Do physicians bring work home with them?

[JakeSill]

After finishing the shift, do they "bring work home with them."

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[bashwell]

After finishing the shift, do they "bring work home with them."

Depends on the specialty. For eg, EM and anesthesiology no not really. But they have their own big challenges. Most others yes. Don't pick a specialty based only on whether or not you "bring work home" but instead on the whole picture of what a specialty entails, pros and cons, etc, and also your "fit" for the specialty.

 

[karayaa]

Since you used quotes, do you mean psychologically?
I'd say it depends on the personality and the field, but it's more likely where you encounter unexpectedly bad outcomes: EM, trauma, maybe some peds fields.

 

[PhillyMed777]

literally ALL the time

 

[Winged Scapula]

Psychologically? Rarely.

Literally? Yes...most of after hours SDN time is a reward for working on charts.

 

[Law2Doc]

After finishing the shift, do they "bring work home with them."

1. Agree with everyone above that said yes you inevitably bring stuff home to work on, be it paperwork, or logging in remotely to EMR to check in things or returning phone calls to people you couldn't catch during the day.
2. Medicine is a field of lifelong learning. You'll always have a backlog if books and journals you want to look at to stay current and maintain your skills.
3. All specialty boards have CME requirements, meaning you need to read articles and take online quizzes in the evening and/or attend lectures/courses every year to log enough credit to keep your board happy. Many have periodic exams you need to study for to maintain certification as well.
4. If you are in an academic setting you may have lectures, presentations to residents and med students to prepare for, meetings to attend, committees to serve on, and research projects/papers to work on during your academic and "free" time.
5. In some fields you will have backup call obligations where you'll need to be reachable by pager even when you aren't technically the primary attending "on" in some fields.

So yeah, if you are thinking you'll do your 60 hours a week of work (or whatever) and have no obligations beyond that, it doesn't really work that way. You need to be a workaholic to thrive in this field because frankly the expectations beyond your work hours are not light.

 

[bashwell]

Part of the problem is what OP means by "bring work home with them". If OP means what someone like @Law2Doc means, for example, then that's absolutely correct, every specialty is going to have "work" to "bring home".

Although to be fair, almost any relatively high-paying and/or high status profession in our society like working for a big law firm, working for a major consulting firm, working for a major accounting firm, being an academic, and so on is going to have "work" to "bring home" (especially if we're broad enough with our definition of "work"). "Bringing work home" isn't unique to medicine.

Pace @Law2Doc, I wouldn't go as extreme as to say "You need to be a workaholic to thrive in this field [i.e. medicine]" (unless he has a considerably different definition of "thrive" in view here than I do).

 

[Law2Doc]

Part of the problem is what OP means by "bring work home with them"...

By his phrasing "after finishing the shift" I think OP was pretty clear. He wants to know if you can close the door, turn out the lights and be done until the next shift. The answer is "not so much".

 

[bashwell]

By his phrasing "after finishing the shift" I think OP was pretty clear. He wants to know if you can close the door, turn out the lights and be done until the next shift. The answer is "not so much".

Of course, not all specialties are based on "finishing the shift" since not all specialties are "shift" work. Hence the ambiguity in OP's original assumptions about medicine.

 

[JakeSill]

Since you used quotes, do you mean psychologically?
I'd say it depends on the personality and the field, but it's more likely where you encounter unexpectedly bad outcomes: EM, trauma, maybe some peds fields.

No, I meant physical. Like for example, bringing home brain scans to look at. Or while home, you receive some brain scans to look at from work.

 

[bc65]

Usually, there is some paperwork to do at the end of the day, such as charting or coding. In theory, you could do this after each patient visit, but of course you rarely get to do that. By the end of the day, you're tired, so you're less efficient and it goes slower. You might stay late and finish the paperwork, or go home and do it from there. There are also emails to answer, and phone calls, from patients and other doctors, results to review, etc. You may or may not do some of that from home. Then you might have to read up on a disease you encountered that you're not familiar with, read a journal, or prepare for surgery ( usually not, but if you're doing an unusual procedure you might do this, even watch a video). Most people include this time into their estimates of how long they work each day.

If you're on call, you will get calls, often have to go back in, or have to read scans / xrays . How often will depend on your specialty.

 

[karayaa]

Usually, there is some paperwork to do at the end of the day, such as charting or coding. In theory, you could do this after each patient visit, but of course you rarely get to do that. By the end of the day, you're tired, so you're less efficient and it goes slower. You might stay late and finish the paperwork, or go home and do it from there. There are also emails to answer, and phone calls, from patients and other doctors, results to review, etc. You may or may not do some of that from home. Then you might have to read up on a disease you encountered that you're not familiar with, read a journal, or prepare for surgery ( usually not, but if you're doing an unusual procedure you might do this, even watch a video). Most people include this time into their estimates of how long they work each day.

