Do we take job security for granted as physicians?

[Splenda88]

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Just got a call from one of my good friend from college who is already worried about losing his job because of impending recession. He is a software engineer and has done extremely well 120-130k/yr after being a software engineer for ~10 yrs... Do we take job security for granted as physicians?

 

[deleted407021]

Human animals always get sick, as recent events illustrate. People will continue to make lots of babies, which specifically will keep me in work. Physicians are one of the most critical jobs and we’re luck in that regard.

I was in middle and high school during the last Great Recession, but it’s my understanding physicians were more or less insulated.

 

[aldol16]

I think you're overestimating job security for physicians. Or rather, the ability to find a job. I'm hearing some stories about difficulty finding jobs in many urban markets and especially in certain specialties.

 

[efle]

Yep. Take a look at any thread that compares medicine to other white-collar careers. All you see are people saying the grass is greener, talking about how they had one friend with a cousin who made >1 million per year in finance or law or consulting.

But the reality is that these are cherry-picked comparisons. There are a bunch of medical specialties with fantastic, secure income and reasonable lifestyle that blow law and finance and consulting and tech out of the water. And I don't just mean uber competitive gigs in derm or plastics - your average doc in rads, anesthesia, EM, etc are clearing a reliable 350k-500k+ doing shift work.

Not to downplay burnout, there is absolutely a toxic element in medicine that makes it seem normal or even expected to sacrifice all semblance of work/life balance (looking at you, surgeries).

I've said it before and I'll say it again - for a bright young American student that wants to guarantee themselves a stable top 1% income and decent work/life balance, there are multiple specialties in medicine that offer you that. We're not supposed to talk about picking medicine for these kinds of reasons, but they're legit reasons.

 

[throwaway1000000]

Not really. Job security, sure we have it, but don't think most people take it for granted. Part of the reason why we work so hard to become physicians.

 

[deleted407021]

“Consulting”

lmao

 

[Mass Effect]

I think you're overestimating job security for physicians. Or rather, the ability to find a job. I'm hearing some stories about difficulty finding jobs in many urban markets and especially in certain specialties.

So don't live in that urban area? A physician is employable. Somewhere someone will pay you a pretty big salary for your skill set. And in most specialties, if they don't, you can open your own practice. That's not really comparable to the poor people who can't find a job anywhere.

 

[Goro]

Human animals always get sick, as recent events illustrate. People will continue to make lots of babies, which specifically will keep me in work. Physicians are one of the most critical jobs and we’re luck in that regard.

I was in middle and high school during the last Great Recession, but it’s my understanding physicians were more or less insulated.

And humans will always do stuff like this:

 

[JoaoMoutinho]

Yep. Take a look at any thread that compares medicine to other white-collar careers. All you see are people saying the grass is greener, talking about how they had one friend with a cousin who made >1 million per year in finance or law or consulting.

But the reality is that these are cherry-picked comparisons. There are a bunch of medical specialties with fantastic, secure income and reasonable lifestyle that blow law and finance and consulting and tech out of the water. And I don't just mean uber competitive gigs in derm or plastics - your average doc in rads, anesthesia, EM, etc are clearing a reliable 350k-500k+ doing shift work.

Not to downplay burnout, there is absolutely a toxic element in medicine that makes it seem normal or even expected to sacrifice all semblance of work/life balance (looking at you, surgeries).

I've said it before and I'll say it again - for a bright young American student that wants to guarantee themselves a stable top 1% income and decent work/life balance, there are multiple specialties in medicine that offer you that. We're not supposed to talk about picking medicine for these kinds of reasons, but they're legit reasons.

Burnout isn't just a problem in medicine either. My UG has a top accounting program that was very heavily recruited by Big 4 firms, and every single person I know who was hired by one has left the field in the 7.

My dad, who is a businessman who has had a very successful and fulfilling career enabled in large part by his extensive community service throughout his life, finally got burned out after getting burned yet again by corporate politics, and now at 56 he's trying to change careers. Out of the 4 kids in my family, even though we all love and admire my dad, none of us have chosen a career remotely related to business. I also can't think of a single time he's worked a regular 40-hour week, though a lot of that is just his very strong FILO personality.

