Academics vs PP...how to choose?

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I would also take extra people with the monetary hit over getting slammed post call every time.
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chocomorsel said:
So you are making a big chunk of change and then you want to run lean?
Shouldn’t be the opposite? So that you can really keep your surgeons and administrators happy and not potentially lose a contract by having tired, haggard, grumpy people working all the time?
I must be missing something here.
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Running lean means everyone does what they need to do to keep things moving along without being disruptive. Yes, it requires extra work and a team effort but the pro is that people will make more money. Usually these practices are composed of people motivated by money so running lean cause people making big bucks to make even bigger bucks.

Big money requires work and that’s just plain and simple. While it may be rough and you find yourself having to bite your lip often, when you get that W2 in January and the first number is a 6, 7, or even 8 it can feel rewarding.
 
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sevoflurane said:
Agree. I feel like a practice should always be a bit fat so that it can take on extra work on the fly or deal with unexpected leaves/sicknesses easily.

Worse case scenario you are fat while waiting for the asc expansion to finish and therefore take more time off.
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It really depends. If that unit value is high enough there people who won’t say a single word about working post call on an almost regular occasion versus hiring more people
 
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Twiggidy said:
It really depends. If that unit value is high enough there people who won’t say a single word about working post call on an almost regular occasion versus hiring more people
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Friend of mine in PP said people often prefer to take 2nd call in their main hospital because it's $1000 for the call, the chance of call in is relatively high and they get paid for their production when called in, and they have a scheduled room for the next day so they can make more money.
 
abolt18 said:
Friend of mine in PP said people often prefer to take 2nd call in their main hospital because it's $1000 for the call, the chance of call in is relatively high and they get paid for their production when called in, and they have a scheduled room for the next day so they can make more money.
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If the money is right people have no problem putting in the extra work. It’s when people get low balled they just just enough to not get fired.
 
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Twiggidy said:
If the money is right people have no problem putting in the extra work. It’s when people get low balled they just just enough to not get fired.
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Yeah, I'm personally a "1st call with post-call day off" kind of guy myself.
 
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Twiggidy said:
Running lean means everyone does what they need to do to keep things moving along without being disruptive. Yes, it requires extra work and a team effort but the pro is that people will make more money. Usually these practices are composed of people motivated by money so running lean cause people making big bucks to make even bigger bucks.

Big money requires work and that’s just plain and simple. While it may be rough and you find yourself having to bite your lip often, when you get that W2 in January and the first number is a 6, 7, or even 8 it can feel rewarding.
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No Thanks. This is what’s leads to depression, anxiety and anger. Also known as burn out.
I don’t need that 6,7, or 8 number in my W2. I can do just fine w a 4 or 5. Like pretty friggin good considering I still shop at Walmart and Kroger instead of Whole Paycheck. And Macy’s instead of Fendi, Gucci and Armani.

Greed is what has lead to the downfall of medicine and people selling out. Greed leads to a lot of problems.

I just had this same discussion a few months ago w a friend of mine. She realized it wasn’t worth it to just work, work, work and be tired all the time.

I just don’t understand why people are so driven by making the mostest. At the risk of ruining so many other aspects of their lives.
 
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Twiggidy said:
If the money is right people have no problem putting in the extra work. It’s when people get low balled they just just enough to not get fired.
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Some of us want to have a work life balance to you know, see our families, travel, have time to actually enjoy life, sleep in occasionally and not be so damn exhausted all the time.
Little things you know.
 
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New grads beware, if you really do find a job paying you in the 800s (and I strongly doubt it, especially straight out), I’ll wager you’re probably working 80+ hours a week on a highway to burnout/divorce-ville. This is one of the reasons we went into this field, folks, for a reasonable work-life balance.
 
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Twiggidy said:
It really depends. If that unit value is high enough there people who won’t say a single word about working post call on an almost regular occasion versus hiring more people
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Maybe. I used to get paid $1000 to be available post call and I would frequently be called into the hospital to work. It was fine at first and great for paying off loans. However as time went on, those post call days and just days away from the hospital mean way more to me than killing it financially. I just don't have to kill it anymore... and would much rather have time off and make less money.

