Am I crazy for considering a job with a 90 minute commute one way?

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Mehd School

Mehd School

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Third year of attendinghood. Not happy at my current job. Hospital system was bought out and for us that came with a pay cut and they have recently told us that they intend to let the CRNA's run loose more or less. They didn't just hint about this, they told us it was their priority after the acquisition. Also time off got screwy. You can take as much or as little time off as you'd like. You just don't get paid for it. Used to get 6 weeks paid.

In the past year I made $530k scratching and clawing through locums during some of my time off. One of the places I did locums shifts at I liked a lot. Unfortunately it's 80-90 minutes away from my house one way. I have no interest in moving closer to this hospital. Some of the pros: Extremely efficient place. Uses epic, every elective case that isn't an ASA 1 comes through preop clinic so your morning preop consists of verifying information rather than hunting and gathering information. CRNA's are fantastic to work with. They will start an uncomplicated case without you with your permission. They reach out early with any concerns. You are notified early with any potential issues. The MD group hires the CRNAs and most of them have been at this hospital >5 years. You make $550k with 8 weeks off. Great benefits. 24 hour home call, post call you are sent out at 7am at the latest and you have your post-post call day off. One weekend of home call per month. Does a decent amount of OB, but CRNA's will do epidurals if you're busy or just don't want to do them. I always try to do them unless I'm currently swamped.

A potential week at this new place could be: On call monday, leave tuesday at 7am putting me home at 8:30am. Off wednesday. Call thursday, leave friday morning and be home at 8:30am. I have taken 7 call shifts at this place. Most nights wrap up around 5pm, probably called back into the hospital 1 out of 5 nights maybe. It's a great job and hospital but the location is poor. I would technically be home more at the new place than if I stuck around, but the commute is significant. I think I'd make the round trip 2 times most weeks and rarely 3 times in one week. Call at this new place is probably a 3 out of 10 on the difficulty scale. I leave the hospital not feeling destroyed. Call at my current place is 9 out of 10 difficulty due to inefficiencies in the hospital, EMR, and supbar CRNAs. Will also say: Anesthesiologists are very involved at this hospital system and have a lot of say in the day to day runnings of the OR's. Add on cases have to be approved by the on call anesthesiologist.

What are your thoughts? I'm 6 years into PSLF and the other options near me are private groups that would not qualify for PSLF.
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That is a tough commute but if you do not mind the drive and being away from home and the family during your "home" call shifts then I would go for it. What about weekends? Would you try to sell those or would you have to cover 48-72 hours?

If it were me, I would probably go for it based on what you are saying. It sounds like you are already unhappy and getting burned out at your current gig. Put on some good music, listen to some podcasts, or just get a Tesla and put on autopilot and there you go (somewhat kidding about the Tesla). Anyways, good luck, tough decision but seems you already know what you should do.
 
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If you really can't move, that's a tough spot to be in, especially with the PSLF issue. My reflexive answer is no but I could barely tolerate the 30 minute commute at my last job, and part of the selection process for my current (and expected-to-be final) job was a commute under 15 minutes.

90 minutes each way is 3 hours of driving each day, or ~15 hours of unpaid time every week. If this $550K & 8 week vacation job is an average 50ish hour/week job, then it's really a 65 hour/week job. 550 / 44 / 65 = $192/hour

It's actually less than that, since your "home call" is going to be spent in a call room, hotel, or a van down by the river. How do you value that time? It's not zero.

If you could commute on good public transit and use that time to read or relax, maybe it'd be tolerable and I wouldn't mentally bill the time to the job.

Mehd School said:
I have no interest in moving closer to this hospital.
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If you moved closer to that hospital, the stuff you're close to now would only be 90 minutes away. Is there a reason why that "commute" is unthinkable, but the same commute to work isn't?

