Can surgeons take time off?

[fourteen12]

Though it's no secret that highly-specialized surgeons make a lot of money, the ones I've talked don't seem to vacation much. What is vacation allowance like for surgeons?

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[Apollyon]

You don't work, you don't get paid. However, if you love your job, you'll never work a day in your life. Private practice, you just close up shop. Employed (whether by hospital, or academics), that's a little different, because you are not your own boss.

Believe it or not, many (or, at least the majority) of surgeons love the job, and the money is just an added bonus. But, I would guess, if you took away student loans, and the malpractice risk, most surgeons would still be workaholic-types that love what they do.

So, the "vacation allowance" is what your contract, or your patient load, allows, although, again, I believe, most surgeons could take more vacation than they actually do, because they love it. That's why they don't seem to vacation much.

 

[vhawk]

Compared to what? Compared to other physicians or compared to no physicians? I'd be shocked if they vacationed less, on average, than nonphysicians

But yes, when you factor in opportunity costs, a one week "staycation" where you sit around doing nothing can still be an extremely expensive vacation, as that is a week you arent operating, arent seeing patients in clinic or booking surgeries for when you are back from vacation, etc.

 

[Winged Scapula]

My business partner just left for a 3.5 week vacation. She takes an extended vacation about every 2 years but she works hard when she's here and has a well paid spouse.

But that would make me nervous (not only financially, but I can't handle the patient squawking about delaying their care). The most I've ever taken at once is 2 weeks; I usually do 1 week stints and I've not taken more than 2 weeks per year (conferences don't count).

I just don't see the point/need more and as note above, its pretty pricey to stay home (especially when the office and consultants just call you/email/text anyway so I might as well work). I'e discovered I have to leave the country if I really want time off.

Anyway, as others have noted, I'm in PP so I can do what I want; employed surgeons will have restrictions placed on their vacation time. I don't know anyone who gets 3 months etc. off a year (like I've seen in some radiology and anesthesia contracts).

 

[OrthoTraumaMD]

I am “allowed” 4 weeks a year by my contract. However the days I don’t use accrue, so I have more vacation time than I know what to do with. On average, I do 2 weeks a year of real vacation, and 2 weeks of conferences, which doesn’t actually count as vacation....but feels like it. The other 2 weeks have been accruing...so this year, I’m taking 2 weeks off in a row


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[ACSurgeon]

As an acute care surgeons, I work week on/week off... 26 weeks off per year. Not too bad. Helps that acute care has a service model where the patients belong to the service not the surgeon.

 

[fourteen12]

As an acute care surgeons, I work week on/week off... 26 weeks off per year. Not too bad. Helps that acute care has a service model where the patients belong to the service not the surgeon.

Wow that’s crazy. I understand that Acute Care Surgery is similar to trauma but a fairly new fellowship. Is it really all that different from trauma and is that the reason you’re able to have the schedule you do?

 

[24GaugeEJ]

I’m also curious about this ACS model. Seems as though there are more than a few of these fellowships that last two years, include trauma, and also include enough ICU time to become boarded in critical care. Do you spend time taking trauma call or working in the unit? Do you solely operate on urgent/emergent cases?

 

[balaguru]

As an acute care surgeons, I work week on/week off... 26 weeks off per year. Not too bad. Helps that acute care has a service model where the patients belong to the service not the surgeon.

It's worth mentioning that there is still much to learn and polish once residency is done. A certain amount of breadth, complexity and volume of cases is needed to do this efficiently. When i was strictly an acute care surgeon after residency i took extra call on the order of 17 to 20 shifts a month. Despite this i did no more than 150 cases a year. Sure, i had a few exciting trauma cases but the bulk of those cases were lap appys and lap choles. The average general surgeon does about 300 to 400 cases a year depending on the study. When your sole source of referrals is the ER you will be missing out on early stage gi cancers, endocrine, breast, melanoma and complex minimally invasive surgery to name a few. You will probably loose your ability to keep credentials for certain procedures like SLNB and some lap procedures. Also there is a certain amount of art to what we do and when you hand your service off to someone else you may not agree with their management of one of your great saves. I realize i may be in the minority of surgeons who wants an old school practice with a broad scope and deep community engagement while still living in a major metropolitan area but i find it so professionally rewarding. The money isnt bad either.

