Doctors and free time

[krayola]

I know medicine as a career has a tradition of long hours in exchange for high pay, but is it possible to flip that so it works the other way around? I ask because free time is way more important to me than money - seriously, I'm renting out someone's closet for 100 bucks a month right now and I'm enjoying life just fine. I'll be perfectly content making 50k a year as a doctor if it means I can work 2 days a week. Is this possible, or am I just kidding myself? I can see malpractice insurance potentially raising overheads to a point where this fails to be a viable income model, but I heard that certain companies scale your insurance costs based on how often you work, which makes sense intuitively since if you work less, there's a smaller risk that you'll get sued and less liability for the insurance company. Also, I'm fortunate enough in my circumstances that debt from med school won't be much of a problem.

I don't anticipate doing this early on in my as-yet prospective career because I won't go into medicine unless I love doing it, and if I love doing it, I probably won't want much time off. But later on if I ever become a family man, I would like to know if the option is possible to cut back on income in order to spend more time at home. It would also be helpful if I ever become a jaded bastard who hates my job, but a career change would probably be a better remedy for that. Any ideas?

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[chessknt]

Like everything in life, it is what you make of it. After your residency, you are free to go wherever you want and nobody is going to force you to work. You can look for jobs that fit the hours you want or if you run your own practice you can set your own hours (with the caveat that you are always on call for random emergencies). Some specialties are more lifestyle oriented than others.

 

[MrBurns10]

It depends. You probably won't be a surgeon if your eventual goal is to work 2 days a week. There are some specialties that are more amenable for you working half-time, but malpractice becomes an issue when you're trying to get a job and it's cheaper for your practice to hire one doctor doing 50 hours a week than two people doing 25 hours. But it is possible.

Something you should look into is instead of joining a private practice or academic job, you just do locum tenens work. Your earnings won't be as high, but your malpractice will be covered and you can definitely work part-time.

 

[ar2388]

what is locum tenens work?

 

[MrBurns10]

what is locum tenens work?

You're basically hired for part-time...for example, if a doctor goes on vacation for a couple weeks, the practice could hire a locum tenens doc to work for those 2 weeks. LT pays your malpractice, and you get paid for those two weeks.

 

[DrJD]

I know medicine as a career has a tradition of long hours in exchange for high pay, but is it possible to flip that so it works the other way around? I ask because free time is way more important to me than money - seriously, I'm renting out someone's closet for 100 bucks a month right now and I'm enjoying life just fine. I'll be perfectly content making 50k a year as a doctor if it means I can work 2 days a week. Is this possible, or am I just kidding myself? I can see malpractice insurance potentially raising overheads to a point where this fails to be a viable income model, but I heard that certain companies scale your insurance costs based on how often you work, which makes sense intuitively since if you work less, there's a smaller risk that you'll get sued and less liability for the insurance company. Also, I'm fortunate enough in my circumstances that debt from med school won't be much of a problem.

I don't anticipate doing this early on in my as-yet prospective career because I won't go into medicine unless I love doing it, and if I love doing it, I probably won't want much time off. But later on if I ever become a family man, I would like to know if the option is possible to cut back on income in order to spend more time at home. It would also be helpful if I ever become a jaded bastard who hates my job, but a career change would probably be a better remedy for that. Any ideas?

Plenty of options for this... My primary care doctor in Davis worked Tuesday and Thursday and every other Friday, or something like that and she made 80Kish... Emergency medicine you could work those kind of hours, or work in an urgent care clinic a couple days a week... Or become a laborist... In house OB/GYN 7, 24 hour work days per month, 175K a year 🙂

 

[Law2Doc]

I'll be perfectly content making 50k a year as a doctor if it means I can work 2 days a week. Is this possible, or am I just kidding myself?

Student loans tend to make this unrealistic, except perhaps in EM where shift work is the norm (but as a younger person you are going to have undesirable overnight hours). Also if you are working two days a week, you frequently don't get any full time benefits (health insurance etc). And many jobs are becoming less interested in part timers because they tend to cost the same amount of overhead (esp medical malpractice) per person even if you are only there half the time. So it's cheaper for an employer to pay one person to work full time than two people to work part time.

Bear in mind that you will still have to get through med school and residency working as much as 80 hours/week, so it will take years before you get to the point where you can opt for such a diminished schedule, and this kind of schedule tends to result in closing all doors to career advancement. So a lot of people who struggle their way through residency and finally get the opportunity for a payoff aren't going to settle for a dead end part time job in lieu of a nice salary and potential for career advancement but requiring longer hours. When you put in a herculean effort to get to your goal, it's hard to settle.