Or do you have family / spousal-job reasons to be anchored where you're at?
 
pgg said:
If you moved closer to that hospital, the stuff you're close to now would only be 90 minutes away. Is there a reason why that "commute" is unthinkable, but the same commute to work isn't?
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The area that the hospital in is in a town of about 35000 people and is pretty rough. One maybe two good restaurants, ****ty schools, low education and average income. The area I live in has some of the best public schools in the country, affordable to live in, great restaurants shopping etc. Major metropolitan area 35 minutes away. I have three young children and I want them to grow up where i currently live.

The entire reason this job is available is because the town it's in is ****. If it was in a somewhat desirable area it would be filled immediately and probably pay $100k less per year.
 
abolt18 said:
Cannot fathom driving 3hrs per day. I refused to even look at homes that were more than a 15 minute drive to work.
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With how the call schedule works there would never be a day that I am driving both to and from work on the same day. I would drive in one morning, do call, and drive home the next morning when I'm post call. I agree I could not do 3 hours per day or anything close to it.
 
I can barely stand 40 minutes a day. 3 hours a day is too much. Sorry that your job sucks now. It may be that the private groups don't qualify for pslf but the hospitals you work for do. It's a tough decision but I would much rather spend time at the hospital with staff I like.

Why aren't you 7 years into pslf? Intern year didn't count?
 
Being the call setup as it is and that you are making the commute only 2-3 times a week I'd take that job over the other one which sounds like a complete ****show. I've been in a similar situation and although the commute was not quite as long, the scenario is similar. The positives of working at a place that does not suck the life out of you FAR outweigh extra driving.
 
Mehd School said:
With how the call schedule works there would never be a day that I am driving both to and from work on the same day. I would drive in one morning, do call, and drive home the next morning when I'm post call. I agree I could not do 3 hours per day or anything close to it.
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You wouldn’t have any noncall days from 7-3 or 7-5?
 
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Thanks everyone for your advice. It does seem like it's almost not worth it. I spend a week there next week so I will think it over again as the week goes by.

I cannot stress enough how easy the job is. The surgeons are skilled, everything is organized and flows nicely. People are reasonable and go out of their way to help your day go better. When you get called for an epidural your kit is open and the patient is prepped and draped. Same with blocks. Your input and skillset is valued. No bull**** is tolerated. Complete opposite at my current job. I will actively wheel the patient to the block area, prep and drape, call a nurse multiple times to come over to witness the block, then the case will be delayed 2 hours for some dumb reason. Rinse and repeat. It's mind numbing. This other place running so smoothly is a large part of why I am considering it. So much less of my mental bandwidth is wasted on bull****.
 
I think I would do it if I could rent a small place near the hospital. I hate sleeping in the hospital. Having your own place there would give flexibility in terms of going/ leaving and be more comfortable.
 
dude lol 3 hrs a day in a car is an insane lifestyle killer, time consuming and taxing on the body (use to do it for rotations).we work early mornings, you'd have to wake up 2.5hrs before first start case assuming u don't run into traffic. I wouldn't even consider this as an option unless you move closer.
 
I want to emphasize that there will not be any days where I drive 3 hours. I will drive 90 minutes, do a call shift and stay overnight, drive 90 minutes home the following morning. Will have the remainder of post call day off and then the day off after that as well before driving back for a call day.

Thanks again everyone. Will continue to look. But if my current job turns into the ****show I think it is I'd rather drive farther for a peaceful work environment temporarily than deal with craziness daily. Either way I will be leaving my current job.
 
My hospital is structured like this. We have a guy who has driven 90 minutes each way for 16 years. He wouldn’t consider doing anything else. If the call shifts are easy and you can typically sleep, I would recommend stacking them in stretches so you can get more time off.
 
GravelRider said:
I wouldn’t do it. I would do locums before I took a job with a 90 minute commute.
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Agree completely.

Do locums. Make your own schedule. Dont have to drive. Make almost the same money.
 
Couple of things

1. You're not crazy and I would do it based on the things you described. Having a longer commute in order to have a more bearable/enjoyable job is worth it. Ideally you would have a short commute combined with a good job but this is not always possible.

