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What if we stopped saying “yes” to new demands and reallocated our time based on our priorities? This three-part exercise can help.

Fam Pract Manag. 2021;28(4):38-40

This content conforms to AAFP criteria for CME.

Author disclosures: no relevant financial affiliations.

As we begin to see the light at the end of the COVID-19 tunnel, it is a good time for family physicians to reflect on the past 18 months and how our lives can be better going forward. The pandemic brought unprecedented challenges to our professional and personal lives. As always, family medicine physicians rose to the occasion, but not without a personal cost to us. Even before the pandemic, many of us could relate to Sisyphus, the king from Greek mythology who was forced to roll a boulder up a hill for eternity. Every time he neared the top, the boulder would roll back down, forcing him to start the process again. This is often what the health care system feels like for physicians, leading not just to burnout but also to moral injury.1

If we aren't careful, at some point in our careers, we may look back with regret over missed opportunities, missed family events, and the missed cultivation of stronger relationships with loved ones. This time of regret may arrive abruptly, when we are on the receiving end of a new diagnosis, a failing relationship, or an avalanche at work from which we feel we may never recover. For many physicians, the unique challenges and stressors of the COVID-19 pandemic have intensified this self-examination. However, if carried to action, such introspection could foster the beginning of a better and healthier relationship with the way we practice medicine.


Progressing through medical school, residency, and our careers, we learned to adapt, adjust, and work harder and longer to become more efficient at a job that constantly heaps new duties on us. Although we often excel at managing time, money, our practices, and patient care, many of us have realized that we cannot manage the people closest to us, despite belonging to a profession based on relationships. Instead, we've learned that we need to add margin, or unscheduled time, to our lives to prioritize these relationships and allow them to grow and flourish.

But adding margin is difficult when our careers are so demanding. Over time, many of us have become disillusioned and frustrated as the very resources intended to “assist” us in medicine have often become our dictators. For example, as electronic health records (EHRs) have become ubiquitous, our work has invaded our homes. A recent study showed that the average family physician spends 1.4 hours each day taking care of patients after their regular workday,2 and “in-basket glut” has been tied to physician burnout.3

These stressors have been compounded by the challenges of practicing family medicine during the pandemic. Concerns about personal protective equipment, our personal and family health, financial instability, and changes in our practices have driven burnout levels even higher. A recent Medscape survey of nearly 7,500 physicians in eight countries found that almost two-thirds of U.S. physicians had intensifying levels of burnout.4

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