Decent hours as cardiologist

[amazin_grace]

I am an MS4 seriously considering cardiology as a long-term career. Is there any way to work reasonable hours as a non-invasive cardiologist? I am talking 45-50 hours/week total. I love cardiology more than any other field by far but I plan on being a very involved parent. I do not want to consistently miss extracurricular activities, dinner at home, or not be able to spend time with my kids on weekends. I am okay with any practice pattern so long as it is at least 2 days of clinic/week (i.e. I do not want to be a pure "radiologist" reading cardiac MRI/CT all week) and I do not care about salary. Cardiology is the main thing within IM that I am interested in, and if there is no way to be the kind of parent I want to be as a cardiologist, I will have to look at non-IM fields for residency.

I have spoken to almost all of the cardiology attendings with children at my home institution (tertiary care center) and they have decent but not great family lives. Most work from 7 AM to 6 PM (about 55 hours/week), take call one weekend in 8, and nominally cover themselves during the week but typically only come in once or twice per year (fellows take care of it until the morning). Most of them are involved in research that eats up time after 6 PM, but a few do not work from home so they are actually present with their kids. I have spoken to one private cardiologist who works like crazy and has a horrible home life (7 AM-7 PM every day, Q5Day call, going in for several hours and working the whole next day each time he is on call), but do not know any others.

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[P Diddy]

I am an MS4 seriously considering cardiology as a long-term career. Is there any way to work reasonable hours as a non-invasive cardiologist? I am talking 45-50 hours/week total. I love cardiology more than any other field by far but I plan on being a very involved parent. I do not want to consistently miss extracurricular activities, dinner at home, or not be able to spend time with my kids on weekends. I am okay with any practice pattern so long as it is at least 2 days of clinic/week (i.e. I do not want to be a pure "radiologist" reading cardiac MRI/CT all week) and I do not care about salary. Cardiology is the main thing within IM that I am interested in, and if there is no way to be the kind of parent I want to be as a cardiologist, I will have to look at non-IM fields for residency.

I have spoken to almost all of the cardiology attendings with children at my home institution (tertiary care center) and they have decent but not great family lives. Most work from 7 AM to 6 PM (about 55 hours/week), take call one weekend in 8, and nominally cover themselves during the week but typically only come in once or twice per year (fellows take care of it until the morning). Most of them are involved in research that eats up time after 6 PM, but a few do not work from home so they are actually present with their kids. I have spoken to one private cardiologist who works like crazy and has a horrible home life (7 AM-7 PM every day, Q5Day call, going in for several hours and working the whole next day each time he is on call), but do not know any others.

Yes this is possible, but those parameters constrain your choices. The best option that comes to mind is the VA at an academic center. You check out at 5, have massive holidays, and residents take call when you're on service. I'm sure there are other possibilities but this is one that I know qualifies.

p diddy

 

[amazin_grace]

Yes this is possible, but those parameters constrain your choices. The best option that comes to mind is the VA at an academic center. You check out at 5, have massive holidays, and residents take call when you're on service. I'm sure there are other possibilities but this is one that I know qualifies.

p diddy

Are there other places you could do this? VA at an academic center sounds like there are not that many job openings in a particular location. Does anyone know if private practices would ever swing for an easier schedule (albeit for less pay)? If not, why not?

 

[P Diddy]

Are there other places you could do this? VA at an academic center sounds like there are not that many job openings in a particular location. Does anyone know if private practices would ever swing for an easier schedule (albeit for less pay)? If not, why not?

Private practices need physicians who work hard and pull their weight, generating not only revenue for the practice but truly sharing in the work. If you're working part-time and seeing patients in clinic, who will cover those patients when you're off/not taking call? Everyone else in the practice. Why would they want to do that? They also want to see their families. You are unlikely to find what you seek in private practice; it's too much of a headache for a private practice, and there are plenty of candidates who don't demand your stipulations.

The academics in your institution seem to have a good schedule. I would suggest also looking at academic medical centers or any hospital with a residency/fellowship program (particularly county hospitals).

