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By late 2020 and early/mid 2021 I was approaching my breaking point at work.
I definitely felt like I was in the grips of burnout, reaching the 7th circle of Burnout Hell.
In that particular post, it was in that 7th Circle where I coined the phrase, “You Can’t Unburn Toast,” which referred to the phenomenon I was experiencing where things still felt grueling even if that particular day of work had a far lower volume of studies to read.
Much like scar tissue formed by a heart attack, it felt like once the damage was done it was irreversible.
Fortunately, as previously mentioned, a hail Mary move by the board occurred that allowed the radiology department to add a coveted radiologist into the fold and pull me back from the precipice of total burnout.
I am pleased to say that it is now exactly 2 months since the addition of the 3rd full-time rad in my department.
I feel like I am in a great place now to see if one can indeed “unburn toast” and recover from burnout.
The Dark Tunnel.
Prior to the arrival of my newest radiology partner, all radiology modalities were covered by 2 radiologists.
Each week-long schedule had us either reading CT, MRI, and Nuclear Medicine studies or X-ray, Ultrasound, and Mammograms.
The CT/MRI week became the most desired one for my partner myself (this assignment did not create as much feelings of burnout as the Xray/US/Mammo one).
On the Mammo week I was reading routinely over 180 studies, and occasionally topped the 200 mark (the breakdown would typically be 60-80 mammograms, 60-80 X-rays, and 50-60 Ultrasounds each day).
On the 200+ study days I really felt fried going home and on more than one occasion questioned why I was subjecting myself to this.
Going to work was not fun, I dreaded what lay in store for me, and noticed sleeping pattern changes.
Mind you there was not much respite being on the other schedule, which I referred to as the “lesser of two evils,” as I routinely still would read 20-25 CTs and 10-15 MRIs/day.
I’m sure there will be some radiologists who will scoff at these numbers, invariably boasting that they easily handle more volume than this and also do it with a smile.
But as I have previously mentioned, this is not a pissing contest.
If you are able to handle far more volume than me and still enjoy working, more power to you.
But for me this volume became unsustainable, especially as I got older, achieved financial independence, and wanted to slow down.
Light at the end of the tunnel.
The day my newest radiology partner joined us could not come soon enough.
In the last few weeks leading up to his arrival I kept reminding myself the end was almost in sight, especially when I had a particularly grueling day at work.
That was just enough motivation to get me through whatever work schedule I was facing.
And then that day finally happened, a sort of Christmas in August (sadly just 2 weeks too late to qualify for the more popular “Christmas in July” moniker).
The schedule was now divided amongst 3 of us.
Because we all agreed the original Xray/US/Mammo week was the toughest, we thought it best to split it and came up with the following schedule breakdown:
- X-ray, Non-Breast Ultrasounds, Nuclear Medicine
- Breast Ultrasounds and Mammography
Scraping off the burnt parts.
To say that this new schedule arrangement was transformative would be a huge understatement.
It was literally like flicking an on/off burnout switch to the off position.
Despite mammography volume increasing (during this time we finally put into service a 3rd mammography suite which we purposely held off until our partner joined), the schedule was now truly a breeze to go through.
The dread of going to work greatly diminished and I might even say altogether disappeared.
It reminded me of when I first joined this practice when it was actually fun to show up to work (I’m still not quite fully there yet though).
The CT/MRI week is now the most demanding one in the rotation (as it really did not change that much from the old schedule), but it is far more tolerable as now I rotate through it every 3rd week.
What is most shocking for me is that my mammogram week, which originally was the one I dreaded the most to be on, is now my favorite one, truly doing a 180.
There are several factors why this happened:
- Removing X-rays and non breast ultrasounds from the mix allowed me to focus primarily on breast imaging and made for a much smoother work flow.
- Without having to go back and forth between X-ray, regular Ultrasound, and Mammograms apparently decreased my mental fatigue (The prior situation was like making a move in chess and then having to play a quarter of football and then go back and do the next chess move).
- My partners and I also decided that this schedule allowed the Mammogram reader to leave early (4pm instead of 5pm) and any stat studies (very uncommon) could be handled by the remaining two.
- I can not emphasize enough how leaving an hour earlier than anticipated improves one’s psyche, especially as it allows me to circumvent rush hour traffic.
Although originally I had planned to go down to a 3-day work week (currently have a 4-day work week), so far we have not found a suitable way to implement this just yet.
With the expansion of the mammography section, as well as increasing volumes due to organic growth of the practice (when I first started out in 2006 it was around 50 physicians in this multi specialty group, currently it is over 90 docs) it is now impossible to have only 2 radiologists to service the volume.
Given how favorable the schedule is for me now, this extra day off is not as vital as it once was for my well-being and therefore was not that big a loss.
The day off my partner and I have is currently provided by our original locum tenens who decided to continue providing this coverage for the near future.
Learning from our past mistakes, we are trying to get ahead of the 8-ball this time and already have plans to start recruiting for a 4th full-time rad.
If you asked me if you could unburn toast/recover from burnout a few months ago I would have emphatically said no.
However my stance on this has softened quite a bit.
I truly feel like a new man/radiologist.
My fiancee has noticed the change as well as I am now far more happier than I was.
There is obviously a financial hit whenever a partner is added to a group, but surprisingly it has not been as dramatic a hit to my financial bottom line as I originally thought.
Granted I know I would obviously make more if the pie was cut in 2 instead of 3 pieces, but, because of the addition of the mammography suite as well as growing volume from continually adding more physicians to the group as a whole, the financial hit is far less than the expected 16.7% decrease (going from 50-50 split to 1/3:1/3:1/3).
Although it looks like it will not apply in my case (I am firmly cemented into the highest marginal tax rate with any scenario), the financial impact will be lessened for those who are able to drop down in their marginal tax bracket with the addition of a partner.
It is hard to completely nail down the financial impact of my new partner joining at this stage namely because I am still having accounts receivable that are coming in from when it was just 2 radiologists working.
The financial statement for last month also was not accurate to determine the financial hit as our newest rad joined almost 2 weeks into the month.
However even if it was a 16.7% financial hit (or even more) I would gladly accept it as my previous workload was unsustainable.
The desire to retire immediately, or even in a couple of years, has also diminished.
I could see myself prolonging my work career a bit, if I choose to, because the current situation is quite manageable.
I no longer feel like I have to escape to save my sanity and one truly cannot put a value on that.
If you can find a job that pays less but allows you to extend your career you may end up having a greater lifetime earning (it is often financially better to have a longer career at a lower pay than a higher paying job that causes you to burnout quickly).
If you are in search of financial help, please consider enlisting the service of any of the sponsors of this blog who I feel are part of the “good guys and gals of finance.”
Even a steadfast DIY’er can sometimes gain benefit from the occasional professional input.
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