Pajama time severance: How to leave work at work

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The Apple TV+ series "Severance" follows Mark Scout, a man grieving the loss of his wife outside of the office and who is unaware he has a wife inside the office. The protagonist submits himself to a "severance" procedure, splitting himself into two people. When severed people enter the office, they have no memory of their life outside of work. However, when they are out of office, they have no memory of their 9-5 day.

It is difficult for physicians to leave work at the end of the day and not take it home. We have coined a term for this called pajama time. Pajama time is a term used to describe doctors working outside of regular hours, often at home. Pajama time includes completing EMR records, billing, and creating prior authorizations to obtain permission for patients' medications, tests, or procedures. These pajama-time tasks are uncompensated and may require 1-2 hours of work each evening.

The causes of pajama time include:

• Administrative tasks may require doctors to complete these tasks outside of work hours.
• Completing electronic health records (EHRs) at the end of the day.
• Responding to emails and phone calls that can't done during office hours is done outside of work hours.
• Staying current on reading journals and publications cannot be accomplished during work hours; it must be done outside of work hours.

Consequences of pajama time?

• Pajama time can affect doctors' job satisfaction and impact patient care.
• Pajama time contributes to physician burnout at epidemic proportions, impacting nearly 50% of all physicians.
• Deterioration in patient satisfaction impacts our online reputation.
• Pajama time can lead to doctors sacrificing personal and family time and deteriorating relationships with family and friends.

To successfully have severance and leave work at work and avoid bringing it home, focus on creating clear boundaries, establishing routines, and practicing self-care techniques.

1. Set clear boundaries:

• Define work hours and stick to them, or at least make a commitment that when you leave the office, you will not work at home and will take only emergency calls or emails.
• Try to start and end your workday at designated times and resist the urge to check emails or work outside these hours.
• Communicate your boundaries: Let your colleagues know you're unavailable after work hours, and avoid taking work-related calls or responding to emails outside your designated work time.

2. Establish routines:

• Create a closing ritual: Develop a routine to signal the end of your workday, such as tidying up your workspace, reviewing your to-do list, or planning for the next day.
• Use your commute to transition: Utilize your commute time to mentally detach from work and shift your focus to personal activities or relaxation.
• Schedule after-work activities: Plan enjoyable activities to look forward to after work, such as exercise, hobbies, or spending time with family and friends.

3. Practice Self-Care:

• Prioritize exercise and relaxation: Incorporate physical activity and mindfulness techniques like meditation or yoga to manage stress and improve mental well-being.

4. Limit work-related discussions:

• Try to avoid work-related conversations at home.

5. Manage your stress:

• Practice mindfulness: Engage in mindfulness exercises to help you manage stress, reduce overthinking, and promote mental clarity.
• Seek professional support: If you're struggling with work-related stress, consider seeking support from a therapist or life coach.

6. Consider an unplugged hour or, better yet, a day where you do not respond to cell phone\internet. Most of us are tethered to the Internet and iPhone seven days a week and even on vacation. We have become slaves of social media, Email, texting, and apps.

A solution to this enslavement is getting unplugged or having an "electronic" Sabbatical" when you are totally unplugged from the Internet, mobile phone, computer, iPad, and other electronic devices for just a few hours in the evening. After going without the computer umbilical cord in the evening, when you are free from the digital world, you will notice dramatic changes within yourself. You will think differently, act differently, and see things from a new perspective.

Bottom Line: It is not easy to be severed from our work when we go home at the end of the day. However, by implementing a few of these recommendations, you can effectively separate work from personal life, reduce stress, create a healthier work-life balance, and maybe use your pajama time for family and friends and have time to pour yourself a glass of wine and watch an episode of "Severance."

Neil Baum, MD, a Professor of Clinical Urology at Tulane University in New Orleans, LA. Dr. Baum is the author of several books, including the best-selling book, Marketing Your Medical Practice-Ethically, Effectively, and Economically, which has sold over 225,000 copies and has been translated into Spanish.