Advice for a better lifestyle as a surgeon?

[ThePostureMan]

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I shadowed an orthopedic surgeon over the summer in an outpatient setting owned by one of those large healthcare conglomerates. It was a phenomenal experience. And it really laid to rest my previously held belief that the job makes surgeons disillusioned, grumpy, and humorless (based on other doctors I had met). He was such a great guy, and an even better doctor. I could see myself doing what he does and being good at it.

And then one day one of the staff walks in to pile 3 more cases onto his already-overflowing schedule. He disappointedly accepts the cases, figures out where to fit them sideways into his schedule, and says "I'm probably headed for divorce." Then proceeds to tell me how 4 of his colleagues in that same office are already divorced. That really put the brakes on my pursuit of a career in surgery.

He works 4am to 8pm (sometimes later) 6-7 days a week. He's probably 7-10 years out of residency (so not new).

I understand there is a call of duty. These people are sick and you can help them. They need you. But your family needs you too. Your body also needs rest, exercise, and proper nutrition.

Is it just a matter of saying no and setting boundaries? What other advice can you give to me? (pretend I'm a surgeon seeking a better work-life balance)

I've read other lifestyle posts on these forums claiming that there are surgeons working 30 hour work weeks. I've never heard of or met a surgeon (or any other specialty) working so little in medicine. Are these edge cases? Does it happen only in the late stages of a career? Are the earnings still good?

 

[deleted1081396]

Taking a heavy workload like that sounds like a him problem, not a field problem. As an orthopod he holds much more power in his health system than other specialties. He just doesn't know how to exercise it properly to get what he wants... Unless of course he's a million dollars in debt from that McMansion, Porsche and boat that he bought and trying to pay it off. But that'd also be also a him problem.

 

[Matthew9Thirtyfive]

Yeah, when you’re an attending working that much, it’s because you’re choosing to.

 

[percyeye]

I'm friends with the Ortho surgeon in town. Works 4.5 days a week and out early on Fridays. Never works past 5 p.m. Takes a ton of vacation and makes more money than they know what to do with. He is no doubt busy but definitely does not live at the hospital. They are also is a partner in a private practice so they can set whatever schedule they want.

 

[GoSpursGo]

Moving to premed.

To a certain extent it is a "him" problem, but it is also a field problem. When you're good at what you do, you are naturally going to get asked to do more. If you do more, you will make more money and you will also get seen as a "bigger name" within the field. No matter whether you think that's important to you right now, everyone likes to be seen as good at what they do.

So yes, it boils down to saying no and setting your priorities. That sounds simple, but in practice can be quite difficult, as evidenced by the number of people who do get their priorities out of whack like this surgeon.

 

[boshtrich]

Taking a heavy workload like that sounds like a him problem, not a field problem. As an orthopod he holds much more power in his health system than other specialties. He just doesn't know how to exercise it properly to get what he wants... Unless of course he's a million dollars in debt from that McMansion, Porsche and boat that he bought and trying to pay it off. But that'd also be also a him problem.

Or maybe he's employed by said large healthcare conglomerate, as more and more physicians are these days, and not part of a true private group that can control their own schedule. When you are employed by the hospital, you do what the hospital demands or you lose your contract, even if that includes fixing hip fractures at midnight. Since four of his other colleagues are in similar situations, I'm guessing its not so much the third mortgage and boat payments, and more another example of a large medical corporation squeezing the last bit of profit out of it's salaried employees (yes surgeons can be employees) as it can.

 

[boshtrich]

I shadowed an orthopedic surgeon over the summer in an outpatient setting owned by one of those large healthcare conglomerates. It was a phenomenal experience. And it really laid to rest my previously held belief that the job makes surgeons disillusioned, grumpy, and humorless (based on other doctors I had met). He was such a great guy, and an even better doctor. I could see myself doing what he does and being good at it.

And then one day one of the staff walks in to pile 3 more cases onto his already-overflowing schedule. He disappointedly accepts the cases, figures out where to fit them sideways into his schedule, and says "I'm probably headed for divorce." Then proceeds to tell me how 4 of his colleagues in that same office are already divorced. That really put the brakes on my pursuit of a career in surgery.

He works 4am to 8pm (sometimes later) 6-7 days a week. He's probably 7-10 years out of residency (so not new).

I understand there is a call of duty. These people are sick and you can help them. They need you. But your family needs you too. Your body also needs rest, exercise, and proper nutrition.

Is it just a matter of saying no and setting boundaries? What other advice can you give to me? (pretend I'm a surgeon seeking a better work-life balance)

I've read other lifestyle posts on these forums claiming that there are surgeons working 30 hour work weeks. I've never heard of or met a surgeon (or any other specialty) working so little in medicine. Are these edge cases? Does it happen only in the late stages of a career? Are the earnings still good?

And to respond to the original post, it depends. There are many different practices out in the world each with their own call schedules and reimbursement structures and your question has far too many variable to answer at this stage in your career (types of surgery, call responsibilities, payor mix, ownership in ASCs, etc.). I feel that a lot of it in the end still boils down to if you want to make more money you are going to have to work more, or work smarter. The surgeon working 30 hours a week may make half of what their partners do, or they may only take patient with premium insurance, or may own their own surgery center and make passive income off of that. I'm not one to predict the future, but the way medicine is moving, most physicians will eventually be employed by one of these large healthcare entities and be paid largely based on healthcare metrics that are largely determined by an accountant without any medical training. There will still be successful private practice groups that are pleasant to work for and pay well, but I think the days of working 30 hours a week and making 500k a year are quickly disappearing. But there will be less and less ability for physicians to "say no" and set boundaries. Your private practice ortho group is employed by ABC Health and a patient shows up in the ED with an open fracture at 2AM, you bet whoever is on call is showing up to operate. Certainly some specialties protect you from this by nature of what type of conditions they treat, but again, what you bring to a healthcare system will determine how much you are compensated. To give you personal responses to your questions, I am an anesthesiologist at a community hospital in a private practice that is contracted with a multi-state healthcare organization. I still take 24 hour call about 2-3 times per week, meaning if any surgeon needs to do a case at any time during the night, I have to come in and do the anesthesia for that case, as well as care for the patient in the post-anesthesia unit. It's annoying to get called in the middle of the night, but it's my responsibility. I have literally no say over my schedule on call, but do have a lot of say on how often I work, what days I have off, etc. I also get compensated well for it (at least I feel that I do). That being said, it certainly takes a toll on family and personal needs. My best advice to you as a premed is to shadow as much as possible, and to ask everyone you shadow not just about the positive aspects of their job, but also the negative. Also know that if you do decide to pursue medicine, there are so many fields outside of surgery that may better fit what you are looking to do with your life. Go into medicine with an open mind and pursue what you are passionate about. If you truly enjoy what you do and the patients you serve, you'll care less about the crap you have to endure along the way and better enjoy an amazing profession.