Considering lifestyle...

[alienwares]

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Hello everyone. I have been thinking about the future a lot recently as I've lined up my ducks to return to school. I recently took a trip to the dentist, who shared with me when I asked that she was very, very happy with her work there. She worked four days a week and as a result was able to see her family a lot of the time.

So I was wondering, I suppose, how doable it is to be a family medicine or internal medicine type of doctor and work "dentist hours" or a roughly 40-something-hour workweek. I realize there are lifestyle specialties, but it seems insane to bank upon getting one of them before I am even in a school. For a medical career, I am mostly interested in having lots of patient interaction, having consistent longer-term relationships with some of them, and having some degree of autonomy. My #1 life priority however is being able to spend quality time with my family.

On a personal level, my dad was an internist and I pretty much never saw him. I'm sure he made a lot of money but my main recollection of him was him plopping down exhausted in front of the computer until bedtime, or leaving in the middle of the night to see a patient, or taking other partners' patients on weekends and holidays. Our family life was pretty nonexistent. I know that medicine is usually a very time-consuming profession, and I am completely willing to give it the next decade of my life for school/residency etc. However, I would like reassurance that if I need to slow down after school and work a limited schedule some time, that I can do that if I make it a priority. I've read Panda's blog and towards the end of residency it gets frightening. I'm in Texas where medical school is still priced humanely, so debt will not be a big driver into a lucrative specialty for me.

Alternately, if anyone here chose, say, dentistry or something with family-friendlier hours over medicine, I would love to hear your thoughts. I have been considering dental for lifestyle but think it would be much less interesting than general medicine.

Thank you for reading in any event.

 

[passerby1ce]

This is just reading from forums but I hear Physician Assistants make a pretty comparable living to Family physicians with less demanding work hours. and it's pretty close in intellectual content to physician's knowledge so you won't get as bored that way. But I have no direct experience of this.

 

[Trismegistus4]

My #1 life priority however is being able to spend quality time with my family.

On a personal level, my dad was an internist and I pretty much never saw him.

Well, you pretty much just answered your own question with those two statements. If your #1 life priority is being able to spend quality time with my family, medicine is not right for you, period. Now that I've said that, 50 different posters are about to pile into this thread to "refute" me by posting anecdotal evidence about some doctor they know who does get to spend time with his family. But the fact that a few such doctors exist does not negate the fact that it does not make sense to enter medicine if family truly is your #1 priority. If it's your #2 priority, maybe. #3 priority, sure. But if literally the most important thing in life for you is to spend time with your family, the risks of medicine far outweigh the rewards. You may wind up in a situation that ultimately allows you to make room for family, but only after ~10 years of med school + residency, which are pretty unfriendly to family, and you'll be going against the grain. Medicine is very demanding and you will have to make career sacrifices to spend time with your family. It can be done, but it doesn't really fit well with the world of medicine. Take it from someone who also considered family his #1 priority, yet now in 3rd year of medical school still has no family, no immediate hope of having one, and doesn't even like medical school. I agree with passerby1ce; it sounds like PA school may be a good fit for you.

 

[Mister T]

Hello everyone. I have been thinking about the future a lot recently as I've lined up my ducks to return to school. I recently took a trip to the dentist, who shared with me when I asked that she was very, very happy with her work there. She worked four days a week and as a result was able to see her family a lot of the time.

So I was wondering, I suppose, how doable it is to be a family medicine or internal medicine type of doctor and work "dentist hours" or a roughly 40-something-hour workweek. I realize there are lifestyle specialties, but it seems insane to bank upon getting one of them before I am even in a school. For a medical career, I am mostly interested in having lots of patient interaction, having consistent longer-term relationships with some of them, and having some degree of autonomy. My #1 life priority however is being able to spend quality time with my family.

On a personal level, my dad was an internist and I pretty much never saw him. I'm sure he made a lot of money but my main recollection of him was him plopping down exhausted in front of the computer until bedtime, or leaving in the middle of the night to see a patient, or taking other partners' patients on weekends and holidays. Our family life was pretty nonexistent. I know that medicine is usually a very time-consuming profession, and I am completely willing to give it the next decade of my life for school/residency etc. However, I would like reassurance that if I need to slow down after school and work a limited schedule some time, that I can do that if I make it a priority. I've read Panda's blog and towards the end of residency it gets frightening. I'm in Texas where medical school is still priced humanely, so debt will not be a big driver into a lucrative specialty for me.

Alternately, if anyone here chose, say, dentistry or something with family-friendlier hours over medicine, I would love to hear your thoughts. I have been considering dental for lifestyle but think it would be much less interesting than general medicine.

Thank you for reading in any event.

Why not be a hospitalist? You do internal medicine as your residency (maybe family practice counts? I dunno), and you're a hospitalist. You can work 40 hours one week and none the next, or 20 one week and none the next, or whatever is available, and rake in 80-100k a year. It's still better than working 40 hours a week as a PA making 80-90k in the long run. Or try psychiatry or "Physical Medicine and Rehabilitation/Physiatry", or infectious disease.

If you're middle of the pack or average in class, go for pathology or physiatry and rehabilitation, or endocrinology, , nephrology, sports medicine,etc.

If you're slighltly above average to average, try Emergency Medicine (but there are HUGE caveats with this as it can be "jarring" with their sleep schedules), allergy doctor, immunology, medical onc.,

if you're well above average but not super above average, opthamology (spelling sorry), diagnostic radiology (okay true they work very hard, but they seem to have long vacations of like 3-4 months), urology

And finally,

If you're a virgin and a super gunner power combo,
Dermatology ---- ta daaaaaaaaaaaaa!

You have a lot of options.

