Academic vs Private Practice for Missions

[warriorpoet85]

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I am curious to know what everyone's thoughts are regarding whether doing PP or Academic anesthesiology would be more conducive to doing mission work. I am looking to (IDEALLY) do 2 months of mission work per year. I realize that this might be individualized with each job, but is this possible? If so, what are your experiences?

Any thoughts would be much appreciated.

 

[IlDestriero]

Two months of mission time seems unlikely wherever you go. Maybe 2 weeks at a time a couple times a year? Expect to have to use your vacation time for these trips.
If you want 1-2 months at a time, you probably need some kind of part time job, or academic job where you are doing sponsored research abroad. Anything's possible, but we need people with fewer limitaions, not more. We wouldn't be interested in supporting that kind of arrangement at my academic program. Now if you only wanted to work 3-4 months over the summer, we could do that. That's our busiest time.

 

[Trajan]

I am curious to know what everyone's thoughts are regarding whether doing PP or Academic anesthesiology would be more conducive to doing mission work. I am looking to (IDEALLY) do 2 months of mission work per year. I realize that this might be individualized with each job, but is this possible? If so, what are your experiences?

Any thoughts would be much appreciated.

I had the exact same question. Would imagine that there are some academic practices that are ok or even encourage such work. However, I'm not sure if working in academics is the best preparation for working as a sole anesthesiologist in a Ethiopian hospital where you are doing countless cases a day, including OB, peds, trauma, with very fast turnover. Seems like a PP anesthesiologist from a busy urban hospital might have an easier time in that environment. Then again, it's entirely possible that nothing can fully prepare you for some of these environments, so perhaps we should just look for a job that accomodates such work.

I was looking around today and found that MSF has brief anesthesiologist bios on their webite:
http://www.doctorswithoutborders.org/work/field/profession.cfm?id=2533

Looks like a mix of PP and academic anesthesiologists.

 

[IlDestriero]

The problem that you're going have, in PP or academics is how to fit you into the schedule. We're not talking about working 3 days a week vs 5 or not taking call. You want to work full time and then go off for 2 months and then come back to work full time again. How can you staff your department with that commitment? Either they have the workload for a person, full or part time, or they don't. If the work is there, everyone will have to work harder to cover your workload while you are away. That means a combination of longer hours and less academic or vacation time. Pass. That will alienate you and damage department morale. If the work is not really there for a full time person 10 months of the year, the department would lose money hiring you at all. That's bad for the bottom line and will hurt salary and bonuses. We only hire the people we need, or expect to need. No more, no less. I can't imagine it's different anywhere else. It's a worthy goal, but finding the right place to pull it off might be very challenging.
Some academic programs might be painfully understaffed and be happy to consider this kind of arrangement, but there's probably a reason that they're chronically understaffed. Of course it wouldn't be as bad as being the only anesthesiologist in Ehiopia, probably.

 

[imfrankie]

I am curious to know what everyone's thoughts are regarding whether doing PP or Academic anesthesiology would be more conducive to doing mission work. I am looking to (IDEALLY) do 2 months of mission work per year. I realize that this might be individualized with each job, but is this possible? If so, what are your experiences?

Any thoughts would be much appreciated.

My opinion differs from Il's: I think your objective is readily achievable in either camp. PLENTY of private practice folks have 12 weeks of vacation. blocking out 8 weeks for global humanitarian work is pretty easy then. In academics, there are an increasing number of departments which themselves have a presence overseas--in fact are starting residencies in the host countries for which they are providing faculty and support. Pursue your dream. There is always a way.

 

[warriorpoet85]

Thanks for the consideration and thoughts. Having a realistic outlook on this from early on (I am an MS-4) is what I needed. I also don't want to crush my dream of serving in missions (the reason I went into medicine), but I realize now that there may be a need for me to lessen my time abroad to 4 weeks or to work 4 weeks out of the year on an annual trips supported by my employer and use another 4 weeks of vacation, if I choose, to make the other month up.

I appreciate the insight and the encouragement.

It does sound like somethnig like this would be achievable if I were in a big enough city at a PP with a ton of anesthesiologists so that I could have more flexibility and use those "8 to 12 weeks" of vacation to accomplish my dream.

 

[DrN2O]

Isn't it backward to think about mission, job, residency, and anesthesia, in that order? It won't matter that your passion is mission if you are not a good anesthesiologist but have all the time in the world to go on trips. What if you don't like anesthesia?

 

[Jeff05]

Thanks for the consideration and thoughts. Having a realistic outlook on this from early on (I am an MS-4) is what I needed. I also don't want to crush my dream of serving in missions (the reason I went into medicine), but I realize now that there may be a need for me to lessen my time abroad to 4 weeks or to work 4 weeks out of the year on an annual trips supported by my employer and use another 4 weeks of vacation, if I choose, to make the other month up.

