Burned out from private practice

[JewOnThis]

Let me start by telling you guys a little bit about my background. I have been practicing for about 5 years. I have been in multispeciality as well. This is my "2nd" job. I practiced in an area of 1 million plus population. I see about 21-26 patients a day, not including surgery.


Recently, I have been having second thoughts. I feel like private practice or podiatry practice is taking a toll on me. I am tired of listening to the patients complain, dealing with complications, unable to treat patients due to their insurance, taking calls etc.

Just the other day, I had a case that was cancelled on the same day as the surgery due to hardware cost. SAME DAY cancellation.

I know I can't be the only one out there with these feelings.

So with all of that being said, I have looked into other jobs as well. The ones that stick out are nursing home/LTC jobs. They offer roughly about the same salary, 401k, mileage reimbursements, NO CALLS, NO WEEKENDS.

Has anyone here made the switch? If so, lets hear it!

---

Members don't see this ad.

 

[NatCh]

I hear you. There’s so much baloney peripheral to practicing medicine that one can get burned out on it all. I was starting to get too annoyed at a lot of it then decided to narrow my practice to only the work I enjoyed. I got rid of routine foot care and anything having to do with diabetes, which I find completely soul-sucking. Now I have an emphasis on surgery and sports medicine, with a lot of ingrown toenails as bread-and-butter. Treating athletes comes with its own idiosyncrasies but at least they come to me because they want to, and they’re really motivated to get better. The work I’m doing feels more meaningful than it used to, so it’s easier to put up with baloney. Having low overhead allows me to be selective.

Are there parts of this job that you enjoy more than others? Do you think you’d be able to nurture a practice geared towards that?

 

[dtrack22]

The ones that stick out are nursing home/LTC jobs.

To replace what I assume your current income is (multispecialty seeing mid 20’s daily) you’d end up working just as many hours seeing twice as many patients doing nursing home care. But if driving around cutting toenails would be less frustrating and more professionally satisfying then go for it.

 

[ExperiencedDPM]

Wow. Of course I’ve heard of many docs burning out and seeking greener pastures. But I personally haven’t heard that in a doc who’s only been in practice a few years.

Listening to patient complaints will not resolve in any form of practice you end up in and is constant among all specialties. Complications are something that once again can’t be avoided, but you may want to step back and ask if your frustration is because you don’t know why you’re experiencing complications. I believe that complications are inevitable but can be well controlled with some self reflection.

I don’t believe you’ll be happier going bed to bed in a nursing home cutting nails. There is nothing less gratifying than using none of your skills. And there is a lot of volatility in that industry.

If you work for a large company, they WILL pressure you to do things you may not feel are legit. You can secure a nursing home and be the best DPM they ever saw. Then the administrators nephew gets a DPM degree and you’re replaced. Additionally, many of these services may soon be provided by NPs, PAs, etc and these services are becoming heavily scrutinized.

NaTCH has great advice regarding trying to tailor your practice with focusing on what you enjoy. That’s not always easy, but it’s worth a try.

Lastly,you may want to seek some form of counseling to see if there are other issues contributing to your frustration and unhappiness. You’re not the first with this issue, but it’s great you’ve recognized the problem and now it’s time to possibly seek a professional opinion for advice.

 

[hematosis]

How much money are u making in pp?

asking because you said you've been there for 5 years and your salary is about the same as a nursing home podiatrist?

 

[Utvolsdpm]

I can definitely relate to OP. In certain situations work is just not enjoyable. I was ready for a change about 6 months in to my first job. The way OP is describing his situation reminds me of my own. I ended up finding a position at a VA and this was the exact change I needed. Of course it’s not perfect, but things are much improved and find my day to day duties much more enjoyable. We do take call at our facility but I don’t think that all do.

Maybe try looking around at different job opportunities. There may be something more fitting for you out there!

 

[JewOnThis]

You guys have made some good points.

Unfortunately, the company I work for does not allow me to pick and choose what type of patients that walk through the door. Our schedule changes on a daily basis. The front desk staff cannot turn down walk ins or add ons due to the company's policy.


The complications I deal with are usually not from myself. They come from other docs here. I staff at one of the 10 offices in the area.

As for, income I making less than I was when I was in multi spec, but it is still 6 figure salary.


I am definitely exploring my options. I'm also talking to friends who are going through similar situations.

 

[ExperiencedDPM]

You guys have made some good points.

Unfortunately, the company I work for does not allow me to pick and choose what type of patients that walk through the door. Our schedule changes on a daily basis. The front desk staff cannot turn down walk ins or add ons due to the company's policy.