You can also do locum tenens work on the side or work for a university or medical school and their hours are known for being pretty damn good (vacation time, sabbaticals, etc.), though for doctors I think they have to do clinical duty instead.

The options are open you just have to research it well enough.

 

[NTF]

From the sounds of it you should do some exploration and see if other avenues are a better fit for you. While it is possible to strike that balance between a medical career and family, one is ALWAYS in tension with the other. At various points one wins out to the neglect of the other. In many ways it's about managing your expectations and what it is that you mean by family being your #1 priority. If by that you mean never missing any significant event in your children's lives than you can pretty much kiss any high-powered career good bye.

But if you mean still being present enough in your kids' lives so they don't feel like they had an absent parent, I think there's a lot of avenues in medicine that could allow for that. But I get the sense that you want something that will never trump your family's needs. And I'd have to say that medicine is probably not that.

 

[sumstorm]

I do know doctors who do find a good balance for them, but part of that is about lifestyle choices; they come home and destress by being with their families, not burying themselves in media (TV, computer, news, books). And in evey case I know of, there is a great deal of investment by both parents in the kids...rather than the 80/20 split that happens in a lot of homes. Also, it depends on what you consider important, some of it is establishing your own baselines and reinforcing what is acceptable/allowable/tolerable early on. Both my folks worked hard, demanding jobs, then came home and operated a small organic farm. I grew up knowing that homework and chores had to be done early to have fun later and understanding the value of shared hobbies and mutual support. I am a foster mom, and when we have kids in the home (and when I have my own biological kids) I alter my routine to include them. Instead of running during the evening, I push a stroller or swim in the pool with the kids, or instead of biking on the weekend, I go to the park with kids and play on the play ground, have a picnic, and go on an appropriate hike. I managed that with a 60+ hour job, and I have managed it while in school 40+ hours every week. The kids, for me, are about fun...and we all pitch in to have a comfortable home, which helps immensely.

 

[NonTradMed]

If you want a good lifestyle in medicine and don't want to aim for one of the lifestyle specialities, the key is shift work. I believe hospitalists have pretty regular hours, at least from what I've seen.

EM docs do shift work, but their hours may be weird (more nights/weekends even if they only work 40 hrs/week). Critical care specialists also do shift work.

The benefit of working a such a wide field of medicine is that there are such variety in what people can do. Also, with more women in medicine, there's been an upsurge in part time work, in more family friendly practices etc. You will need to find out the arrangement that works for YOU. But it can be done. I've seen dual physician households with four kids who manage to strike a balance.

But as others noted, if you want to have a career, or a high powered profession, you have to make small sacrifices in your home life. Short of becoming a stay at home mother, you will not be putting your family "first". Your kids will have to learn that sometimes, mommy or daddy will have to finish work up before playing with them. Stuff like that I don't consider a true sacrifice and I think kids should learn they are not the center of the world, but everyone's limitations are different.

In life, short of being independently wealthy, you will almost certainly make sacrifices, whether financial, familial or professional to achieve your goals.

 

[morning]

There are enough open jobs in family and internal medicine that you could find one with good hours, but you'd have to be willing to relocate. If you open your own clinic, my understanding is that low reimbursement makes "lifestyle" hours prohibitive. You have to see a LOT of patients to make good dough in family medicine. I'm interested in it but I don't think I could handle that so it's not really on my radar.

The rise of the hospitalist will PROBABLY make a lot of unappealing fields more appealing. Hospitalists lower the time you spend on call and sometimes eliminates the need to round inpatient completely. So not only is hospitalist work a lifestyle specialty in and of itself, but it frees up time for other specialties as well.

There are lots of "lifestyle" specialties and not all of them are competitive. I made a long list in the order that they interest me (NOT AT ALL interested in radiology up to very interested in EM) and there might be more out there that I don't know of. There are non-lifestyle specialties I like, too. If you LOVE your job, longer hours are more tolerable. No amount of money or time could convince me to do a job I hate. And there are specialties with decent hours that I am interested in that are fellowships after a difficult residency, like maternal-fetal medicine and reproductive endocrinology after a grueling OBGYN residency.

Radiology
Plastic surgery
ENT
Opthamology
Anesthesiology
Psychiatry
Pathology
Allergy/Immunology
Endocrinology
Neurology
Genetics
Radiation Oncology
Dermatology
Intensivist
PM&R
Emergency medicine
Hospitalist


You should check this out: http://www.smbs.buffalo.edu/RESIDENT/CareerCounseling/interior.htm?specialty_profiles.htm

Near the bottom of each specialty's PDF there's a bar for how regular their hours are and another column for how they feel about their schedule in general.

 

[NTF]

One point I'd like to contribute is that working part-time as a physician isn't always as easy as it sounds (though many do find arrangements that work). Many practices balk at hiring too many part-timers because malpractice insurance premiums aren't appreciably lower than for full-timers. So it becomes more expensive for them to staff the equivalent amount of hours with part-time physicians than full-time ones.
Alot of friends of mine would like to work less than they do, but their particular practices will only keep them on if they work a certain minimum number of hours. For most it works out, especially if their spouse has a good benefits package at their job (another consideration). But the process of finding a good fit, often took some searching, negotiating, or building goodwill by being a full-time "good teamplayer" for a several years.
So it isn't necessarily just a matter of "hey, I'll just work 1/2 time and make 75-90k". For instance, an EM doc friend of mine was recently notified by her practice that they couldn't keep her on unless she upped to at least 75% appointment (she had been 60%). Which may not seem like a big deal but because she can only work 8hr shifts it means she has to work 4 shifts instead of 3. And when you're raising 3 kids under 10 having to work an additional day can throw a whole wrench into things.