In a situation where your blended unit value is super high, making a killing becomes less important- especially those who have already amassed sufficient funds to retire. If you play your cards right, eventually retirement accounts can generate more income than your actual job. So I don't see the point in wasting away in the OR.
 
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AdmiralChz said:
New grads beware, if you really do find a job paying you in the 800s (and I strongly doubt it, especially straight out), I’ll wager you’re probably working 80+ hours a week on a highway to burnout/divorce-ville. This is one of the reasons we went into this field, folks, for a reasonable work-life balance.
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I would say if you can make 800k- go for it. Do it, for a few years (5 years?)- pay off loans, invest wisely... then slow the F down and enjoy a balanced lifestyle.


Pretty much my plan. Worked hard in BFE for 6 years, then moved to my dream location with plans to go 1/2 time and/or retire entirely. All loans/homes paid off... invested in the market early and in other investments that provide passive income.
 
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chocomorsel said:
Some of us want to have a work life balance to you know, see our families, travel, have time to actually enjoy life, sleep in occasionally and not be so damn exhausted all the time.
Little things you know.
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Again, all of this depends. Realize that high cost of living areas also need anesthesiologists. Some people are ok working a little harder so they can have nice homes, pad their bank accounts, and send their kids to privatel in areas where it never snows theirs is mild weather all year around. I don’t need 800k in BFE but that salary may be nice in LA and as people have said it can be done if you put in the work.

Some people don’t mind hard work.....and honestly, this is anesthesia, it’s not like the work is that hard to begin with. But I also have a good relationship with my hospital and surgical colleagues so I don’t mind helping and getting paid to do so.
 
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Twiggidy said:
Again, all of this depends. Realize that high cost of living areas also need anesthesiologists. Some people are ok working a little harder so they can have nice homes, pad their bank accounts, and send their kids to privatel in areas where it never snows theirs is mild weather all year around. I don’t need 800k in BFE but that salary may be nice in LA and as people have said it can be done if you put in the work.

Some people don’t mind hard work.....and honestly, this is anesthesia, it’s not like the work is that hard to begin with. But I also have a good relationship with my hospital and surgical colleagues so I don’t mind helping and getting paid to do so.
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I see way too many haggard anesthesiologists in the 40's and 50's who complain on how they got beat up on call again. And how much they can't wait till they can slow down.
This work can be a grind if call involves nights of being up all night after grinding it all day. So yeah, the work can be hard. As in, my feet start killing me after about 14 hours of running around the ORs all day long.
Lets agree to disagree on the difficulty of Anesthesia.
Good thing I have no kids to slave away and sacrifice my well being for. Hell even if I did, I certainly would not be spoiling them like I see some doctors do.
At the end of the day, it's a good paying job. You don't need to work that hard. Unless you are trying to keep up with the Joneses. Which we all know is endemic in this country.
 
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sevoflurane said:
I would say if you can make 800k- go for it. Do it, for a few years (5 years?)- pay off loans, invest wisely... then slow the F down and enjoy a balanced lifestyle.


Pretty much my plan. Worked hard in BFE for 6 years, then moved to my dream location with plans to go 1/2 time and/or retire entirely. All loans/homes paid off... invested in the market early and in other investments that provide passive income.
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Hell, I don't even have much NW since I married a loser and got divorced, but I refuse to sacrifice my health for 600K+.
Especially my mental health. I almost fell apart in Residency. Of course those circumstances were different but it was still stress nonetheless.
Not gonna do that to myself again.
I pay my bills no problem, am poor compared to people on this board who've been out as long as I have been, but I like my down time and am finally saving a bunch of money.
I abhor being awake for 24 hours. Cruel and inhumane.
 
