Can this still be a lifestyle job?

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JacobMcCandles said:
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.
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He does not.
Unless something very interesting happened.
Not to speak for others but I've been on SDN...15+ years now(!?!) and know a thing or two. Though I only know the irl names of three people and that's because they're known publicly outside SDN. I would guess some others are too but keep it more "anon."
 
JacobMcCandles said:
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.
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No kids. Hell no.
I came from a big family and got to see the them on the holidays, etc. That was enough.

I'm talking about situations such as: "We would move to (city) because job and things but family is here" and I'm like... uhh, it's a :90 minute drive. Get in the effing car. Super common here.
 
RustedFox said:
No kids. Hell no.
I came from a big family and got to see the them on the holidays, etc. That was enough.

I'm talking about situations such as: "We would move to (city) because job and things but family is here" and I'm like... uhh, it's a :90 minute drive. Get in the effing car. Super common here.
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It’s tough to understand until you live it. I was the same way before I had kids but I’m not surprised now at what people will do in the name of family.
 
JacobMcCandles said:
It’s tough to understand until you live it. I was the same way before I had kids but I’m not surprised now at what people will do in the name of family.
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I mean, I understand the argument that "since I don't have kids, I have little footing in this matter", but at the same time I'm like: "it's not a different state, region, or timezone. Tell the fam to get their asses here if they wanna see the kids and you'll find out just how much they really wanna see the kids."
 
JacobMcCandles said:
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.
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I was raised hundreds of miles away from any extended family, and my wife and I currently live hundreds of miles from either of our families.

My current rheumatology job is really, really good (as in I make 2-3x more than what I was making at my original crappy hospital job) and thus I wouldn’t trade it for the world. The dramatically better pay and treatment I get at this job is far more important to us than having grandma living down the street. Making this much more money means my wife can afford not to work, and can watch the kids. It also means we can afford traveling to see people regularly. Thus, living this far away seems to work out ok. In-laws fly in to visit fairly frequently, and sometimes they drive to see us in their RV. We fly/drive elsewhere to see people. It’s really not the end of the world.

(And not moving over a 90 minute drive? Seriously?)
 
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dozitgetchahi said:
I was raised hundreds of miles away from any extended family, and my wife and I currently live hundreds of miles from either of our families.

My current rheumatology job is really, really good (as in I make 2-3x more than what I was making at my original crappy hospital job) and thus I wouldn’t trade it for the world. The dramatically better pay and treatment I get at this job is far more important to us than having grandma living down the street. Making this much more money means my wife can afford not to work, and can watch the kids. It also means we can afford traveling to see people regularly. Thus, living this far away seems to work out ok. In-laws fly in to visit fairly frequently, and sometimes they drive to see us in their RV. We fly/drive elsewhere to see people. It’s really not the end of the world.

(And not moving over a 90 minute drive? Seriously?)
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We've been in similar positions. I'm just saying that I understand when people choose that aspect over other aspects of their life.
 
RustedFox said:
I mean, I understand the argument that "since I don't have kids, I have little footing in this matter", but at the same time I'm like: "it's not a different state, region, or timezone. Tell the fam to get their asses here if they wanna see the kids and you'll find out just how much they really wanna see the kids."
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Date nights, sick kid coverage (this one is huge when they're in daycare), cook outs, just a night in while they take the kids somewhwere, etc. There are lots of things where being 1-2 hours away is pretty inconvenient. Different strokes for different folks but I'm just saying I understand the decisions that people make with regards to family at the expense of other aspects of their life.
 
RustedFox said:
The tone of this is not meant to be adversarial:

I absolutely do not understand the "extended family keeps me here" nonsense.
Is it YOUR family?
Are YOU the head of your household?
Do YOU call the shots?

No, I don't care what Tia or Abuela (or whatever their equivalents are) has to say. They don't go to work and pay your bills.
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My father died in December. My only sibling died 13 years ago. My mother is aging and someone needs to care for her.

I think for many of us in the “sandwich generation,” raising children but also cognizant of aging parents, this is a common theme.
 
JacobMcCandles said:
sick kid coverage (this one is huge when they're in daycare)
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Out here in Normal Planet land, if your kid is sick, you take a sick day.