The complications I deal with are usually not from myself. They come from other docs here. I staff at one of the 10 offices in the area.

As for, income I making less than I was when I was in multi spec, but it is still 6 figure salary.


I am definitely exploring my options. I'm also talking to friends who are going through similar situations.

I don’t know of any employer who will allow you to pick and choose the type of patients you treat. The only way that is realistically going to happen is if you opened your own practice.

 

[post-bacc]

Do you have any way of seeing if the actual day to day of your desired new career would be better? Try to make sure you have some proof that the grass really will be greener. Can you shadow or get some other experience in that new career before making the switch?

 

[janV88]

I don’t know of any employer who will allow you to pick and choose the type of patients you treat. The only way that is realistically going to happen is if you opened your own practice.

This is the by far the most common complaint I hear about. Inability to dictate type of patients you see, call schedule, time off, etc. But it is possible. My new job is a great example. I take no mandatory call, except for my own patients. I decide what days I have clinic and have surgery. I decide what I will and will not see (I don’t see any routine foot care or diabetic foot exams). I can take time off anytime I want. My mandate is either 1 surgery, 1 inpatient rounding, or a half day of clinic. Otherwise I must take a PTO day...which I have over 30 of per year. These jobs do exist.

Toughest part about leaving a job is the uncertainty. What if the next job is the same or worse? But on the other hand you may find yourself thinking; why didn’t I do this sooner? Best of luck to the OP or anyone else in this situation.

 

[bunNfxr]

No brainer .....start interviewing for the VA. Patients are appreciative, everything is covered. There is a ship ton of bureaucracy to work with, but your check comes every 2 weeks. 26 paid days off per year (you may not get approved to actually take that much off until you have been there a while, but it accrues), + 10 paid federal holidays + sick leave and + paid time off for conferences.
Contrary to popular belief the VA uses the same hardware and other supplies as most private sector facilities with less frustration. Wright, stryker, you name it , most is in system and you can push to get other things in if your needs are not met. Patient Volume would be similar in most cases. But workflow may take some getting used to.
Don't put yourself in a situation where your skills and training go cold and your nail cutting job gets farmed out to an LPN as times change. I know, we are too important that could never happen....
IM me if you want to talk about it

 

[Utvolsdpm]

No brainer .....start interviewing for the VA. Patients are appreciative, everything is covered. There is a ship ton of bureaucracy to work with, but your check comes every 2 weeks. 26 paid days off per year (you may not get approved to actually take that much off until you have been there a while, but it accrues), + 10 paid federal holidays + sick leave and + paid time off for conferences.
Contrary to popular belief the VA uses the same hardware and other supplies as most private sector facilities with less frustration. Wright, stryker, you name it , most is in system and you can push to get other things in if your needs are not met. Patient Volume would be similar in most cases. But workflow may take some getting used to.
Don't put yourself in a situation where your skills and training go cold and your nail cutting job gets farmed out to an LPN as times change. I know, we are too important that could never happen....
IM me if you want to talk about it

I’m with you 100 percent, in addition that personal liability is removed (no malpractice insurance needed) and the workload/hours (7-330) are favorable. With the salary changes coming I think its very difficult to beat a Va gig.

 

[bunNfxr]

There is some liability at the VA. It may not be financial, but it could impact you keeping your job and the rest of your career. People do get fired now. There is a point system with a lifetime limit on reviewed cases based on peer reviews.

 

[Utvolsdpm]

There is some liability at the VA. It may not be financial, but it could impact you keeping your job and the rest of your career. People do get fired now. There is a point system with a lifetime limit on reviewed cases based on peer reviews.

Any reference material on this? I don’t think any of my coworkers are aware of this. Also, does being in the union help at all?

 

[bunNfxr]

http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2250

 

[Utvolsdpm]

http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2250

I’m vaguely familiar with the peer review process. Is there anything specifically about actually getting fired though? From what I understand if you get a bunch of level 2 or 3s within a short time period then maybe you’d be at risk for losing your job, but otherwise job security is very very good. Even trumps new rules are more aimed at administrative types. Apparently there are podiatrists that get terminated (roughly 20 in the last year) but the only incident I’ve seen specifically was from taking gifts from reps... I appreciate your insight!

Maybe we should dm as to not hijack this thread, but I do think this info is not readily apparent to pods out there and is good for others to know.

 

[g squared 23]

If I had a case get cancelled, I would be stoked. On my OR day either I operate or I don't, so either way I'm kind of happy. If you'd rather cut nails all day, bruh, you're in a baaaaad place right now and need to talk to a counselor or something double quick.