Leaving Home Ann Evensen, MD, FAAFP University of Wisconsin School of Medicine and Public Health September 11, 2009

Goals Introduce and explore components of an ideal leave plan Start your own leave plan by Considering your future practice Brainstorming options Creating to do list

Reasons to “leave home” Sabbatical Illness Childbearing Adoption Armed services Burn out

Why not slip out the back door?

Why not sneak out the back door? Protect hospital privileges Increase patient safety Improve patient satisfaction Preserve workplace relationships

Be safe! Know your goals Know your options Make a plan

An ideal plan 1) Learn the rules 2) Arrange coverage 3) Make the announcement 4) Manage in boxes 5) Protect privileges 6) Reorient

Know the rules Leave classification Paycheck Benefits Advance warning FMLA

Clinic and call coverage Ask early Keep records Be creative Have reasonable expectations Consider your support staff

Hand-offs are risky Develop procedures Inform all players Empower patients

Notify patients Honor patients’ desire to choose their physician Allows time to develop individual care plans for complex patients Nursing home patients Obstetric patients Frequent flyers

Prepare patients and partners Arrange phone calls, office visits or med refills Schedule realistically Longer appointment times No new patients More administrative time

Notify others Labs, emergency department, med records, medical staff office, referral phone centers, nursing homes No USPS forwarding after 60 days

Where are all of your mailboxes? Close Forward Monitor

Protect hospital privileges What do you want to do when you grow up? Protecting active privileges is easier than getting new privileges. Talk to your hospital medical staff office.

Unique responsibilities Give them up Reschedule Find a substitute

Prepare for return to practice Emotions Retraining Limitations Scheduling

Reorientation Job tasks (scrubs, doors, pager, email) Hospital operations Clinic operations Paycheck and benefits Advertising

Unplanned leave Delegate these tasks Prioritize patient safety and protecting privileges

Planning for the inevitable Leave plan that can be put into quick action for An individual (spouse’s health is deteriorating, high risk pregnancy) An organization (generic leave plan that can be activated for unplanned leaves)

Create your own plan

Take Home Message Taking time off is ok! Leaves of absence are possible with planning and negotiation. Be creative! Protect yourself and your patients. Don’t forget to say thank you to those who made it possible for you to go.

Thank you