If you're on call, you will get calls, often have to go back in, or have to read scans / xrays . How often will depend on your specialty.

Can you can lessen this by using MAs or scribes in the office?
As already mentioned, seems like some specialties (EM, anesth) take less work home with them.
And some hospital-based/employed doctors (surgicalists, hospitalists) might be able to do this administrative work during their normal shift.

In general, what fields tend to have more of this paperwork/followup work to do at the end of the day? Primary care?

 

[redpanda]

Went home today -> grabbed a beer, microwaved dinner -> checked on clinic follow-ups and stalked my inpatients -> did reading on my inpatients -> internet fun times. Taking work home in this manner is far better than the alternative, which is me leaving the hospital at 8p instead of 6:30p.

 

[bc65]

Can you can lessen this by using MAs or scribes in the office?

I think scribes are primarily for the ER. If you're a surgeon or internist, or anyone seeing patients in an office, it won't pay to have a scribe. They need to pay for themselves in terms of efficiency.

And some hospital-based/employed doctors (surgicalists, hospitalists) might be able to do this administrative work during their normal shift.

Anyone can do it during the regular shift if it's quiet, but it's almost never quiet. Hospitalists often stay an hour or two after the end of shift to do paperwork, from what I hear. Same as office based. What happens is simple: you have a full schedule in the office, in theory you have 5 or 10 minutes after the patient leaves to write your notes, but one of your patients calls with a problem and gets squeezed onto the schedule, so you skip the notes and see the patient. That might happen 3 or 4 times a day. So you get backed up, and do the notes later. After the paperwork is done, you answer the non-urgent emails and phone calls. This will affect all specialties, except anesthesia, who have do document contemporaneously. I think even ER will usually be writing up their last few patients after their shift ends, for 30 or more minutes.

All jobs have this element to them. Teachers grade tests at home. Executives answer emails and do work at home, write reports, etc.

That's why they call it work, and that's why they have to pay people to do it.

 

[sloop]

Can you can lessen this by using MAs or scribes in the office?
As already mentioned, seems like some specialties (EM, anesth) take less work home with them.
And some hospital-based/employed doctors (surgicalists, hospitalists) might be able to do this administrative work during their normal shift.

In general, what fields tend to have more of this paperwork/followup work to do at the end of the day? Primary care?

Not a physician yet, but I've seen enough MAs at offices I've rotated through to say the answer to your first question is probably "not so much." They're good for taking blood pressures or eliciting a brief chief complaint and can hugely expedite the process by allowing you to see more patients in a day, but they don't help much with the charting.

The MAs are not usually in the room during the H&P and often will do this poorly if asked to. They are also basically incapable of writing an assessment and plan for most patients because they don't have the type of medical knowledge for this. Scribes may or may not be somewhat better for this purpose depending on the scribe. Honestly, from what I've seen, the best person to reduce this burden is a good medical student who the physician/resident trusts to write in the chart (and the institution allows it).

As a med student, the best way to get your residents to like you is to write good visit notes/progress notes that they can basically just look over quickly, add/edit a few things, and then be done with it.

 

[Winged Scapula]

I bring work home psychologically too 🙁

Please allow me a word of advice.

With your intended field of practice, continuing to do this will hurt you and possibly your family. There are so many sad stories out there that bringing those home is not healthy.

 

[Law2Doc]

No, I meant physical. Like for example, bringing home brain scans to look at. Or while home, you receive some brain scans to look at from work.

It's all digital now. You wouldn't have to physically bring anything home, you can just log in to the hospital VPN and see EMR stuff, imaging, etc. And yes, you aren't done with work just because the "shift" is over. If you need to look at something again or someone asks you to, you do. This isn't a career where you turn off your taxi light and go off duty.

 

[Law2Doc]

Can you can lessen this by using MAs or scribes in the office?
As already mentioned, seems like some specialties (EM, anesth) take less work home with them.
And some hospital-based/employed doctors (surgicalists, hospitalists) might be able to do this administrative work during their normal shift.

In general, what fields tend to have more of this paperwork/followup work to do at the end of the day? Primary care?

Honestly I think all fields tend to have their paperwork and scut that you'd need to finish at home at times. Even EM and gas. And as mentioned you have a variety of CME and reading/keeping up obligations in every field even if you are done with the days work. And in an academic setting you'll have teaching/lecturing/research "homework" to boot. If you are asking, what field can I work 9-5 and then forget about medicine every evening, I think the answer is really "none". you can take a night/weekend/week off here or there, but this career is a big time commitment, not something you can dabble in.

 

[VA Hopeful Dr]

Please allow me a word of advice.

With your intended field of practice, continuing to do this will hurt you and possibly your family. There are so many sad stories out there that bringing those home is not healthy.