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chocomorsel said:
I see way too many haggard anesthesiologists in the 40's and 50's who complain on how they got beat up on call again. And how much they can't wait till they can slow down.
This work can be a grind if call involves nights of being up all night after grinding it all day. So yeah, the work can be hard. As in, my feet start killing me after about 14 hours of running around the ORs all day long.
Lets agree to disagree on the difficulty of Anesthesia.
Good thing I have no kids to slave away and sacrifice my well being for. Hell even if I did, I certainly would not be spoiling them like I see some doctors do.
At the end of the day, it's a good paying job. You don't need to work that hard. Unless you are trying to keep up with the Joneses. Which we all know is endemic in this country.
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Yeah. I want my kid to have everything I didn’t growing up and I don’t mind working for that
 
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Twiggidy said:
Yeah. I want my kid to have everything I didn’t growing up and I don’t mind working for that
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That's good for you. I want my kid to have necessities and love and enjoy some family vacations. They don't need fancy toys just because their friends have them. They don't need fancy Ivy League educations or Private schools. Most doctors aren't exactly living in poor school districts.
But since I have no kids, it's a moot point really.
But again, those are your priorities and mine are just different.

People create expensive lifestyles and become trapped by them. Very common in Medicine. No thank you.
EDIT: I may not have kids but I have family that's disabled that completely relies on me for financial support. So I know what it's like to support someone besides myself. I shop for them and me at Marshalls and Macys. I have upgraded from Ross.
 
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sevoflurane said:
I would say if you can make 800k- go for it. Do it, for a few years (5 years?)- pay off loans, invest wisely... then slow the F down and enjoy a balanced lifestyle.


Pretty much my plan. Worked hard in BFE for 6 years, then moved to my dream location with plans to go 1/2 time and/or retire entirely. All loans/homes paid off... invested in the market early and in other investments that provide passive income.
Click to expand...

3 of my divorced partners giving about 50% of their income to their ex-spouses would disagree with you. I would 100% end up in that boat working that hard. Residency sucked ass I have no interest in working that hard, who cares how much you make.
 
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AdmiralChz said:
3 of my divorced partners giving about 50% of their income to their ex-spouses would disagree with you. I would 100% end up in that boat working that hard. Residency sucked ass I have no interest in working that hard, who cares how much you make.
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But come on!!! That sailboat is not gonna steer itself. It's calling your name. Can't you hear it?
 
chocomorsel said:
That's good for you. I want my kid to have necessities and love and enjoy some family vacations. They don't need fancy toys just because their friends have them. They don't need fancy Ivy League educations or Private schools. Most doctors aren't exactly living in poor school districts.
But since I have no kids, it's a moot point really.
But again, those are your priorities and mine are just different.

People create expensive lifestyles and become trapped by them. Very common in Medicine. No thank you.
EDIT: I may not have kids but I have family that's disabled that completely relies on me for financial support. So I know what it's like to support someone besides myself. I shop for them and me at Marshalls and Macys. I have upgraded from Ross.
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I still go to, and love, Ross!
 
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AdmiralChz said:
3 of my divorced partners giving about 50% of their income to their ex-spouses would disagree with you. I would 100% end up in that boat working that hard. Residency sucked ass I have no interest in working that hard, who cares how much you make.
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Ya divorce ain’t gonna help you- and it’s super common in medicine.

Luckily for me, my awesome wife did cardiac with me working her ass off in BFE.
X2 BFE cardiac salary.... you do the math.
EVERYTHING good requires some sort of sacrifice.
If anything, it stregthened our relationahip because we were working towards a goal together. Reaping the rewards of those years hands over fist. Best move of my career.
 
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Burnout in this speciality is real. It is the biggest issue of working hard for a long period of time-hands down.
I feel it, my wife feels it.
2 weeks on 2 weeks off in my 40’s is going to be amazing. Still healthy enough to do a lot stuff.
 
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Twiggidy said:
when you get that W2 in January and the first number is a 6, 7, or even 8 it can feel rewarding.
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I did this during residency/fellowship. did not feel rewarding at all.

