonable, in fact, that you’ll next hear from me in two weeks.

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