The many benefits of break-time

Even in a busy practice, there should always be time to take a breath and reflect

I noticed recently at medical education meetings that when you ask another doctor how they are, or how work is at the moment, the default answer is always “Oh, busy.” This, of course, is often a true and valid answer – medicine is infamous for being a job with long, hard hours, from the early years in the hospital trenches to when you are finally an established consultant or GP with even more responsibility. I do wonder, however, if we feed into this narrative a little, perhaps for fear of being seen as not working as hard or being as dedicated as our colleagues. It’s rare that you would hear someone say “Things aren’t too bad actually, we’re in a bit of a summer lull” or “We were expecting the post-Bank Holiday rush to be much worse.”

This performative busy-ness starts in medical school, with people boasting that they’re up until midnight studying – it was seen as a badge of honour to be the first one in the library in the morning. I used to feel intimidated and inadequate that I wasn’t keeping up with them all. But now, with the wisdom of time, I look back and wonder what it was all for and how much efficient studying was actually being done.

It gets even worse in the NCHD years when you hear boasting of being too busy to eat or drink or even use the bathroom. I remember hearing stories of people being admitted to the emergency department with renal stones while at work because they were so chronically dehydrated. These incidents used to be talked about with almost a sense of admiration, but again, looking back, it seems absolutely mad and totally unnecessary.

Now that I am in the world of general practice, it’s a different sort of busy-ness. You may not be racking up the step count by running around the hospital, but it’s a constant sustained workload with constant demands for your attention. The challenge is juggling about 20 things in your head at any one time, with the knowledge that there will always be more patients needing to be seen than hours in the day. There will always be something or someone outstanding, there is no point when every task is completed and the job is ‘done’.

However, these breaks aren’t a luxury – we have actually rebranded the 11am slot in our schedule from ‘coffee break’ to ‘clinical meeting’, because very often that’s what they become

Even still, I think it is essential to carve out a few minutes in the day to break together with colleagues, to refresh the sugar and fluid levels, and to catch your breath. I mentioned this to another GP recently and the response was a scoff.

“We’re far too busy for that in our place,” they said.

However, these breaks aren’t a luxury – we have actually rebranded the 11am slot in our schedule from ‘coffee break’ to ‘clinical meeting’, because very often that’s what they become.

Over the kettle, the chat will be along the lines of “Mary was just in to me there and she’s looking awful shook”. Then you’re into a full discussion of her background and personal situation, pulling together a plan of how you’re best going to manage her and her family as a practice going forward. These informal get-togethers allow for sharing of experiences and knowledge, as well as a little burst of light social interaction in the day.

Even though you are spending all day interacting with people, general practice can be a very lonely job if you let it be. You can very easily find yourself being squirrelled away in a room all day by yourself, not talking to anyone but your patients. As the now rare breed of the single-handed GP is becoming more endangered, it is important to remember that the benefits of a large group practice can be just as much for the clinicians as well as the patients. Your colleagues are the people who you spend the most hours of your day with. It is nice to get to know them as people, to find out what they did at the weekend or, more importantly, to check in if they are doing okay or if they need a little bit of support. If you can do all this with a biscuit and a nice cup of tea, more the better.

We very often have medical students in our practice and my one piece of advice for them is that unless there is literally a life-threatening emergency, there is always time to take five minutes to eat, drink, and breathe. This can be an important lesson for medics of all ages and expertise to remember – it will make you a happier, safer, and better doctor.

Dr Neasa Conneally