It's culturally normalized the family comes before your work. It's the employer's responsibility to anticipate a predictable amount of sick call and have mitigations.
 
xaelia said:
Out here in Normal Planet land, if your kid is sick, you take a sick day.

It's culturally normalized the family comes before your work. It's the employer's responsibility to anticipate a predictable amount of sick call and have mitigations.
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Honestly, I understand the desire to have sick days. But I also subscribe to the belief that I am a small business (1099). If I were an employee (W2), different story and the CMG/whoever could owe me sick days.
 
I grew up in Pakistan where celebrations included all extended family members. I grew up knowing all my cousins and my first cousins i probably saw at least once every other week.

But i don’t think I’ve valued that much at all when i moved to the US. I think if you work on it, you could effectively replace family with a friends circle that feels like family.

While i legitimately considered moving back to Texas where my brother was 3 years ago, the job market in Austin/Dallas was bad enough where i didn’t feel like taking a crappy job just to be near family. Instead we moved to the midwest where we knew absolutely no one, but had excellent career opportunities at ERs that i would consider sustainable. A part of me thinks we should have even considered the dakotas because some of the job posts i see coming out of there are incredible 😂

But over time, we’ve replaced the need for family. Have a group of 6-7 families with kids around 3-6 years old who basically hang out 2-3 times a month. We’ve effectively replaced what i had growing up with a friends circle. So i think family is replaceable.

This is why a part of me doesn’t care about moving again - I’ve moved so much - pakistan -> Illinois-> multiple cities in Texas -> Ohio -> Indiana. Honestly my mortgage rate of 2.75% is truly what has grounded us more than anything else.

But maybe at 40, in 5 years, i might leave it all and just move to Spain/portugal/kuala lumpur/Greece. I should have 4 million in investment assets by then and could retire in those countries to never work again.
 
xaelia said:
Out here in Normal Planet land, if your kid is sick, you take a sick day.

It's culturally normalized the family comes before your work. It's the employer's responsibility to anticipate a predictable amount of sick call and have mitigations.
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The ED (and many aspects of medicine) isn't Normal Planet Land.
 
Yes it can be lifestyle. IF you work as 1099/IC. Basically do locums only, and work when you truly want. With W2 job you'll be stuck to be having to work half the holidays, half the weekends, some nights unless you're at a place with nocturnists, etc. True freedom and the "lifestyle" in EM is if you work full PRN locums
 
Waterlover said:
Yes it can be lifestyle. IF you work as 1099/IC. Basically do locums only, and work when you truly want. With W2 job you'll be stuck to be having to work half the holidays, half the weekends, some nights unless you're at a place with nocturnists, etc. True freedom and the "lifestyle" in EM is if you work full PRN locums
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I mean maybe? This isn't good catch all advice for all comers. You either need to a) come from means or have an already established nest egg, b) be married to someone who can provide reasonably priced health insurance, or c) don't get sick.

In addition:

1) it's not inherently easy to get a rotation of 5-6 places to string together a FT or close to FT compliment of hours. And it will become harder and harder to achieve this with the glut of residents being graduated. Shops hate PRN / locums and you'll be the first out.

2) These sort of "locums lifers" have a reputation. In my experience, many have weird personalities, are weak clinically, and downright combative w staff, patients and other doctors. They don't tend to play well in the sandbox.

That all being said, I do think if you have a nice 2-3 million or more in assets and are sorta on that "coast FIRE" path, it can be a good move for a mid to late career physician, so long as you can tolerate the potential monthly swings in income. Or maybe you're a young buck who doesn't care that much about living an inflated lifestyle and are happy w a modest existence (likely without kids cause those things are luxury items believe me). It definitely is a tradeoff between freedom and predictable income.
 
WhatJobDoIPick said:
Lol nice downvote @PB2464 . Sorry you don't like the truth.
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If a post sucks, it sucks. The downvote is there for a reason. Imagine the little whiny dude calling out someone for not liking what he says. And the only thing he does is rile up his little internet fake friends to feel good about what he says. Pretty pathetic...bro.
 
PB2464 said:
If a post sucks, it sucks. The downvote is there for a reason. Imagine the little whiny dude calling out someone for not liking what he says. And the only thing he does is rile up his little internet fake friends to feel good about what he says. Pretty pathetic...bro.
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This isn't Reddit, bro.
This is where the adults talk.
Maybe listen to what he says; he's saying it for damn good reason.
 