This is all anecdotal, but my points are that
1) it's not just medicine where your work-life balance can be expected to be thrown out the window

2) the grass isn't always greener, just like you said

3) I obviously chose medicine in spite of much more exposure to business/finance fields than medicine or science. I had a conversation with my wife last night about what the impending financial crisis might do to her job, and it made me grateful to be in a career path where I will always have an MD to fall back on with guaranteed job security.

 

[JoaoMoutinho]

And humans will always do stuff like this:
View attachment 298926

This is why I've always had that itch to do rural primary care.


Not to treat those patients (which I assume was your point), but because that looks like a heck of a lot of fun.

 

[longhaul3]

I don't think we take it for granted. I think most physicians are aware of it and acknowledge that it's one of the biggest advantages of the profession. It's a reward for going through training that no other professionals have to go through. It definitely weighed on my decision to go to medical school.

Frankly, we deserve it.

 

[Money-Moniker]

Surely you must be joking OP, to pick a time like this to virtue signal about how "thankful" we should be as healthcare workers. You do realize that it is healthcare workers who gets smashed the worst during a pandemic, right? Your job security consists of you having to go to the most concentrated foci of the plague, hospitals, and get repeatedly blasted with viral loads while your immune system is already weakened by poor sleep and exhaustion from overwork. Good luck with your attitude of gratitude if you catch a serious case of this thing and end up with pulmonary fibrosis.

 

[Sephirakra]

Surely you must be joking OP, to pick a time like this to virtue signal about how "thankful" we should be as healthcare workers. You do realize that it is healthcare workers who gets smashed the worst during a pandemic, right? Your job security consists of you having to go to the most concentrated foci of the plague, hospitals, and get repeatedly blasted with viral loads while your immune system is already weakened by poor sleep and exhaustion from overwork. Good luck with your attitude of gratitude if you catch a serious case of this thing and end up with pulmonary fibrosis.

 

[libertyyne]

Surely you must be joking OP, to pick a time like this to virtue signal about how "thankful" we should be as healthcare workers. You do realize that it is healthcare workers who gets smashed the worst during a pandemic, right? Your job security consists of you having to go to the most concentrated foci of the plague, hospitals, and get repeatedly blasted with viral loads while your immune system is already weakened by poor sleep and exhaustion from overwork. Good luck with your attitude of gratitude if you catch a serious case of this thing and end up with pulmonary fibrosis.

You are still free to quit at anytime.
There is no free lunch in life.

 

[Money-Moniker]

You are still free to quit at anytime.
There is no free lunch in life.

I never said anyone should quit. I was just making the point that the job security OP was referring to comes at a price and it's naive in the extreme to use a pandemic to virtue signal about how great doctors have it and how grateful we should all be for our opportunity to work in highly dangerous conditions.

 

[Sephirakra]

I never said anyone should quit. I was just making the point that the job security OP was referring to comes at a price and it's naive in the extreme to use a pandemic to virtue signal about how great doctors have it and how grateful we should all be for our opportunity to work in highly dangerous conditions.

Say "virtue signal" one more time. God forbid someone on this forum is actually grateful for something.

 

[Money-Moniker]

From the anesthesiology forum. Be grateful and virtue signal all you want, but if you're being grateful for something stupid, I'll comment to that effect if I feel like it. Sue me.

I read a group chat exchange between a couple people I know and a friend of theirs (Anesthesia/ICU Physician) in a northern Italy city hospital. It’s really bad. Wartime bad. Worse than the news reports. They could intubate patients in respiratory failure, but they have no vents for them, so they are rationing care, they are reusing PPE because they have none left. Everyone there is C19 positive, patients dying all over. They’re completely overwhelmed. Multiple infected colleagues, and still getting worse. Many of the critically ill and dead were physicians. They try novel therapies, vent strategies, etc. nothing seems to make a difference in the critically ill. They’re frightened and exhausted, the citizens are frightened and exhausted. And it’s coming in a few weeks for us. Hopefully the social distancing and extreme measures will flatten the curve and limit the number of hospital systems that are overwhelmed.

 

[Sephirakra]

From the anesthesiology forum. Be grateful and virtue signal all you want, but if you're being grateful for something stupid, I'll comment to that effect if I feel like it. Sue me.

Ah, it's good to see young people so proud to be jackasses. Think I'll do myself a favor and Ignore you.