2. Your current job sounds horrible. Please PM me the location of the job so I can avoid it. Thank you.
 
I would probably do the 90 min commute since you have post call off and you are not happy at your other job. Job satisfaction is huge. I would just consider the commute time part of the job and consider it non paid work. Although call may suck only working Monday and Thursday is a pretty good set up. You might be tired post call but you’ll have a 3 day weekend all the time.
 
Gaseous Clay said:
Post post call day off is huge and makes it worth it IMO.
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I think this was a missing detail. So you'd only make the drive a maximum of 5x in a week?

Work Sunday
Drive home Monday (post call)
Of Tuesday
Work Wednesday
Drive home Thursday (post call)
Off Friday
Work Saturday.

So at your worst possible week, you work 3 days and have 4 days off. Most weeks, work 2x24hr days with 5 days off. And if you could stack a couple 24s and have a longer gap that would be awesome.

This sounds MUCH more reasonable than what everyone was imagining, with a daily or every other day 90 minute commute.
 
Mehd School said:
I want to emphasize that there will not be any days where I drive 3 hours. I will drive 90 minutes, do a call shift and stay overnight, drive 90 minutes home the following morning. Will have the remainder of post call day off and then the day off after that as well before driving back for a call day.

Thanks again everyone. Will continue to look. But if my current job turns into the ****show I think it is I'd rather drive farther for a peaceful work environment temporarily than deal with craziness daily. Either way I will be leaving my current job.
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So would this job be two 24hr shifts a week? If call isn’t bad, could you do the 48hrs consecutively? If that’s the case, either rent or buy a small 1 or 2 bedroom condo and just go for 48 hours at a time. That’s something I would consider…if and only if call was light and not in-house.
 
I think the op was pretty clear in the original post and subsequent post that the round trip was not daily but everybody jumped to conclusions when they saw the 90 min commute
 
I can't believe ppl are encouraging you to take this job. It doesn't matter how light call is, you still can't go home. So you are gone from your family about 48 hours a week?

You better work hard buddy, cause divorces are expensive if or when you do get married.

You're gonna live sleep eat in a hotel or hospital call room those 2 days? Better work fast and hard. All that **** food/hotel lifestyle you'll be having your stents before you clear your debt...
 
abolt18 said:
I think this was a missing detail. So you'd only make the drive a maximum of 5x in a week?

Work Sunday
Drive home Monday (post call)
Of Tuesday
Work Wednesday
Drive home Thursday (post call)
Off Friday
Work Saturday.

So at your worst possible week, you work 3 days and have 4 days off. Most weeks, work 2x24hr days with 5 days off. And if you could stack a couple 24s and have a longer gap that would be awesome.

This sounds MUCH more reasonable than what everyone was imagining, with a daily or every other day 90 minute commute.
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The commute is more reasonable ... but it's a rare human who can retain sanity working multiple 24h shifts per week.

It's bad enough the handful times per month I have to be on call overnight, even if I'm not working the whole time, even if I get to sleep.

I was first call last night, arrived at 7 PM, worked until about midnight, slept until a 3 AM epidural call, then stayed up for a c-section and another case that was allegedly being transferred in to us but didn't actually show until I was off at 7 AM. It wasn't even a 24h shift, but still I went home and slept from about 8 to noon. It was a better than average C1.

Our worst day is actually second call, which is a 24 h shift, starts at 7 AM, goes to 7 AM the next day, and MOST nights you're done working between 7 and 11 PM, and MOST nights you can sleep as C1 handles everything. Usually if you're called, it's because OB has reared its ugly head while C1 is in a case.

C2 is tolerable because it only comes around about once per month (and our group recognizes it sucks and the shift pays at 3.5 x the base day rate). If I had to do that 2.33 times per week on a 3 day cycle (24h call, then POST, then OFF), even if it was the only thing I was doing, even if there was a substantial amount of sleep in the hospital overnight, I'd quit. I believe that people who do unnatural shift work like that are generally less healthy and probably burn out at far higher rates. Humans aren't built to live that way. Also, there's a toll on the family.

