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Balancing Hustle and Rest: A Guide to Self-Employed Time Off

Apr 27, 2024

A recent Medscape study on physician time off revealed some startling findings.

The analysis was representative of all US practicing physicians. Among 3024 respondents who responded to a subsurvey about vacations, about 40% took more than 15 days of vacation over the past year, about 40% took 6-15 days, and about 20% took 5 or fewer days.

The lack of taking time off for so many doctors is shocking to me as someone who has always followed the axiom of "work hard, play hard." Thus, I always take four weeks of vacation every year and one week for continuing medical education. The refreshment of each of these times off is critical for refilling my tank.

PTO & Self -Employment

In your bustling world of medicine, where every moment is dedicated to patient care, documentation, and professional development, the concept of time off can seem like a distant dream. Yet it's essential for you to recognize the significance of downtime in nurturing your well-being and maintaining a healthy work-life balance.

For traditionally employed doctors, paid time off (PTO) is often built into your employment contract, providing a designated period for rest and rejuvenation. You would be foolish not max out this fringe benefit.

However, for self-employed physicians navigating the entrepreneurial landscape, the notion of PTO may seem like a luxury beyond reach. Without the safety net of employer-provided benefits, self-employed doctors often find themselves caught in a perpetual cycle of work, with little time for rest and relaxation.

Sometimes it's just easier to keep working rather than taking time off—with all the arrangements and coverage required.

I get it, as I've always said that the week prior to time off and the week after can be so busy that it makes you wonder if it's worth it—but the reality is that it is worth it. Not only is it worthwhile, but it's critical to your well-being and refilling your energy reserves.

Although time off for self-employed doctors is not a deductible business, it is still an important practice that enhances your long-term productivity and personal resiliency.

Cost of Time Off For The Self-Employed

If you work for yourself, you know time off has an opportunity cost. Self-employed doctors are well aware that taking time off results in a loss of income. In fact, every week I take off from my clinic costs me approximately $14, 000 in income for my PC. Additionally, this leads to fluctuating revenue for my micro-corporation, which has to be carefully managed in my business cash flow.

But it’s worth mentioning that while away, I still receive my self-employment salary from my micro-corporation. Thus, in a way, I do have a form of paid time off similar to my traditionally employed peers. However, as any self-employed business owner will tell you, there are times when you may need to "hold your paycheck" until the cash flow into the business catches up to cover your largest micro-corporation’s expense - your salary.

Allow me to go a little deeper in explaining how things work in my professional corporation’s employment lite contract.

According to my employment agreement, my payment is based on the previous month's wRVUs and is paid two weeks after the last day of the month. This two-week lag is due to the time it takes for the wRVUs to be calculated, reconciled, and approved before my payment is processed. Usually, the direct deposit arrives around mid-month. My wife manages the bookkeeping for our micro-corporation, and our salaries are disbursed on a monthly basis.

This means that when I take time off, it can significantly impact the PC's cash flow, making it especially tight—especially if I take 2 weeks off! Adding to this, we try to operate my PC leanly, essentially emptying any profits annually, therefore managing the cash flow can be quite a task for my bookkeeping wife! When we took 3 weeks off to go to Australia and New Zealand this winter, she really had her work cut out for her.

But time off is crucial, especially for those charting their own professional course as self-employed business owners. Let's explore the importance of downtime in promoting physical, mental, and emotional well-being, and discover strategies for incorporating time off into the life of a self-employed physician.

The Importance of Downtime

1. Rest and Recovery

As physicians, our work is demanding, both physically and mentally. Long hours, high-stress environments, and emotional demands can take a toll on our well-being over time. Time off provides an opportunity for rest and recovery, allowing our bodies and minds to recharge and replenish depleted energy stores. Whether it's a weekend getaway, a leisurely stroll in nature, or simply a day spent lounging at home, prioritizing rest is essential for maintaining peak performance and preventing burnout.

2. Mental Health

The relentless pace of medical practice can have a profound impact on our mental health. Constant exposure to patient suffering, challenging cases, and administrative burdens can contribute to feelings of stress, anxiety, and depression. Time off offers a much-needed respite from the pressures of work, providing space for reflection, relaxation, and self-care. Whether it's engaging in hobbies, spending time with loved ones, or seeking professional support, prioritizing mental health is essential for maintaining overall well-being.