I appreciate the insight and the encouragement.

It does sound like somethnig like this would be achievable if I were in a big enough city at a PP with a ton of anesthesiologists so that I could have more flexibility and use those "8 to 12 weeks" of vacation to accomplish my dream.

No big city PP anesthesia group is gonna give you 12 weeks of vacation...

 

[Arch Guillotti]

No big city PP anesthesia group is gonna give you 12 weeks of vacation...

I don't think this is necessarily true. Groups like this may be very hard to find but they are out there. Some places let you take a boatload of vacation, you just don't get paid because someone else is working for you.

 

[urge]

I don't understand the reason for foreign missions when there are millions here who cannot access healthcare.

 

[Trajan]

I don't understand the reason for foreign missions when there are millions here who cannot access healthcare.

Not having health insurance in the United States absolutely sucks. However, if you are shot, get run over by a car, go into labor, etc. you can go to any ER and doctors will save your life or try their hardest to do so.
That is not true in Burundi, Democratic Republic of the Congo, Sri Lanka, or Haiti, which is why some people feel a need to work overseas.

 

[countingdays]

I don't understand the reason for foreign missions when there are millions here who cannot access healthcare.

I think that the problem with missions is that they are not cost effective. More good would be done funding training of their doctors than sending ours there to work briefly. The exception to the rule is with highly specialized surgeries (eg peds cardiac) where training third world docs is impractical. Going to do a hundred general surgery cases abroad probably costs as much as training a local who could do thousands and thousands of cases for the same population.

 

[B-Bone]

I work in a PP group in a medium sized city. Our partners take 14 weeks vacation currently (took 16 last year). It would still be really difficult for anyone to get eight consecutive weeks of vacation. You might be able to randomly string them together in some really unpopular month like october or november, but it'd be pretty hard with the way we pick vacation weeks. It wouldn't be fair for everyone else if someone just said "I want july and august off". My group would never go for it.

Academic groups are a different story, but I still don't think it's gonna be a popular idea. Think how many of your attendings from residency had to fight tooth and nail for a half-day a week of non-clinical time to work on research or talks. Now picture them trying to peace out for two months at a time. Not teaching residents, not producing research, not doing administrative stuff, not producing revenue in the OR.

Basically, the idea of doing mission work/MSF/etc doesn't really line up with the prime directive of either of these types of practices. Honestly, unelss you're in a group of anesthesiologists who all place the same importance on this type of work, you'll likely be screwing your partners/department somehow (time, money, extra work, whatever). Why would they buy into that?

The best idea if you want to do this stuff is work locums. Then no one gives a s%*@ how much time you're off traveling the globe. It's your show, your time.

 

[Trajan]

I think that the problem with missions is that they are not cost effective. More good would be done funding training of their doctors than sending ours there to work briefly. The exception to the rule is with highly specialized surgeries (eg peds cardiac) where training third world docs is impractical. Going to do a hundred general surgery cases abroad probably costs as much as training a local who could do thousands and thousands of cases for the same population.

Sometimes what you are saying is true. However, MSF is an extraordinary organization because its missions have long-term presence, a primary mission of the volunteers is to work with and train locals, and, finally, they go to places where you can't just give money and expect local hospitals to do something with it.

 

[warriorpoet85]

Isn't it backward to think about mission, job, residency, and anesthesia, in that order? It won't matter that your passion is mission if you are not a good anesthesiologist but have all the time in the world to go on trips. What if you don't like anesthesia?

I am absolutely not taking this approach. I am going into anesthesiology because I love it. I want to be well trained. I enjoy the procedures. I enjoy the intellectual stimulation of applied phys/pharm. I love critical thinking and the need to do it quickly. And (like every other reasonable person) I love the flexibility and life style that anesthesiology provides. I would do this job if it paid 150k a year... which now of days seems like a real possibility by the time I am through fellowship and practicing. Who knows? The point is that I am going into it because I love it.

Also, I understand the concern regarding mission work when there is a need in the US. I would like to provide both, it simply depends on what opportunities I am given. Also, if I was given the opportunity to go abroad where health care is simply not as good nor available (like it is in the US when you are uninsured and want to visit the ED)...my goal would not be to do all the work myself, I would be much more interested in teaching anesthesiology to providers in those local countries so that they can continue to care for patients long after I am gone. It is better to teach people how to fish than to fish for them. Fishing for them only works for as long as you are there.

I would not want to screw any of my partners and have no interest in taking a job and do mission work if that is what I would end up doing. I also realize that what I want to do is a long shot in terms of pragmatics, but that is why I wanted to pose the question. I appreciate the insight that this might be a problem, though.