I hereby revise my opinion 🙂 and declare that the thing about this job that gives me the most angst isn't the commute but the multiple 24s per week.
 
No matter now light the call is, I don't think it is safe to drive 90 minutes on your post-call day. There will be occasional bad nights where you really shouldn't drive 90 minutes home, so if you decide to sleep some more in the hospital on your post-call, that's more time away from home. My commute is 40 min one away, and it is exhausting.
 
Commute matters a lot. I have a pretty easy daytime job. But it’s 40 min drive for
Me day. Perfect world would be for me to move 20 min closer but my kids have their friends here. So I just commute. I have Tesla so don’t have to deal with gas. Electricity is roughly 1/3 of gasoline.

My buddy commute 80 minutes each day for his job. It’s painful for him. He stays in hotel some days but he’s like OP. He doesn’t like any of the local practices and his kids are in school districts they have friends.
Lots of sacrifices we all make.

It’s a personal decision. 90 min is a long commute each way. You are losing at least 2 hours commute each time you go to work. Over a standard 20-30 min daily commute (average American commute time is 20 minutes).
 
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Honestly this doesn’t sound terrible. If you work 2 shifts weekly, that’s 54 hours when factoring in the commute. But 16 of those are when your family (and hopefully you) are sleeping. You would probably be missing less time with them than most of us, and it’s more predictable. Our group actually pays a PRN for a similar schedule, in fact it’s even worse because it’s Friday/Sunday 24 shifts. He loves it and I’m kinda jealous of all the free time he has.
 
1) What is your current call? Is it 12, 16, 24 hours? Home or in house? Post call day off?
2) At the "new" place, what would your weekend expectation be?
3) Thursday call you lose the benefit of post post off. A better schedule might be on call Sunday, post off Monday/Tuesday, on call Wedneday, post off Thursday and Friday. I would imagine Wednesday call is very desirable but if you are willing to do Sundays, that might make for a win win,

People commenting on being away from the family, we all do when we take call. I estimated in 14 years of taking in house call, I stayed in the hospital over 700 nights of my life. It didn't matter if my commute was walking next door or driving an hour.

As I said before, this job sounds like you are much happier, getting that extra post is nice, and as long as you think your wife will stay sane, then do it. If you are truly unhappy with your current job, it probably reflects at home too. Before I came to my current practice, they had a locums guy cover 3 weeks in a row from Florida (job in Ohio). He did that for maybe 2-3 years during COVID. Now how he did that is beyond me but the money was high and the job relatively cush.
 
that is 100% stupid. you will spend years of your life sitting in traffic and driving to and from work. wasted time not earning money, spending time with family, hobbies etc... complete waste.
 
Our job requires call to make money in the vast majority of situations.

To me, just factor in the estimated driving time to your hours worked. If it’s similar to your current setup and palatable, go for it.
 
Realgassy said:
Ask your spouse how they feel about it. I preferred working very long shifts 3-4d/w. My spouse felt otherwise and it created tension as time went on.
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Same here. My wife would be annoyed to do the bedtime and dinner routine by herself 2-3 nights per week. Even if I meant I did it by myself the other nights.
 
Mehd School said:
Third year of attendinghood. Not happy at my current job. Hospital system was bought out and for us that came with a pay cut and they have recently told us that they intend to let the CRNA's run loose more or less. They didn't just hint about this, they told us it was their priority after the acquisition. Also time off got screwy. You can take as much or as little time off as you'd like. You just don't get paid for it. Used to get 6 weeks paid.