In all sincerity, I'd love to know how one doesn't do this from time to time. I mean, obviously you stop sweating what we consider little things that other people don't - like I hope you aren't going to get super upset if your patient's cancer has spread by time of surgery. But how do you not get upset by something completely unexpected. Like say if a post-op patient throws a PE and dies, especially if its a young person whose cancer you just surgeoned out of them?

 

[Winged Scapula]

Not a physician yet, but I've seen enough MAs at offices I've rotated through to say the answer to your first question is probably "not so much." They're good for taking blood pressures or eliciting a brief chief complaint and can hugely expedite the process by allowing you to see more patients in a day, but they don't help much with the charting.

The MAs are not usually in the room during the H&P and often will do this poorly if asked to. They are also basically incapable of writing an assessment and plan for most patients because they don't have the type of medical knowledge for this. Scribes may or may not be somewhat better for this purpose depending on the scribe. Honestly, from what I've seen, the best person to reduce this burden is a good medical student who the physician/resident trusts to write in the chart (and the institution allows it).

As a med student, the best way to get your residents to like you is to write good visit notes/progress notes that they can basically just look over quickly, add/edit a few things, and then be done with it.

A thousand times yes.

MAs are typically HS grads with minimal additional education. I've never seen one capable of an H&P; they're barely capable of taking vitals (we have an automatic machine which has been malfunctioning so I asked them to do the pressures manually and caught one of them with the cuff on upside down our way down by the wrist on a normal weight patient).

What some of them are great at, and which helps me immensely in reducing my paperwork is putting in a relevant social, family history, imaging and Lab reports and uploading images from my ultrasound. I've trained my brightest one to read the radiology reports, to put the relevant information in the presenting complaint and figure out who might need a biopsy so to get the equipment set up. But she's an exception.

A medical student is an asset in collecting the history and physical but they slow you down because you have to teach them.

My partner uses a scribe to do her A/P which has helped her a great deal.

 

[Winged Scapula]

In all sincerity, I'd love to know how one doesn't do this from time to time. I mean, obviously you stop sweating what we consider little things that other people don't - like I hope you aren't going to get super upset if your patient's cancer has spread by time of surgery. But how do you not get upset by something completely unexpected. Like say if a post-op patient throws a PE and dies, especially if its a young person whose cancer you just surgeoned out of them?

I think it's impossible not to bring it home from time to time.

Just last night I was thinking about the 36-year-old mother of three for whom I performed prophylactic surgery and found a tumor that was not apparent on preoperative Imaging. Today I get to call her and tell her that the PET scan shows bony mets.

So yeah, things like that do come home with me as do other unexpected or even expected postoperative complications.

In regards to how I let it not bother me, I'm normally sanguine about most things, but take A realistic approach that some things are unpreventable and unfair and that there is no use brooding about it if I've done everything I can to try to prevent and/or help.

 

[KnuxNole]

It's all digital now. You wouldn't have to physically bring anything home, you can just log in to the hospital VPN and see EMR stuff, imaging, etc. And yes, you aren't done with work just because the "shift" is over. If you need to look at something again or someone asks you to, you do. This isn't a career where you turn off your taxi light and go off duty.

While there ARE people who do that(and it sucks for the on call person!), I agree, once it is 5:00pm, if your work is not done, you are not done.

 

[ZX10R]

Any job/title that requires a profession degree will bring work home. Lets not forget learning never stops either, once you become board certified you will have to take re-certification tests every X amount of years and you have to complete X amount of education credits every two years.

 

[vtucci]

Charting sometimes yes. Academic duties if you work in training programs, yes.

 

[Kaustikos]

Any job/title that requires a profession degree will bring work home. Lets not forget learning never stops either, once you become board certified you will have to take re-certification tests every X amount of years and you have to complete X amount of education credits every two years.

Thank you for your first sentence.

It brings home the point that it's not just MDs that do it (and I'm not saying it in a bad way).
I wasn't surprised to know that doctors took work home. Partly from seeing my dad read echocardiograms or ekgs at home (kind of fun at times when I tried to diagnose things...and was wrong)
But also from my previous job in pharm. It wasn't required to work at home, but damn if it wasn't needed to keep up or look good. My friend and I would have text/email conversations after work about our projects numerous times.
So, I'd be surprised if someone said it wasn't the norm to bring work home.

 

[Stagg737]

Thank you for your first sentence.

It brings home the point that it's not just MDs that do it (and I'm not saying it in a bad way).
I wasn't surprised to know that doctors took work home. Partly from seeing my dad read echocardiograms or ekgs at home (kind of fun at times when I tried to diagnose things...and was wrong)
But also from my previous job in pharm. It wasn't required to work at home, but damn if it wasn't needed to keep up or look good. My friend and I would have text/email conversations after work about our projects numerous times.
So, I'd be surprised if someone said it wasn't the norm to bring work home.

I used to work in fast food and I brought my work home all the time...then ate it...