24 hour shifts

[JkGrocerz]

I never heard about these until a few days ago. Are there people out there who really work 24 hour shifts? I heard they do about 8 a month or so but even with all that time off, I think a shift like that would be insane. I start zoning out after 9 hours and am dead tired after 12. Have any of the seniors looked into positions like these?

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[spyderdoc]

A lot of these are in low volume, middle of nowhere EDs where you can get some predictable (usually, of course) downtime. I don't think I can ever do these either. Too painful...I do 8hr shifts now, and by the time the 6-7th hr comes around, I am itching to get out of there....

 

[mikecwru]

I never heard about these until a few days ago. Are there people out there who really work 24 hour shifts? I heard they do about 8 a month or so but even with all that time off, I think a shift like that would be insane. I start zoning out after 9 hours and am dead tired after 12. Have any of the seniors looked into positions like these?

I only have one friend who is in a work situation like this, and like was said previously, it's a very low <10k volume podunk ED where it's more like a "call" and he gets downtime to sleep, etc. He gets paid very well and has a lot of off time.

mike

 

[DrQuinn]

If I were single, I would so do it. Work 2 days a week, make 250-300k a year for a couple years. Wow. I would probably post more on SDN (while at work), too.

Q

 

[beyond all hope]

One of my former attendings just busted out. 5 24 hour shifts a month at a 8K/year ER in a little skitown in New Mexico, I think.

Yes, she works one day a week. Probably makes 150-200K. Probably sleeps most nights. Pretty crazy, eh?

 

[JackBauERfan]

One of my former attendings just busted out. 5 24 hour shifts a month at a 8K/year ER in a little skitown in New Mexico, I think.

Yes, she works one day a week. Probably makes 150-200K. Probably sleeps most nights. Pretty crazy, eh?

yeah like everyone says this happens in small towns. I did ED tech at one of these places and there were 3 docs with the 4th beind a random moonlighting one. So they worked one day and was off the next three (at least the regulars did) and it is busiest (12 bed ED) from like 7-1am, then it seems like normal nights they get some naps in, and if the patients are not life-threatening complaints, they would wait to be seen until like 3-4 piled up, then the ed doctor would come in, make his orders, see the patient, then sleep for another hour til everything came back and thats how it pretty much went. Sometimes not any patients would come so they can get some nice sleep.

 

[AmoryBlaine]

The only person I know who did this was working in a very rural ED and would often sleep for 2-3 hours between pts. I think he told me that on his worst shift he still got like 6 hours of sleep.

 

[docB]

I do some of these in our rural EDs. I usually see ~20 during the 24. I have a bad black cloud so I usually don't get any sleep. I've done my best to quit the 24s and only do 12s.

 

[binswanger]

I also moonlight at 2 rural EDs. One has 24 hour shifts and the other has 36 hour shift for "moonlighters" (come in on Friday 7p leave Sunday 7a). On the 24 hour shifts I see about 30 patients with on average 3-5 hours of sleep. The place with the 36 hour shifts I see on average 20 patients with 7-9 hours of sleep (sometimes interrupted) each night. Certainly these shifts are not set up for a high volume ED like many of you are used to working out but its not a bad gig for moonlighting.......

 

[Saladin MD]

I also moonlight at 2 rural EDs. One has 24 hour shifts and the other has 36 hour shift for "moonlighters" (come in on Friday 7p leave Sunday 7a). On the 24 hour shifts I see about 30 patients with on average 3-5 hours of sleep. The place with the 36 hour shifts I see on average 20 patients with 7-9 hours of sleep (sometimes interrupted) each night. Certainly these shifts are not set up for a high volume ED like many of you are used to working out but its not a bad gig for moonlighting.......

Wow. This sounds amazing. I don't care where I live if I could work just one day a week or one 36 hour shift. Question for you: do such options exist for IM doctors? I am asking this because it seems like these sort of gigs are only available in rural places, and I've also heard that some rural Emergency rooms will hire IM doctors. So if I did IM, would such opportunities exist in rural places? I ask because I think EM would be too hard for me to match into (being an IMG). Plus, I am a bit undecided on things, so going the IM route would leave my doors open.

 

[WerdSalid]

I do 24 hrs shifts. I am contracted for 5-8 shifts per month but usually pick up 9-10. Our annual census is around 17K and it seems I average anywhere from 40-60 patients on any given shift. A good night for me is 3-4 hrs of frequently interrupted sleep somewhere between 3am and 7am. We have single MD coverage but have a very experienced PA that works afternoons mon-fri. Overall, I love the 24 hr setup. I only have to THINK about work while DRIVING to work 8 times per month.

