For many physicians, returning from vacation means more than getting back to patient care — it also means stepping into one of the most demanding days of the year. A packed schedule, chronic patients due for follow-up, a backlog of test results, administrative responsibilities, and the pressure of clinical decision-making can make that first day back especially tough. It’s little surprising that many doctors say it feels more exhausting than an ordinary workday.

This phenomenon, commonly known as the “rebound effect” of returning to work, is a cause for concern both because of its impact on professionals’ well-being and its potential repercussions on the quality of care. However, experts agree that this situation is not inevitable. Proper organization, gradual planning for the return, and coordinated efforts by the entire healthcare team can make all the difference.

Marisa Valiente Millán, a family and community physician and coordinator of the Emotions and Health Working Group at the Spanish Society of Family and Community Medicine, explained that there are well-identified causes behind this feeling of being overwhelmed.

“Returning to work is not usually stressful for a single reason but rather due to the combination of an abrupt transition from time off to high patient care demands, coupled with a backlog of tasks and the pressure to catch up immediately,” noted Millán.

In primary care, this situation takes on a special dimension. A single clinic appointment can involve scheduled patients, walk-in patients, urgent cases, follow-up for chronic conditions, administrative tasks, and coordination with other levels of care. All of this forces healthcare professionals to constantly switch between tasks while trying to maintain the quality of care.

Determining Factors

Furthermore, scientific evidence on burnout syndrome among healthcare professionals shows that the root of the problem does not lie solely in an individual’s ability to manage stress. Work overload, excessively rigid schedules, limited autonomy in organizing one’s time, constant interruptions, and the perception of a lack of organizational support are all determining factors.

For this reason, Millán pointed out that “it is important to recognize that a short adjustment period is needed upon returning to work because it is a completely normal response to a change in pace.”

For Maria Pilar Niño Oviedo, a specialist in family and community medicine and a member of Spanish Society of Primary Care Physician’s occupational health working group, anxiety about returning to work “is becoming increasingly common and increasingly severe.” And, as she pointed out, it is classified in psychiatric diagnostic manuals. It is an emotionally disruptive response and occurs, above all, in societies with high work demands — particularly among executives, company CEOs, corporate staff, or people who have very little leisure time in their daily lives.

In the specific case of healthcare workers, he described how, after a vacation, “3 or 4 days before returning to work, you begin to experience symptoms of anxiety, such as fatigue, and you’re already anticipating what’s going to happen — such as feeling overwhelmed — once you return to your normal routine.

The Danger of Trying to Make Up for Lost Time

One of the most common mistakes is trying to catch up on everything that was left undone during the vacation within the first few days back. The result is often longer workdays, the elimination of breaks, and a greater sense of exhaustion right from the start.

“It’s unrealistic to try to catch up in 1 or 2 days on everything that piled up during vacation. That effort quickly erases the benefits of rest and increases physical and emotional fatigue,” warned Oviedo.

Compounding the challenge is another common issue: cramming complex clinical visits together with administrative work, prescription refills, report writing, and bureaucratic hassles. This kind of disorganized workflow makes time management harder and leaves many physicians feeling as though they’re constantly running behind.

Various studies on healthcare organization point precisely in the opposite direction. Separating types of consultations, allocating different time slots based on patient complexity, and reducing interruptions improve both efficiency and professional satisfaction.

A Gradual Return to Work

From an organizational standpoint, the ideal return to work is far from starting immediately with a full schedule.

As Millán agreed, the first few days should include dedicated time slots for reviewing medical records, checking diagnostic test results, responding to pending messages, updating treatments, and resolving administrative issues before taking on a full patient load.

The available evidence also supports giving priority attention to certain patients during those first few days. People with complex chronic conditions, frail patients, those recently discharged from the hospital, or those who have experienced recent changes in their treatment are the ones who benefit most from restoring continuity of care as soon as possible.

This approach not only improves clinical follow-up but also reduces the risk for decompensation and prevents minor problems from escalating into more serious situations.

According to Oviedo, the best way to prevent or ease this situation is to put strategies in place that address these dynamics. A gradual transition can make a meaningful difference. Rather than ending vacation abruptly and jumping straight back into the routine, it helps to set aside a day or two to ease back in, check emails before returning, and map out the first week at work, including sleep adjustments if needed. That approach can significantly reduce the sense of overload on day 1.