 

[aldol16]

So don't live in that urban area? A physician is employable. Somewhere someone will pay you a pretty big salary for your skill set. And in most specialties, if they don't, you can open your own practice. That's not really comparable to the poor people who can't find a job anywhere.

I'm drawing the distinction between being employed and being employed in a location and place that you want. If your goal is to be employed, then sure, there is tons of job security. But if your goal is to be employed at a major research university where you can continue your research, then the opportunities are more limited. Even more so if you're in academic medicine and want to go to an academic place that isn't University of Alaska.

 

[Mass Effect]

I'm drawing the distinction between being employed and being employed in a location and place that you want. If your goal is to be employed, then sure, there is tons of job security. But if your goal is to be employed at a major research university where you can continue your research, then the opportunities are more limited. Even more so if you're in academic medicine and want to go to an academic place that isn't University of Alaska.

Opportunities are not limited in the way they are in any other field. Not a single person can guarantee being able to do the exact job they want in the exact location they want, but physicians come pretty darn close.

 

[Mass Effect]

This is a time of somewhat shaky job security for some physicians

I've been hearing about graduating residents who are losing post-residency job offers since practices have been freezing hiring due to volume being slashed by the pandemic

Do you have a source you can cite or are you going by word of mouth? I find it hard to believe that practices are taking away job offers considering volume wasn't slashed until this past week for the vast majority of places.

Chief surgical residents are losing their most valuable period of training, so who knows what that will mean/they might need to extend training and turn down current job offers

No one knows if they will need to extend training and even if they did, that has nothing to do with job "security." That's ACGME and residency requirements.

 

[Mass Effect]

It's coming from word of mouth from residents. I wouldn't have a written source to cite unless it was something that happened to me.

There are hiring freezes going on in other jobs sectors already, so, to me, it wasn't a far out thing for me to believe. I'm also from an epicenter city.

Hiring freezes in other industries is entirely understandable. Not so for physicians. Right now, we need all the doctors we can get and in 3 - 4 months, all the backlog these last few months caused will need to be addressed. Plus, it's literally been a week that patients and healthcare providers have converted to telehealth, so low volume just doesn't make sense in that context. Surgeons are likely feeling the crunch, especially those doing elective procedures, but as I said, all those patients and procedures will need to be absorbed, probably right around the time residents graduate.

I'm wondering if this is the fear/anxiety people are feeling versus what's actually happening.

 

[Skindoc83]

As a physician you will always have a job, but not necessarily in the town, city, or part of the country you want to be in. You will always make decent money, but unless the whole healthcare market changes and it becomes realistic to go cash based, you will never set your prices and reimbursement will continue to decline.

 

[slowthai]

It's coming from word of mouth from residents. I wouldn't have a written source to cite unless it was something that happened to me.

There are hiring freezes going on in other jobs sectors already, so it wasn't a far out thing for me to believe. I'm also from an epicenter city. Perhaps there was a miscommunication and the residents were talking about job opportunities they were pursuing/applying for that are no longer available due to freezes rather than jobs that they were offered, but that's what I got from the convos

This is a time of somewhat shaky job security for some physicians

I've been hearing about graduating residents who are losing post-residency job offers since practices have been freezing hiring due to volume being slashed by the pandemic. Chief surgical residents are losing their most valuable period of training, so who knows what that will mean/they might need to extend training and turn down current job offers. The rads people have been talking about how they think there will be an oversupply of graduating residents again due to the hits they are taking to volume.

There are threats to physician job security, but we do benefit from more security than other fields (in exchange for putting in a lot more time and years into the front end). I think most physicians appreciate that.

Yeah, rads is definitely experiencing hiring freezes. They've lost a significant amount of volume. If anyone's curious, just head on over to the rads forum.

 

[Mass Effect]

As a physician you will always have a job, but not necessarily in the town, city, or part of the country you want to be in. You will always make decent money, but unless the whole healthcare market changes and it becomes realistic to go cash based, you will never set your prices and reimbursement will continue to decline.

It's already realistic to go cash-based in some fields and many people do it and make bank. #psychiatry

 

[Mass Effect]

Yeah, rads is definitely experiencing hiring freezes. They've lost a significant amount of volume. If anyone's curious, just head on over to the rads forum.

I did and no one's lost their job according to that forum. One person commented on his own practice and he said that they're pushing the start dates back and not hiring anyone new. Will job losses come in the future? Possibly. But as I said above, it's too early to tell.