RustedFox said:
LoL @ "word salad".
4 lines.
3 sentences.
One with a semicolon.
It's not hard.
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You got some dressing for that salad? Is she RustedFox or the Riddler? A vague woman. But comes to the defense of the weaklings. Upstanding and internet strong. What a legend.
 
Apollyon said:
There are d-bags that do this. It empowers them, I guess?
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Should we be using that language on a professional forum? A donor? What the
If I donate, do I get offending rights?
 
Just a lurker here who is interested in EM. I’ve read a lot about the downsides of EM on this forum, but I’m curious if all that has been discussed about EM on SDN also applies to academic EM. Seems like everyone’s experience comes from non-academic jobs. I read Cyanides post from 2023 and am curious if all of the information he found also applies to academia, especially job security.
 
PB2464 said:
Should we be using that language on a professional forum? A donor? What the
If I donate, do I get offending rights?
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Dude. Chill out. Relax. Seriously, you sound hypomanic, at the minimum. If you have indeed sought out that guy's posts, just to give them a dislike, any number of disparaging epithets can be applied to you.
 
Apollyon said:
Dude. Chill out. Relax. Seriously, you sound hypomanic, at the minimum. If you have indeed sought out that guy's posts, just to give them a dislike, any number of disparaging epithets can be applied to you.
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You're the one calling names and I'm supposed to "chill out". Get a life.
Or you can keep trying to rescue your damsel in distress over his one downvote.
 
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Apollyon said:
Dude. Chill out. Relax. Seriously, you sound hypomanic, at the minimum. If you have indeed sought out that guy's posts, just to give them a dislike, any number of disparaging epithets can be applied to you.
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Bro got on full tilt. What a meme lol.
 
Apollyon said:
Was it one dislike, or did he give you more than one, over two or more threads?
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It was a couple after reading some other stuff I've honestly disagreed with.
I've also liked some other stuff, yet he (she?) is going to ignore that.

You've been reported for language with your initial remark. I don't care how long you guys have been on here or what you donate, there are rules to interactions on a "professional" forum. Crying about one downvote isn't against the rules but your name calling is.
 
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PB2464 said:
It was a couple after reading some other stuff I've honestly disagreed with.
I've also liked some other stuff, yet he (she?) is going to ignore that.

You've been reported for language with your initial remark. I don't care how long you guys have been on here or what you donate, there are rules to interactions on a "professional" forum. Crying about one downvote isn't against the rules but your name calling is.
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Uh, thanks?
 
MeinTraum said:
Just a lurker here who is interested in EM. I’ve read a lot about the downsides of EM on this forum, but I’m curious if all that has been discussed about EM on SDN also applies to academic EM. Seems like everyone’s experience comes from non-academic jobs. I read Cyanides post from 2023 and am curious if all of the information he found also applies to academia, especially job security.
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I mean if you don’t mind getting paid 250k.

I wouldn’t do emergency medicine for 250k 😂
 
PB2464 said:
It was a couple after reading some other stuff I've honestly disagreed with.
I've also liked some other stuff, yet he (she?) is going to ignore that.

You've been reported for language with your initial remark. I don't care how long you guys have been on here or what you donate, there are rules to interactions on a "professional" forum. Crying about one downvote isn't against the rules but your name calling is.
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15+ year member. Just curious, Are you an attending or did you join the forum in middle school?
 
cyanide12345678 said:
15+ year member. Just curious, Are you an attending or did you join the forum in middle school?
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Oh hey. Another one joining. Of course. Are you going to ask the 20+ year member the same? Who still uses the phrase d-bag? Hahaha. Of course not.

I don't come here much because I have something called a life. But I don't mind standing up for myself...alone.

Thought I would come check in on the whole EM whining business.
 
PB2464 said:
Oh hey. Another one joining. Of course. Are you going to ask the 20+ year member the same? Who still uses the phrase d-bag? Hahaha. Of course not.

I don't come here much because I have something called a life. But I don't mind standing up for myself...alone.