Another piece of advice is to “try to let go of negative thoughts — what’s known as cognitive restructuring. And, on the other hand, remember that going back to work isn’t like being in prison. You should try to reconnect with your personal values: since you’re a doctor, focus on responsibility, care, creativity, and finding some satisfaction in the structure of your routine — seeing it as something positive. And, at the same time, as you prepare to return, try to plan your ‘micro-pleasures,’ which will gradually bring you back into your routine. For example, having a cup of coffee by yourself, going for a walk at sunset, or calling a friend.”

But, Oviedo warned, “we may also feel a bit uncomfortable with these kinds of changes that are going to occur because it’s not just an individual problem: it’s often an increasingly systemic indicator of this society, with a culture in which productive time and leisure time can become incompatible.”

Prioritizing Based on Clinical Criteria

When demand clearly exceeds the clinic’s capacity — a common situation following vacation periods — the key is not simply to see patients on a first-come, first-served basis.

Experts recommend establishing prioritization criteria based on clinical severity, patient risk, and the need for follow-up.

Acute decompensations, vulnerable patients, those recently discharged from the hospital, or those undergoing significant changes in treatment should be among the top priorities.

At the same time, many administrative or low-complexity consultations can be handled remotely, avoiding unnecessary travel and freeing up time for patients who truly require a physical examination.

“When there is predictability, time to make decisions, and the ability to rely on the rest of the team, the feeling of being overwhelmed decreases, and the capacity to provide attentive, safe, and high-quality care increases,” Oviedo emphasized.

This approach also helps preserve one of the essential elements of family medicine: continuity of care, which is especially important for patients with chronic conditions or multiple illnesses.

Teamwork as a Protective Factor

Returning to work cannot be viewed as the sole responsibility of the physician. There is growing evidence that the best outcomes are achieved through the coordinated efforts of all healthcare professionals at the clinic.

Administrative staff play a key role in the initial triage of patient requests, managing appointments, handling administrative procedures, and guiding patients. For their part, nurses are taking on an increasingly important role in the protocol-based follow-up of chronic patients, health education, and the management of multiple processes.

“Coordination among administration, nursing, and other professionals allows for a better distribution of the care workload, reduces interruptions, and provides more efficient and safer care,” emphasized Millán.

Flexibility in roles, the establishment of shared workflows, and the appropriate use of telephone or telemedicine consultations make it possible to optimize available resources without compromising the quality of care.

Caring for the Professional to Care for the Patient

For Millán, organizing the return to work after vacations should be part of healthcare centers’ routine planning. Designing staggered schedules, temporarily reducing the pressure of care, setting aside dedicated time to review accumulated work, and establishing clear prioritization criteria would contribute both to the well-being of healthcare professionals and to patient safety.

The backlog of demand following vacation periods will likely continue to be a reality in the National Health System. However, assuming that the first day back must necessarily be a race against the clock does not seem to be the best strategy.

According to Oviedo, one factor shaping this shift is that younger generations have a stronger appreciation for work-life balance. They are also more open to building in micro-vacations throughout the year or even taking short breaks — a day here and there — that create small windows to disconnect. During vacations, she said, it’s important to truly unplug both mentally and digitally. Just as importantly, she added, doctors should make room for pleasure, creativity, and a sense of autonomy from work, not only during time off but throughout the year.

But, as Oviedo emphasized, postvacation anxiety “should not be seen as a sign of professional weakness but rather as a legitimate signal from each of us regarding our relationship with work and with ourselves — one that requires attention and demands that we take time to focus on ourselves: rather than thinking of it as a pathology or something that requires medication, I believe we can view it as an opportunity and an invitation to seek fulfillment beyond what our work schedules provide — to seek a culture that values balance more highly, the possibility of taking the vacations we deserve, and not having to endure that daily routine with anxiety and that sense of obligation, but rather to adopt a mindset focused on self-care. And prevention — from a psychological standpoint.”

As Millán concluded, “Protecting professionals’ health through realistic organizational practices isn’t a benefit exclusive to them: caring for the professional is part of caring for the patient and ensures safer, more consistent, and higher-quality care.”

For Oviedo, the new regulations he’s promoting could help mitigate this conflict. “I believe we’ll increasingly have to move in that direction — monitoring and adapting the workplace to address the entire issue of mental health. And this may be because of the kind of life we lead and the race against the clock, especially for family physicians: we know we’ll arrive at the clinic with 80 patients and have only 5 minutes for each one. We’re going to need more and more coping and prevention strategies and, if necessary, seek professional help,” he advised.

This story was translated from El Médico Interactivo on Univadis, part of the Medscape Professional Network.