My purpose in clarifying this is because SDN tends to extrapolate from one or two posts a disaster of epic proportions and the last thing we need is to catastrophize the physician job market on top of the actual catastrophe occurring right now. I would also suggest if things get worse, as predicted, with Covid, unemployed physicians should explore the option of working in more needed specialties until things settle down. As a psychiatrist, I just received a locums email for helping out the medical services in the ED of community hospitals.

 

[deleted87051]

Hiring freezes in other industries is entirely understandable. Not so for physicians. Right now, we need all the doctors we can get and in 3 - 4 months, all the backlog these last few months caused will need to be addressed. Plus, it's literally been a week that patients and healthcare providers have converted to telehealth, so low volume just doesn't make sense in that context. Surgeons are likely feeling the crunch, especially those doing elective procedures, but as I said, all those patients and procedures will need to be absorbed, probably right around the time residents graduate.

I'm wondering if this is the fear/anxiety people are feeling versus what's actually happening.

That’s a best case scenario. I’m in FFS PP anesthesia. We usually have 16-17 doctors working daily. Nowadays it’s 3-4. The rest of us are socially distancing at home. I’m expecting my income to be 25% of usual for the next few months. If there is a backlog, we’ll all be working harder to make up for lost income. The hiring picture will not be good for at least a year or 2. I feel bad for June 2020 graduates. That said, I think it will eventually recover.

 

[<L>]

That’s a best case scenario. I’m in FFS PP anesthesia. We usually have 16-17 doctors working daily. Nowadays it’s 3-4. The rest of us are socially distancing at home. I’m expecting my income to be 25% of usual for the next few months. If there is a backlog, we’ll all be working harder to make up for lost income. The hiring picture will not be good for at least a year or 2. I feel bad for June 2020 graduates. That said, I think it will eventually recover.

At least you guys are in an eat what you kill setup. Friend working for a big hospital system in psych was told she was taking a 25% pay cut despite still working at 100% of her normal RVUs to subsidize the surgical MDs who aren't working.

 

[Mass Effect]

At least you guys are in an eat what you kill setup. Friend working for a big hospital system in psych was told she was taking a 25% pay cut despite still working at 100% of her normal RVUs to subsidize the surgical MDs who aren't working.

That's ridiculous. Your friend should consider supplementing with locums until she can get another job. TONS of psych need out there.

 

[<L>]

That's ridiculous. Your friend should consider supplementing with locums until she can get another job. TONS of psych need out there.

I think she had one foot out the door before that. Part of the problem is she's not really centrally located so options are more limited.

 

[deleted87051]

That’s a best case scenario. I’m in FFS PP anesthesia. We usually have 16-17 doctors working daily. Nowadays it’s 3-4. The rest of us are socially distancing at home. I’m expecting my income to be 25% of usual for the next few months. If there is a backlog, we’ll all be working harder to make up for lost income. The hiring picture will not be good for at least a year or 2. I feel bad for June 2020 graduates. That said, I think it will eventually recover.

Here’s an update.

We have restarted elective cases but we are constrained by availability of testing (we test all patients), PPE(masks+gowns), drugs (propofol), supplies (glidescope blades), and icu beds. Currently 30-40% of our ICU beds are occupied by COVID patients. Our current volume is about 60-70% of pre-COVID levels. We have 10-13 people working on most weekdays.

 

[deleted87051]

I think that overall, we as physicians have job security on the higher end of the spectrum compared to most people. However, it's not guaranteed by any means as we've recently seen. Private practitioners are having to make hard choices regarding their staff and future while physician employees can be at the whim of their administrators. It highlights the importance of making sure that your financial well-being is in order, which unfortunately is not the case for many. Even a simple principle like having a 3-6 month emergency fund is often overlooked or just advice that one doesn't hear soon enough. Thankfully it's never too late to begin our financial education as I found out.

I started the blog The Prudent Plastic Surgeon (www.prudentplasticsurgeon.com) to share the steps that I am taking as I start my journey to financial well-being along with resources to help you along the way. I encourage you all to visit and let me know what you think!

I agree emergency fund is a high priority above retirement, down payment, college fund, etc. I’m in my 50s so I’m doing fine but I feel bad for my younger colleagues who are just starting out and have large debt burdens.