 

[gutonc]

Wow. This sounds amazing. I don't care where I live if I could work just one day a week or one 36 hour shift. Question for you: do such options exist for IM doctors? I am asking this because it seems like these sort of gigs are only available in rural places, and I've also heard that some rural Emergency rooms will hire IM doctors. So if I did IM, would such opportunities exist in rural places? I ask because I think EM would be too hard for me to match into (being an IMG). Plus, I am a bit undecided on things, so going the IM route would leave my doors open.

There are rural hospitals in my neck of the woods that hire hospitalist moonlighters to cover the entire weekend. 7a Sat - 7a Mon or thereabouts. They usually have housing in or near the hospital. IIRC (and it's been 2 years since looked into this) pay was $60-70/h and workload was something like 5-8 patients already in the hospital and admitting usually roughly that many over the weekend.

Another hospital in town hires moonlighters to do admitting shifts on the weekends. No cross-cover, no rounding. 7p-7a F, Sa, Su nights. $1200/shift. You earn it though.

These jobs are out there in IM too and probably easier to get than ED jobs for an IM trained MD.

 

[Saladin MD]

There are rural hospitals in my neck of the woods that hire hospitalist moonlighters to cover the entire weekend. 7a Sat - 7a Mon or thereabouts. They usually have housing in or near the hospital. IIRC (and it's been 2 years since looked into this) pay was $60-70/h and workload was something like 5-8 patients already in the hospital and admitting usually roughly that many over the weekend.

Another hospital in town hires moonlighters to do admitting shifts on the weekends. No cross-cover, no rounding. 7p-7a F, Sa, Su nights. $1200/shift. You earn it though.

These jobs are out there in IM too and probably easier to get than ED jobs for an IM trained MD.

Thanks. I appreciate your response. So it seems that IM docs get paid $70-100/hr (which seems to be what you said as well as what one of my resident friends told me) as opposed to the ER pay of $150/hr ? Do IM docs make a bit of that up in bonuses?

So at this second job, could you potentially work one massive 36 hour shift per week, making $2400 per week?

Also, if you did such a thing, then do you lose out on health benefits and other forms of compensation that jobs generally offer?

I guess this is all very premature for me to ask since I am just applying for the match this year, but I just wanted to know that those sort of opportunities exist, so that I can feel better about having to give up my extra-curriculars for 3 years of IM residency. That thought is really bumming me out.

 

[Saladin MD]

I do 24 hrs shifts. I am contracted for 5-8 shifts per month but usually pick up 9-10. Our annual census is around 17K and it seems I average anywhere from 40-60 patients on any given shift. A good night for me is 3-4 hrs of frequently interrupted sleep somewhere between 3am and 7am. We have single MD coverage but have a very experienced PA that works afternoons mon-fri. Overall, I love the 24 hr setup. I only have to THINK about work while DRIVING to work 8 times per month.

Are you an ER doctor or IM doctor? Can you give us a hint about the pay for each 24 hour shift?

EDIT: Sorry, I didn't mean to hijack the thread. Just really fascinated by this concept of 24 hour shifts, since it would mean I could not need to abandon my extra-curriculars in life.

 

[WerdSalid]

My group is compensated around $145-$155 per hour depending on the number of years with the group. Flat hourly rate. No RVU's. I am EM trained as are the other group members. Remember though that hourly compensation is just a slice of the overall compensation package including health insurance, bonuses, malpractice, CME expenses, etc.

 

[GeneralVeers]

A couple of rural EDs I work at doing 12 hour shifts let me get 3-4 hours of sleep usually.

I think the 24 hour would be a bit much, as some nights you're going to get a constant stream of low-acuity BS interrupting your nap time.

 

[Saladin MD]

My group is compensated around $145-$155 per hour depending on the number of years with the group. Flat hourly rate. No RVU's. I am EM trained as are the other group members. Remember though that hourly compensation is just a slice of the overall compensation package including health insurance, bonuses, malpractice, CME expenses, etc.

So if you got a job with one 36 hour shift per week, would you still get the health insurance, bonuses, retirement stuff, malpractice, etc?

 

[GeneralVeers]

So if you got a job with one 36 hour shift per week, would you still get the health insurance, bonuses, retirement stuff, malpractice, etc?

It depends on the group. Almost all have minimum number of monthly hours to be considered "full time" and hence get benefits. At my group it's 108 hours. In other groups it can be up to 140.

