We have a number of partners that work an 8-10 shift per month schedule and they don't really look for extra shifts. I'm not sure how that plays out as our medical insurance costs keep creeping up and annual retirement account limits go up as our reimbursement does not. Eventually they have to work more or contribute less. But their jobs aren't at risk.
We don't use any locums. We keep our doc roster heavy so it's pretty rare to have a shift someone wants out of that someone else won't pick up. The flip side is that I'm about 20-30 hours shorter than planned the next few months, but there are worse problems to have and I have side work anyway.
I don't agree with this assessment but those jobs are probably hard to find.
I would venture to guess most old strippers look better than most of the old ED docs i see.
I mean depends on how much money they have. I save a stupid amount of money now. I am making hay while the sun is shining. We have some of our older docs who are financially set so they dont care. This is pretty frequent. It is the mid career non planner who is screwed. Imagine being 45 and not thinking about your financial well being.. Those people exist.. they work a mediocre job and dont see or hear the freight train coming….. i worry for them..
There was a prior thread on all this.. I am much more of the work hard, stay busy and make good money. It is rare that i leave a shift and feel tired or anything like that. IMO max income with minimum hours. I work about 100 hours a month and I wonder if/when i should work less. It has little to nothing to do with work itself on shift. It is the hours switching, it is wanting to be around more for my kids. I work less in the summers and try to work more when they are in school and ideally during the hours they are in school or early morning so i only miss them for a few hours in the morning which IMO isnt “quality” time anyhow.
Both SCP and Team health down here in South Florida have said that the direct orders from the regional leadership is to staff about 0.5 full time equivalents beyond your need AND to have enough prns on staff to potentially absorb 3 concurrent full timers resigning at once. That works out to having about 6 prns... Which we all have.
Bro south Florida is a damned waste land medically. If my family wasn’t here I’d be gone for good. I have a new grad friend who just signed for FT at $155/hr with no RVU component. Palmetto hospital is so bankrupt they stopped paying for PCI supplies and they lost their STEMI accreditation. Northshore is so broke they sold the land underneath the hospital and now have to lease it back lol.
Only well paying job in the area is Jackson North which WILL grind you into a defeated burned out powder within a few months.
Maybe the same job, a good friend of mine took one of the locums contracts in the Florida panhandle for 350/hr.
Did he quit right after?
He did not but I sure as hell would have.
i am almost 100% certain i know what job that is because I considered applying but I work at its competitor in the same town (and surrounding cities) and asked around and everyone was like 'oh no man. that place is the wild west'. I'll take 300/hr (sure, low for travel) and expenses covered in order to help pad the schedule at high functioning hospitals with multiple person concurrent coverage that are pleasures to work at.
Um wtf.
It will extend to every single large city and eventually to the outlying places that no one currently wants to work at. I love the concept of locums but in EM it’s not a long term strategy and you could end in a spot where you won’t be able to find a normal job in a location you want once you can’t find locums.
Thankfully I've only ever done locums part time. I like to work 180ish hours a month so its not hard to tell my full time that ill do the contracted minimum of 120 (or even less if theyll let me) and i fill the rest with whatever locums job pays the best. But never lose the home base even if its harder work for less pay - its harder work for less pay near my home and family.
You have perfectly summed up a large reason why I, a PGY-16, am seeking a fellowship next year and getting out of the EM grind. And I'm someone who works 70-80 hours a month and pulls in about 250K. When driving to work fills you with anxiety, you have to take stock. Luckily, I have a big interest outside of EM (hence the fellowship).
You’re making 250k working 70-80hrs/week of EM? Hell man I'd be the first one out the door too.
A month, not a week!
Works out to about 250/hr..
80 hrs per week * 250/hr = $1,040,000 per year.
She clarified that she meant 80 hours a month which by that math would be about 240k per year.
Did you miss "no nights"? There's a Senior Registrar that catches all the tougher cases. He only gets called if the SHTF. (Which it doesn't.)
Disagree I love them lol. Gives you the option to wake up early or sleep in a little late. Maybe get some errands done, hit the gym, maybe sneak in a little 1 hour nap before heading out and getting your shift done. It’s still dark when you get home so can fully sleep with night outside the window. Give me a 3 or 4pm shift anytime
. Just my thoughts.Disagree I love them lol. Gives you the option to wake up early or sleep in a little late. Maybe get some errands done, hit the gym, maybe sneak in a little 1 hour nap before heading out and getting your shift done. It’s still dark when you get home so can fully sleep with night outside the window. Give me a 3 or 4pm shift anytime
I like them; can exercise, get some errands done, etc. before work – but I only ever do one a week (unless I'm on for the weekend, and then I'd do Sat/Sun of them). If they were relentless, I might grow weary of them, but they're a lesser evil than night shifts.
COL varies depending on where you live. There's only one true City in Auckland, and you can find neighbourhoods with NZD$5-10M houses as much as you can find cheaper places further out from those desirable areas. Other small "cities" (Wellington, Hamilton, Christchurch) tend to be more affordable, again, with variation. Rural places can be even further less expensive for housing, but then inherit some additional costs relating to distribution due to their isolation.
Any primers on convincing my wife to take the family around the world and away from the extended family?
Being on the opposite side of the world is a big annoyance, to put it mildly.
Honest question: do you have kids? I used to think the same way but I understand the pull of family and it's tough. Especially when you get to see your kids interact with their cousins and develop relationships with their aunts, uncles, grandparents, etc. There are certainly difficulties and challenges with being a dual income household with kids and no relatives close by.
