Editor's Note
A Business of Busyness
“Busy?” a colleague asks as we pass in the hall. I mumble a perfunctory “Yep” and start to count the number of times I get asked that by fellow physicians and patients. It’s a well-meaning, pro forma greeting whose answer gets lost in the banter. Yet there must be a reason why physicians ask each other that question so often. At times I’ve thought it’s almost a macho thing, residue from the era when physicians wore bags under their eyes like medals for meritorious service and bragged about the 50 patients they saw that day. And why do patients ask about the “B” word? Perhaps they view it as a symbol of quality, each chart they see in your stack for the day further evidence of your excellence. After all, if your doctor doesn’t have many patients to see, can he or she be any good?
Medicine is a business of busyness. The “busy doctor” is a cultural cliché nurtured by physicians reaching for their pagers at social gatherings or by television’s scrub-suited doctors rushing wherever they go. Physicians get introduced to the cliché when medical school crams every hour with courses and rotations and residency tests the limits of work-hour restrictions so physicians-in-training can see more cases to get more education. Once in practice, the pressures to be punctual and productive keep doctors dashing from exam room to exam room, further perpetuating the cliché.
To a certain extent, busyness is a necessity of medicine. As lifelong learners, the more we see the more we know. Taking care of more people means more people are cared for. And it does take a certain volume of business to support a practice.
Yet the returns diminish when busyness hits the wall. Learning stops when the brain is overloaded. Caring suffers when fatigue rules. We start worrying more about meeting deadlines than meeting people. Practicing medicine trumps family. And, epitomized by the morphing of the doctors’ lounge from gathering place to work station and the demise of the hospital staff meeting, we let socializing with our peers wither. It is a prescription for the burnout that can start as early as medical school.
Fortunately, many doctors have recognized the insidious debility of busyness and designed their own treatment. Some have chosen specialties or jobs with well-defined time demands. Some have pursued mid-career development through a Bush fellowship. And one spent a year on a boat. As with treating any illness, diagnosing the problem is the first and most important step.
So how busy is busy enough? I’ve asked fellow physicians that question for years. I frequently get a perplexed look or a shrug or “less busy than I am today” as an answer. Certainly one doctor’s sprint is another’s stroll, and I doubt any formula can calculate the perfect pace. But I think “listening” to the pace of your day and continually asking yourself whether you are ignoring what’s important in your work or your life is a start to finding balance.
I had an attending physician in medical school who was a superb clinician with a bulldog intellect who drove himself to exhaustion and terrorized his students and residents while teaching them good medicine. Convinced that I would adopt his approach to the medical life, he came up to my wife at my medical school graduation and said, “Don’t expect to see your husband too much in future years. He’ll be too busy.” I carry many of his lessons with me today. However, that piece of “wisdom” I chose to ignore.
Charles R. Meyer, M.D., editor in chief
Dr. Meyer can be reached at
cmeyer1@fairview.org