 

[Saladin MD]

It depends on the group. Almost all have minimum number of monthly hours to be considered "full time" and hence get benefits. At my group it's 108 hours. In other groups it can be up to 140.

Cool. Thirty-six hours per week would be full-time in both cases.

36 x 4 = 144 > 140 > 108

 

[SoCuteMD]

Cool. Thirty-six hours per week would be full-time in both cases.

36 x 4 = 144 > 140 > 108

It also depends on what the setup at that ED is. Some are independent contractor - meaning you don't get any benefits (other than malpractice in many cases). Health/life/dental/disability are all your responsibility.

 

[GeneralVeers]

It also depends on what the setup at that ED is. Some are independent contractor - meaning you don't get any benefits (other than malpractice in many cases). Health/life/dental/disability are all your responsibility.

That's almost entirely up to you. Most of the larger groups offer benefits if you're full time. When you're part time you typically sign an independent contractor agreement.

My group owns its own malpractice and health insurance plans, so there is some advantage in terms of overhead if you're in a group that does this.

 

[Jeff698]

I would rather shoot myself than do 24 hour shifts. The thought of it makes me tired. I'm doing 12 hour single coverage shifts and leave feeling drained.

For those that want to do 24s, more power to you. I can't think of anything that would be more physically and emotionally draining than that, but more power to ya.

Take care,
Jeff

 

[Saladin MD]

Thanks guys. I know it's all premature at this stage for me, but it's nice to know that there is light at the end of the tunnel and a possible end to the rat race. Makes it easier to bear the burden now.

 

[omarsaleh66]

I would rather shoot myself than do 24 hour shifts. The thought of it makes me tired. I'm doing 12 hour single coverage shifts and leave feeling drained.

For those that want to do 24s, more power to you. I can't think of anything that would be more physically and emotionally draining than that, but more power to ya.

Take care,
Jeff

I did a 60hour shift last week which was Fri 6pm - monday 6am. That included workig at my real job on friday and going back to that job on monday. It was rough, but paid me about = 2 months of my residency.

I will never do that 60 hour again, maybe 36 or 24.

 

[Midwest Medic]

I was considering moving back to Iowa after residency. As most can imagine, most of the hospitals there are very rural. The norm seemed to be in the smaller ones, 24 hour shifts during the week, then a 48-60 hour weekend shift (come in at 7p on Friday, leave at 7a on Monday). Granted most of the places had a volume of 2000-7000 per YEAR, so you would typically see about 5-15 people per day. The pay was not great, but decent for the work that you did. Never ended up going there, I think seeing only 20 people on a 60 hour shift wold drive me crazy.

 

[deleted109597]

CareerMD has a few of these type jobs available in Alaska.

 

[deleted6669]

these jobs are out there. I have friends who do 48's and avg 7 pts/24 hrs in very small rural ed's. they have an on call room with a bed, tv, and dvd player and bring lots of books to work with them....
4 forty eight hr shifts/mo is full time with benefits....

 

[12R34Y]

these jobs are out there. I have friends who do 48's and avg 7 pts/24 hrs in very small rural ed's. they have an on call room with a bed, tv, and dvd player and bring lots of books to work with them....
4 forty eight hr shifts/mo is full time with benefits....

I work 24's at one of my moonlighting gigs this last year. Rural hospital. See about 20-25/ 24 hr shift and no trauma. 6 beds. one nurse, tech/clerk and me. but i have a doctor room, tv, computer, shower, bathroom, bed etc...

great money, knock out lots of money in one fell swoop instead of doing three 8s.

i love it.

later

 

[deleted6669]

I did 24's as a medic but my longest regular shifts now are 16's with a very rare 21 hr shift.
my goal is to eventually work myself into a position where I can do 7-8 24 hr shifts/mo.
(most of this involves convincing the wife to leave the big city for something a bit more rural....maybe when the kids go to college....)

 

[Old_Mil]

I never heard about these until a few days ago. Are there people out there who really work 24 hour shifts? I heard they do about 8 a month or so but even with all that time off, I think a shift like that would be insane. I start zoning out after 9 hours and am dead tired after 12. Have any of the seniors looked into positions like these?

I did one rotation like this in my 3rd year, and absolutely loved it. Granted, they are in lower volume rural EDs. The money you make is going to be about 1/2 to 2/3rds what you'd make at Trauma I in Gotham General. However, the cost of living is low, the commute was nonexistent, the people were friendly, and the amount of time you got off a month was insane.

I can't think of a better deal in the entire house of medicine, and if that department was to offer me a contract I'd go back there in a heartbeat.