AdmiralChz said:
3 of my divorced partners giving about 50% of their income to their ex-spouses would disagree with you. I would 100% end up in that boat working that hard. Residency sucked ass I have no interest in working that hard, who cares how much you make.
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This is bad science man. There is no way you can prove that they wouldn't have been divorced anyways if they didn't work that hard. Some marriages are just not meant to be.

sevoflurane said:
Ya divorce ain’t gonna help you- and it’s super common in medicine.

Luckily for me, my awesome wife did cardiac with me working her ass off in BFE.
X2 BFE cardiac salary.... you do the math.
EVERYTHING good requires some sort of sacrifice.
If anything, it stregthened our relationahip because we were working towards a goal together. Reaping the rewards of those years hands over fist. Best move of my career.
Click to expand...

Tips on getting a cardiac wife?
 
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sevoflurane said:
Ya divorce ain’t gonna help you- and it’s super common in medicine.

Luckily for me, my awesome wife did cardiac with me working her ass off in BFE.
X2 BFE cardiac salary.... you do the math.
EVERYTHING good requires some sort of sacrifice.
If anything, it stregthened our relationahip because we were working towards a goal together. Reaping the rewards of those years hands over fist. Best move of my career.
Click to expand...
I sort of agree. It's a scorching hot take but I think Doctors should really do their best to have a Doctor spouse because then at least you both understand what you're dealing with as far as career and workload. Of course that doesn't guarantee someone won't cheat on their spouse but it almost eliminates all the other reasons doctors get divorces.
 
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Seriously...you guys didn’t have department dinners where people would get cleaned up and suddenly you’re like...
46E80B3F-5C6A-45AE-A24F-8CA00994CEBD.gif

Or did you guys have a department full of Freddie Jacksons lol
 
GandalfTheWhite said:
How do you know he wants to date a younger adult? Maybe he is into cougars??
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Possibly. But let’s face it, many White men are into younger women for some reason. I have never understood the divorce your wife and then date someone young enough to be your child thing with them. Or from the very beginning forty year olds chasing after twenty year olds. Always chasing youth.
And most men on this board are White men.

But of course, I could be totally wrong. It could be he’s into cougars.
But I don’t even know if @SnapperRocks is a man now that I think about it. But most of us on this board are.
 
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chocomorsel said:
Possibly. But let’s face it, many White men are into younger women for some reason. I have never understood the divorce your wife and then date someone young enough to be your child thing with them. Or from the very beginning forty year olds chasing after twenty year olds. Always chasing youth.
And most men on this board are White men.

But of course, I could be totally wrong. It could be he’s into cougars.
But I don’t even know if @SnapperRocks is a man now that I think about it. But most of us on this board are.
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I went to san francisco recently and the number of white haired men with women half their age was ridiculous. Every block, every restaurant. I know where I will go to retire.
 
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GassYous said:
I went to san francisco recently and the number of white haired men with women half their age was ridiculous. Every block, every restaurant. I know where I will go to retire.
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How else are young people supposed to afford San Francisco rent if not for sugar daddies?!
 
It comes down to your tolerance to burnout and whether you value time or money more. You make more money in PP but the work can get exhausting with long hours. I just started PP and am already starting to feel the burn out.
 
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GASPER20 said:
It comes down to your tolerance to burnout and whether you value time or money more. You make more money in PP but the work can get exhausting with long hours. I just started PP and am already starting to feel the burn out.
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This is very true. I prioritized less caseload for lower pay, no regrets at all. A good PP group may get a few weeks more vaca and an extra $1-200k, but they’re working hard for it. I’m happy to get a couple academic days a month, get off by 3 often, do a lot of my own cases, rarely take call, etc. I also didn’t have any debt, I can’t ignore that affected my decision making. Having said that I know a few folks that took high pay, high hour, 4:1 jobs for a few years to kill their debt and then came back to the mother ship for a better lifestyle and teaching opportunities. Those folks can be quite valuable as well as they bring a different perspective and skills to the group.
 
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