Temporary leave from medical practice: Insights and tips from Dr Mayhew

Taking a temporary leave from your medical practice can give you time and capacity to manage challenges in your personal life or pursue endeavours beyond traditional clinical practice. Planning your temporary leave time strategically will enable you to make the best use of your time away from practice while ensuring your patients have access to continuous care.  

Business Pathways is excited to share insights on temporary leave from Dr Maureen Mayhew, Program Physician at the Physician Health Program (PHP). Dr Mayhew is also a physician coach, author, and clinical professor at the University of British Columbia (UBC). 

What are common kinds of temporary leave?

1. Medical leave: Medical leave is taken when a physician experiences illness or treatment that prevents them from fulfilling their duties as a physician. Medical leave for physicians typically involves weeks, months, or years of absence from work rather than days.
2. Parental leave: Doctors of BC offers physicians up to 17 weeks of paid leave through the Parental Leave Program, and new parents may extend their absence by taking additional unpaid leave. 
3. Leave of absence or unpaid leave: This form of leave encompasses circumstances that justify a physician taking a temporary break from their professional duties. Unpaid leave enables physicians to pursue humanitarian work, to care for a loved one, or to seek personal enrichment, while maintaining their professional standing. 

How might I plan for temporary leave?

When contemplating a temporary leave, it’s best to plan well in advance, as this will ensure a smooth transition. Regardless of your reasons for planning a leave, the planning process can evoke emotions such as guilt or shame, which may cause you to veer away from making the difficult decision to temporarily leave your practice—even if you know it’s the best decision for you. In this circumstance it may be helpful to speak with the Physician Health Program (PHP) to work through these emotions and accept that taking a break from work may be crucial to your well-being and to developing healthy routines.

In circumstances where planning a leave in advance isn’t possible and you must leave your practice suddenly, planning may need to occur after your leave begins. 

Workplace considerations

Locum physicians can provide work coverage so you can reap the benefits of a full break from professional duties, giving you time to heal or focus on other important elements in your life. If hiring a locum is not feasible, consider asking a network of colleagues to cover your leave. If you are in a group practice, does your group have a policy on cross-covering for each other in equitable ways? 

You may find it helpful to discuss business concerns or needs with a regional Business Advisor before taking prolonged leave.

Financial considerations

Before you take a leave, assess your financial situation and identify how you will cover upcoming bills. Speak with your accountant and financial planner to develop a plan for the duration of the leave. This may include claiming insurance or withdrawing savings or RSPs if your annual income allows. 

Rural physicians on a maternity, parental, or medical leave of absence may be eligible for up to 1 year of continued rural benefits and should consult the Rural Retention Program (RRP) requirements prior to taking the leave. Link to policy framework is here.

Insurance coverage

Early planning in anticipation of a temporary leave includes ensuring fees are paid so your plans never lapse, and determining if your plans provide adequate coverage for your changing cost of living requirements.

Adequate insurance functions as a safety net throughout your career and allows you to take a temporary leave when needed. Delaying the purchase of insurance or changing your insurance can have an enormous impact on your well-being. A few key types of insurance are listed below:

• Disability insurance is critical; it protects against income loss during periods when you cannot work. If disability insurance lapses, any disease you have at the time you reapply will not be covered by the plan. Contact an Insurance Advisor at Doctors of BC for help navigating disability insurance. It can often be advantageous to have more than one disability insurance plan. The Doctors of BC Physician Disability Insurance (PDI) Plan is free for physicians.
• Professional expense insurance covers overhead expenses and staff salaries when you're on medical leave. Although no physician wants to need professional expense insurance or any other kind of insurance, having it in times of need can be life changing.
• Life insurance is especially important if you are supporting dependents.

Thoroughly review and understand your insurance policies, including coverage, waiting periods, reimbursement processes, and exclusions. Note that early enrollment in insurance programs often mitigates cost and potential limitations in coverage. 

For more information on these types of insurance and others, or to review your coverage, you can speak to one of our Insurance Advisors at Doctors of BC.