3. Work-Life Balance

For self-employed physicians, achieving work-life balance can be particularly challenging. Without the structure imposed by traditional employment arrangements, it's easy to fall into the trap of overwork and burnout. Time off serves as a crucial tool for establishing boundaries between work and personal life, allowing us to carve out space for activities outside of medicine. Whether it's pursuing hobbies, spending time with family, or simply enjoying moments of solitude, prioritizing work-life balance is essential for long-term career satisfaction and fulfillment.

4. Creativity and Innovation

Time off provides an opportunity for creativity and innovation to flourish. Stepping away from the demands of work allows our minds to wander, explore new ideas, and make unexpected connections. Whether it's brainstorming solutions to clinical challenges, developing new business ventures, or pursuing passion projects, time off fuels our creativity and fosters a spirit of innovation. Embracing downtime as a catalyst for growth and exploration can lead to exciting opportunities and transformative breakthroughs in both our personal and professional lives.

  1. Connecting With Your Partner

When life gets busy, it's easy for our relationships to take a backseat. But making time to connect with your partner, even during time off, is crucial for maintaining a strong, fulfilling bond. Whether it's a weekend getaway or a simple staycation, prioritizing quality time together can breathe new life into your marriage and help you feel closer than ever.

During your time off, try to fully unplug from work and other distractions. Focus on being present with your partner, engaging in meaningful conversations, and creating shared experiences. This could mean trying a new activity, revisiting a favorite spot, or simply savoring quiet moments at home. The key is to be intentional about nurturing your partnership and making it a top priority.

Effective communication is also paramount. Use this time to have meaningful conversations, share your thoughts and feelings, and listen actively to your partner. This not only strengthens your emotional connection but also helps you better understand each other's needs and desires.

Investing in your relationship during time off is an investment in your future. By nurturing the bond you share, you'll build a stronger, more resilient partnership that can withstand the challenges of everyday life. So, make the most of your time off and cherish the opportunity to deepen your connection with your partner.

I am so happy that my wife and I invested in our marriage by taking time away over the years, and with 5 kids, that always included at least a week away for just the two of us—and also included regular weekend getaways. Thank goodness for nearby grandparents!

Incorporating Time Off into Your Life

While the demands of self-employment may make it challenging to take time off, it's essential to prioritize downtime for the sake of our well-being. Here are some strategies for incorporating time off into your life as a self-employed physician:

  • Schedule Regular Breaks: Block off time in your calendar for regular breaks and vacations, treating them as non-negotiable appointments.

  • Set Boundaries: Establish clear boundaries between work and personal life, avoiding the temptation to constantly check emails or take work calls during leisure time.

  • Delegate Tasks: Delegate non-essential tasks to trusted colleagues or support staff, allowing you to free up time for relaxation and self-care.

  • Practice Self-Care: Prioritize self-care activities such as exercise, meditation, and hobbies, making time for activities that nourish your body, mind, and soul.

  • Seek Support: Surround yourself with a supportive network of friends, family, and colleagues who understand the importance of time off and encourage you to prioritize self-care.


In the fast-paced world of medicine, time off may seem like a luxury reserved for the traditionally employed. However, as self-employed physicians, it's essential to recognize the importance of downtime in nurturing our well-being and maintaining a healthy work-life balance. By prioritizing rest, relaxation, and self-care, we can recharge our batteries, foster creativity and innovation, and ultimately lead happier, healthier, and more fulfilling lives.

Here's to embracing the transformative power of time off and nurturing our well-being every step of the way.

If you are looking for a great summer or fall retreat for your family, I invite you to consider getting away to the shores of Lake Michigan at Simpli SoHa.

If you looking for an amazing international CME experience as your time away, I encourage you to check out CME Away—I love traveling with them. Remember to let them know you found about it at SimpliMD. You can read about my Safari in Africa in this post: Unlocking the Magic: Thrilling CME Adventures in Kenya's African Safari