I would also add your demands won't be easy to meet in non-IM fields either, so be prepared. I would add again that there is value in doing what you love for your job. For example, you could do general outpatient IM and have the schedule you desire (many IM practices have 4 days/week 8-5 and an admin day, and if anything serious comes in on home call you just send them to the ED) in terms of hours, but if it's no fun those hours are going to seem pretty long, and you won't be in the best of moods when you go home to your family. What's that worth?

p diddy

 

[hotshotdoc]

Frankly speaking it would be hard to find such a job in the present scenario. Not impossible though. You would certainly not fit into private practice. VA or an academic center would be a better choice. The way medicine is moving forward we all may have to work more for the same (or even less) amount of money.

 

[Weinberg Angle]

...

 

[nope80]

How about as a woman wanting a part-time job? Are these possible? What would be the best way of achieving this?

 

[desdinova]

I don't think you will be able to have a lifestyle and do cards in any setting other than clinical educator in academia..Even there though you are expected to produce research results or stay on administrative side.
On a side note... Medicine is (still) a very unique and elite profession which commands some respect and prestige because of education but also involvement, dedication and sacrifices we have to make for our patients. If you're looking for "day job" and not a career then medicine and in particular cards is probably not the best choice. Perhaps derm office will get you that lifestyle if you don't like anything else other than cards in IM.
I don't want to sound rude and it's nothing personal but attitude you're presenting , I suppose typical for Generation Y , is one of the reasons why medicine lost so much of its prestige.. Current residents don't know what 36h call is , they are developing "shift-work mentality" (sign out at 4:30 no matter what) with no ownership of their patients or passion for what they do.

Again, medicine and particularly cards is a career for determined, driven individuals and keep this in mind when you choose specialty. Derm/Endo/Rheum come to mind if lifestyle is important but it's still hardly a fixed schedule. Only PAs, APRNs and administration people have fixed schedules. Good luck with your choice, make sure explore all the options since professional happiness is the most important factor contributing to how happy you will be at home no matter how many hours you will work per week or day.

 

[nope80]

I don't think its fair to tie the prestige of a specialty to the number of hours people want to work. Cardiology is incredibly prestigious but people need to have lives. If a person is forced to work all the time, is unhappy about this, they aren't going to be able to give as a doctor. I hope there are private practice jobs out there that understand work life balance.....

 

[gutonc]

I don't think its fair to tie the prestige of a specialty to the number of hours people want to work. Cardiology is incredibly prestigious but people need to have lives. If a person is forced to work all the time, is unhappy about this, they aren't going to be able to give as a doctor. I hope there are private practice jobs out there that understand work life balance.....

There are...just not in cardiology.

 

[nope80]

If that is true, that is really depressing.....
There has got to be a way to work as a cardiologist, and have manageable schedule. especially for women w families

 

[Myostatin]

Spot on. In an academic setting as a non-invasive cardiologist or EP, it might be possible, but those jobs are few and far between. CMS has been / is on the war path with cardiology reimbursement. In private practice, with fixed expenses, the only way to make a decent living is see more and more patients / do more procedures... If you're seeing 40-50 patients a day, you're not going to have a good work life balance, and if you're going into private practice not ready to do what it takes, you're going to flounder / not make partner.

Consider derm, ophthalmology, etc.... if work life balance is that important to you.

I don't condone 30+ hr shifts (or worse) that prior generations had to go through, but at the end of the day it prepares you for the reality that there are no work hours once you're in the real world....

 

[nope80]

Consider derm, ophthalmology, etc.... if work life balance is that important to you.

I don't condone 30+ hr shifts (or worse) that prior generations had to go through, but at the end of the day it prepares you for the reality that there are no work hours once you're in the real world....

Haha well what about for us that already made this "mistake". work life balance is important but we are in cards training, past the point of specialty decision making :/

 

[gutonc]

Haha well what about for us that already made this "mistake". work life balance is important but we are in cards training, past the point of specialty decision making :/

So you're already a cards fellow? At any point in your training to this stage, have you seen someone with the type of career you want? Sure, it may seem like everyone in academic medicine is a gunner at times (and certain programs either promote or require that kind of attitude) but I assure you that if the kind of career that you want is practical, someone near you is doing it. Find them and ask how they did it.