College notification and license requirements

You must notify the College of Physicians and Surgeons of BC when taking a temporary leave. Prior notification is required but is situation dependent. For more personalized information contact the College or the Physician Health Program. Disclosing temporary leave to the College is valuable for your own protection. 

The College allows you to temporarily inactivate your license when you are not able to work for several months. The advantage of inactivating your license is that you are no longer responsible for providing medical care to your patients until the license is reactivated. You may also apply for refunds on the cost of your license as well as membership to organizations. The disadvantage to inactivating your license is that this will render any repeat prescriptions or lab requisitions invalid, and the patient will have to seek care elsewhere. Inactivating your license simply requires filling out a one-page form from the College.

What do I do when I want to return to work?

How quickly and at what pace you return to work after a temporary leave varies immensely. Some physicians are ready to return to work at full capacity after their temporary leave; others require a gradual approach. To establish a greater work-life balance, you may consider options like shifting your work to part-time or adopting other alternatives.

Managing expectations from patients and colleagues can set you up for a successful return to work. Set clear boundaries and include yourself as someone to whom you provide care every day to help prolong your longevity in practice. 

Create a return-to-work plan

The purpose of a return-to-work plan is to provide structure to you and your colleagues. A good plan helps manage expectations, especially when you are returning from medical leave. After an illness, many doctors want to return to work as quickly as possible, but there can be significant challenges with a rapid return to work. A return-to-work plan can help you set and maintain healthy work boundaries and minimize the risk of relapsing or feeling overwhelmed. Creating a return-to-work plan with your treating team can help everyone understand your approach.

It’s a good idea to seek an outside opinion when re-evaluating your health and personal situation. The Physician Health Program is a good place to start.

Reactivate your license with the College

If you inactivated your license temporarily, you would need to contact the Health Monitoring Department of the College to discuss your return to work. During that discussion the Registrar will want to see a return-to-work plan and letters of support from your treating team.

Seek support

When returning to work, you may choose to seek support both at home and in the workplace. 

A few useful strategies and supports may include:

• Reassessing your work patterns and hours of work.
• Allocating time to fulfilling your new priorities. 
• Engaging a nanny or family member to help at home.
• Employing a personal assistant.
• Sharing a practice.
• Delegating work.
• Cutting costs to meet a lower income.

Conclusion

Temporary leave for medical professionals is a multi-faceted journey that is best experienced with careful planning and support. Understanding the diverse kinds of leave and their implications will enable you to make informed decisions and navigate both your absence and your eventual return in a healthy, sustainable way. 

The Physician Health Program has a dedicated and skilled clinical team trained to support physicians and medical learners navigate temporary leave and returning to work. Read the Return to Work Support informational one-pager to learn how they can support you. Access the program by calling the 24/7 support line (1 800-663-6729), or emailing them at View Email Addressinfo@physicianhealth.com. 

Dr Mayhew is a program physician at the Physician Health Program, a physician coach, and a clinical professor at the University of British Columbia (UBC). 

Dr Mayhew supports and guides physicians needing mental health advice through her work with PHP and in the life/leadership coaching she offers physicians. Recently, Dr Mayhew authored a memoir, Hand on my Heart – A Canadian Doctor’s Awakening in Afghanistan. In it, she explores the unexpected lessons learned during her decade-long tenure in Afghanistan. With a rich background in global health, she offers a unique perspective shaped by years of teaching, research, and hands-on experience.

Resources

• Hand on my Heart – A Canadian Doctor’s Awakening in Afghanistan by Dr Maureen Mayhew
  • Interviews about the book 
• Physician Health Program 
• Changing to temporarily inactive – The College of Physicians and Surgeons of British Columbia
• Parental leave – Doctors of BC
• Disability insurance – Doctors of BC
• Business expense insurance – Doctors of BC
• How to maintain mental health every day – Healthy Mind Platter
• Boundaries - Brené Brown, PhD
• Kindness and compassion practices 
• Meditation and mindfulness – Waking Up App