In the past year I made $530k scratching and clawing through locums during some of my time off. One of the places I did locums shifts at I liked a lot. Unfortunately it's 80-90 minutes away from my house one way. I have no interest in moving closer to this hospital. Some of the pros: Extremely efficient place. Uses epic, every elective case that isn't an ASA 1 comes through preop clinic so your morning preop consists of verifying information rather than hunting and gathering information. CRNA's are fantastic to work with. They will start an uncomplicated case without you with your permission. They reach out early with any concerns. You are notified early with any potential issues. The MD group hires the CRNAs and most of them have been at this hospital >5 years. You make $550k with 8 weeks off. Great benefits. 24 hour home call, post call you are sent out at 7am at the latest and you have your post-post call day off. One weekend of home call per month. Does a decent amount of OB, but CRNA's will do epidurals if you're busy or just don't want to do them. I always try to do them unless I'm currently swamped.

A potential week at this new place could be: On call monday, leave tuesday at 7am putting me home at 8:30am. Off wednesday. Call thursday, leave friday morning and be home at 8:30am. I have taken 7 call shifts at this place. Most nights wrap up around 5pm, probably called back into the hospital 1 out of 5 nights maybe. It's a great job and hospital but the location is poor. I would technically be home more at the new place than if I stuck around, but the commute is significant. I think I'd make the round trip 2 times most weeks and rarely 3 times in one week. Call at this new place is probably a 3 out of 10 on the difficulty scale. I leave the hospital not feeling destroyed. Call at my current place is 9 out of 10 difficulty due to inefficiencies in the hospital, EMR, and supbar CRNAs. Will also say: Anesthesiologists are very involved at this hospital system and have a lot of say in the day to day runnings of the OR's. Add on cases have to be approved by the on call anesthesiologist.

What are your thoughts? I'm 6 years into PSLF and the other options near me are private groups that would not qualify for PSLF.
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All right before I went to grad school, I commuted like that. It got old really quick
 
pgg said:
. I believe that people who do unnatural shift work like that are generally less healthy and probably burn out at far higher rates. Humans aren't built to live that way.
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And the data supports this imo! I suspect it's even worse when you do rotating shifts



I make way less then most people here but (even with my call) do most of my work like an early morning banker on the weekdays. I tell myself that it's worth the financial hit but😂
 
My commute was 45 min one way. I couldn’t take home call when rest of my other colleagues did. We also did 48 hour weekend calls. So basically I was living in the hospital for 2 straight days. (I did get out periodically, when it’s slow). It’s certainly doable…. When I know I’d have 6 free weekends. But doesn’t sound like that would be the case for you.

I do like the idea have a Uber driver…. How much could it be? 500 round trip? Got three hours of your life back.
 
Mehd School said:
I want to emphasize that there will not be any days where I drive 3 hours. I will drive 90 minutes, do a call shift and stay overnight, drive 90 minutes home the following morning. Will have the remainder of post call day off and then the day off after that as well before driving back for a call day.

Thanks again everyone. Will continue to look. But if my current job turns into the ****show I think it is I'd rather drive farther for a peaceful work environment temporarily than deal with craziness daily. Either way I will be leaving my current job.
Click to expand...

I’m confused. Are you negotiating for a call only position? Two 24’s every week is an odd setup. If that’s not in the contract why do you think you’ll get a 24hr call every Monday and then Wednesday or Thursday to have weekends off? I also haven’t seen a practice give you 2 post call days off for a 24hr shift (that’s really what it is if you say you’ll do a Monday then have Wednesday as your postcall) but I certainly haven’t looked at even 5% of practices etc so maybe my sense is off.

How big is this place? If you’re supervising I imagine there’s a decent number of ORs and OB but how many docs on the group? Again, two 24’s a week is a lifestyle stress as it is. My radar is up a bit if the group is looking for a guy to do 2 calls a week, you sure the guys there aren’t making bank working rare call and throwing you a salary guarantee they think you’ll take to get call covered?

Make sure you’re asking these things and not just accepting a similar salary to get out of one hellish job but finding yourself in another.
 
Maybe doable if you get a Tesla with Full Self Driving to make the commute easier. At the same time, find some good podcasts and I could see it being a worth it if your workplace is that good.
 
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