Thought I would come check in on the whole EM whining business.
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Pls stop

We EM docs do enough of a good job making ourselves look bad, you don't need to lower the bar further. Also your post makes you sound like a regional teamhealth director/VP, which is less an insult and more an observation that has probably a 20% chance of being accurate
 
AlmostAnMD said:
Pls stop

We EM docs do enough of a good job making ourselves look bad, you don't need to lower the bar further. Also your post makes you sound like a regional teamhealth director/VP, which is less an insult and more an observation that has probably a 20% chance of being accurate
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Another one!

This is a nerdy Internet forum. Trust me no one is coming here.

The only one that initially looked bad with his little whining on a downvote.

Some of you guys just can't ever think you're wrong. Now that's what gives doctors a bad name.
 
MeinTraum said:
Just a lurker here who is interested in EM. I’ve read a lot about the downsides of EM on this forum, but I’m curious if all that has been discussed about EM on SDN also applies to academic EM. Seems like everyone’s experience comes from non-academic jobs. I read Cyanides post from 2023 and am curious if all of the information he found also applies to academia, especially job security.
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Bruh, I’m not even EM and know academia is worse
 
If your lifestyle is traveling constantly or working a set night schedule so you don't have to pay/deal with someone else taking care of your kids then yes, it can still be a lifestyle specialty.
 
PB2464 said:
Oh hey. Another one joining. Of course. Are you going to ask the 20+ year member the same? Who still uses the phrase d-bag? Hahaha. Of course not.

I don't come here much because I have something called a life. But I don't mind standing up for myself...alone.

Thought I would come check in on the whole EM whining business.
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All i asked if you’re a student or resident or an attending.

I think it’s a valid question, yet you didn’t quite give a straight answer. I would value your opinion more as to the state of emergency medicine if you are a practicing attending.

So my question stands - are you a practicing attending?
 
cyanide12345678 said:
All i asked if you’re a student or resident or an attending.

I think it’s a valid question, yet you didn’t quite give a straight answer. I would value your opinion more as to the state of emergency medicine if you are a practicing attending.

So my question stands - are you a practicing attending?
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Value my opinion of a downvote? That's a stretch. So no it's not a valid question. You're just being a weasel like the others.
This whole thing is over the other dude crying because I down voted his comment.
Man, what is the button even there for it it can't be used? Complain to the forum admin.
But, you're just coming get to tag team with your internet "bros".
 
Dad voice: @PB2464 is no longer able to post in this thread 2/2 numerous reports. They are still permitted to post elsewhere in the forum. Hopefully things stay civil enough to keep from generating another flood of reports. Back on topic.
 
MeinTraum said:
Just a lurker here who is interested in EM. I’ve read a lot about the downsides of EM on this forum, but I’m curious if all that has been discussed about EM on SDN also applies to academic EM. Seems like everyone’s experience comes from non-academic jobs. I read Cyanides post from 2023 and am curious if all of the information he found also applies to academia, especially job security.
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Back to the topic...

I worked academics for several years and have been PRN in the community the last few years working as a 1099 for an SDG. Academics is overall more tolerable for a long term career imo. Can't speak to an SDG partnership gig, though.

You have two main options in academia:
1. Full time clinical, permanently an assistant professor, never join a committee, do bare minimum lectures, clock in and clock out mentality, etc. Not a bad choice if you have residents doing all your scut. Plus having learners around can be rewarding sometimes and makes the job less lonely.

2. Carve out a niche, climb the academic ladder with the goal of accruing buy-down time. This is getting harder without a fellowship, connection, or super suck up mentality.

The way you mess up academics is landing in between 1 and 2. You try to do a little extra or care a little too much, but not enough (or not recognized) to get you firmly on the #2 track.

Income is hugely site specific. At my prior academic job I made as much as the surrounding CMG or hospital employed jobs, plus had better benefits.
 
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Academia is interesting in that the docs stay a while at least at the true academic centers. Not the new hca joke residencies or other similar junk.

That being said pay is typically atrocious.

Also be careful in knowing working for an academic org isn’t the same as working at their real academic center. See Indiana university among others who have been scooping up hospitals and growing.
 
I plan to work 10 years hard community time then transition to an academic organization. I plan to be a Number 1 in the above post.

After 10 years of community time, I will have plenty of money to live a good life as a Number 1. But 10 years for me equates to 18-20 years of income/savings for a normal community doc.

I recently started being a 3rd/4th year medical student clinical adjunct professor for a nearby DO school. I have so far enjoyed teaching.
 
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