I admit, i do need to do a better job of taking vacations. Ive only had 1 week of true vacation in 3 years. It can be hard to leave when you are strictly eat what you treat and dont have regular coverage. It was awesome and much needed though.

 

[ACSurgeon]

It's worth mentioning that there is still much to learn and polish once residency is done. A certain amount of breadth, complexity and volume of cases is needed to do this efficiently. When i was strictly an acute care surgeon after residency i took extra call on the order of 17 to 20 shifts a month. Despite this i did no more than 150 cases a year. Sure, i had a few exciting trauma cases but the bulk of those cases were lap appys and lap choles. The average general surgeon does about 300 to 400 cases a year depending on the study. When your sole source of referrals is the ER you will be missing out on early stage gi cancers, endocrine, breast, melanoma and complex minimally invasive surgery to name a few. You will probably loose your ability to keep credentials for certain procedures like SLNB and some lap procedures. Also there is a certain amount of art to what we do and when you hand your service off to someone else you may not agree with their management of one of your great saves. I realize i may be in the minority of surgeons who wants an old school practice with a broad scope and deep community engagement while still living in a major metropolitan area but i find it so professionally rewarding. The money isnt bad either.

I admit, i do need to do a better job of taking vacations. Ive only had 1 week of true vacation in 3 years. It can be hard to leave when you are strictly eat what you treat and dont have regular coverage. It was awesome and much needed though.

Point well taken. I do have some concern about skill decay, but not so much in terms of cancer, breast or endocrine surgery. Happy to never do that again.

Acute care surgery in the right setting could exceed 300 cases a year. In other settings, you could develop an elective practice on the side to keep volumes up.

So far, I feel like I have a good work life balance, have opportunity to work more when I want, and my patients are attended to when I’m off. The flexibility is nice, especially with a young family

 

[dpmd]

I take as much time off as I want. I eat what I kill with my only overhead a percentage of what I bring in (well my malpractice is fixed but isn't that high), so the limiting factor is needing to keep the people who cover for me when I am gone happy. That means I try not to take more than two weeks in a month (so that way I can still take the usual number of calls per month so they don't have to take extra) and I try not to dump patients too much (so I round on my patients still in house on weekends unless I have out of town plans). Before my husband finished school and started working we would do two or three 8 to 10 day trips a year plus some long weekends. Now that he has been there long enough to start taking vacation we are shooting for one or two long trips and more of the short ones since he changed to a three day work week (though the day I assist a surgeon regularly means we have to stick with three day trips rather than four days. Plus I do volunteer stuff that takes an extra week or two here and there.

 

[vhawk]

I take as much time off as I want. I eat what I kill with my only overhead a percentage of what I bring in (well my malpractice is fixed but isn't that high), so the limiting factor is needing to keep the people who cover for me when I am gone happy. That means I try not to take more than two weeks in a month (so that way I can still take the usual number of calls per month so they don't have to take extra) and I try not to dump patients too much (so I round on my patients still in house on weekends unless I have out of town plans). Before my husband finished school and started working we would do two or three 8 to 10 day trips a year plus some long weekends. Now that he has been there long enough to start taking vacation we are shooting for one or two long trips and more of the short ones since he changed to a three day work week (though the day I assist a surgeon regularly means we have to stick with three day trips rather than four days. Plus I do volunteer stuff that takes an extra week or two here and there.

Very nice

 

[bizdr]

Though it's no secret that highly-specialized surgeons make a lot of money, the ones I've talked don't seem to vacation much. What is vacation allowance like for surgeons?

Once you are out in private practice, you make your own hours. Most do work lots of hours, but that is related to personality type and liking being in the OR. I also know that for many, once you start making $$$$, your lifestyle often changes and then you feel a need to keep bringing in the big bucks. I have a friend who wanted more time with family, and switched to wound care primarily.