 

[poiuyt123]

Like others have said, it depends on what specialties you choose. I know people in my family that have worked two days a week, four days a week, and 10-12 days a month. So yes its possible and its probably one of advantages of being a doctor.

 

[Law2Doc]

So yes its possible and its probably one of advantages of being a doctor.

You hear this kind of statement more on the premed boards than the boards for folks further down the road. Medicine is, IMHO, a really bad field for folks who don't want to work hard. It is hugely expensive education, many years of training, and you can expect part time jobs to become fairly scarce as the current lifestyle oriented generation snap up the small handful of positions, and the tight financial situations make employers less willing to offer part time options (which are more expensive in terms of overhead).

 

[strongboy2005]

Emergency medicine you could work those kind of hours

Really? I mean, hypothetically speaking of course, could an emergency medicine physician work ~40 hours per week and still make six figures? What about 25-30 hours per week?

 

[tdittyx2x3]

Definitely looking into lifestyle specialties, along with everyone else on these boards.

I looked into EM. Typical schedule is twelve 12hr shifts/month = 36hr/week, no call. Avg pay is around 200,000... maybe a bit less than that.

Fewer than 36 hrs/wk, you see a steeper drop in pay due to losing benefits (sometimes malpractice.. I've heard its about $20-25,000 a year) and getting payed on a reduced part time employee scale. Still, at a modest $100/hr (probably actually more than this) * 30 hrs/week * 48work weeks/year (month vacation) = $144,000. Three 10hr shifts a week doesn't sound so bad, but from what I've heard it can be exhausting and tough to find a good sleep regimen.

 

[Law2Doc]

Really? I mean, hypothetically speaking of course, could an emergency medicine physician work ~40 hours per week and still make six figures? What about 25-30 hours per week?

Yes, but there's a catch -- as a younger doctor you are going to work more overnights, because the senior folks are going to want more regular hours. So you will do 3-4 twelve hour shifts a week that may be from 6pm to 6am, and end up sleeping during the following days off. Sounds better on paper than in reality for some because you really screw up your sleep cycle. But some folks love it. And yes, it pays well. You won't get below those hours and still be a full time employee. See my comment on the scarcity of part time jobs, salary, and related career issues above. Medicine is not a good career if your goal is to work short hours. This discussion has been raised multiple times and the consensus of folks further along in this career (as opposed to pre-allos) is if your goal is a 40 hour work week or less, except for some rare exceptions (EM being the obvious one), this simply is a lousy career choice. There are some part time options, but they are becoming scarcer and are going to result in lack of career advancement. There are also options to work for yourself (in things like psych), but the income you can generate working part time is going to be low, and you will have to deal with overhead, marketing etc., which all takes time and money.

 

[poiuyt123]

You hear this kind of statement more on the premed boards than the boards for folks further down the road. Medicine is, IMHO, a really bad field for folks who don't want to work hard. It is hugely expensive education, many years of training, and you can expect part time jobs to become fairly scarce as the current lifestyle oriented generation snap up the small handful of positions, and the tight financial situations make employers less willing to offer part time options (which are more expensive in terms of overhead).

I'm not saying that people should go into medicine thinking they are gonna have such opportunities. I'm saying that it is possible to find jobs/shifts that allow you to work less than a regular 40 hour week. Medicine is one of those careers where at least you have the ability to do this if you can find the opportunity, there are just some other careers out there where you have no chance at all for having a flexible schedule.

 

[Law2Doc]

I'm not saying that people should go into medicine thinking they are gonna have such opportunities. I'm saying that it is possible to find jobs/shifts that allow you to work less than a regular 40 hour week. Medicine is one of those careers where at least you have the ability to do this if you can find the opportunity, there are just some other careers out there where you have no chance at all for having a flexible schedule.

I think you are overstating the flexibility -- as mentioned, such positions are becoming scarcer by the minute (due to the costs involved for employers), and if you try to severely limit your hours in general, you also hamper your income and career progression. If you consider that flexibility, then I guess yeah, you can find it. But you'd be crazy to go into the field, and rack up $200k in debt, knowing that you were going to try to pay it off on a less than 40 hour/week income post-residency (other than EM, which is starting to get a bit more competitive for this reason, and there is the overnight issue mentioned above). The numbers simply don't work out in most cases.

Not that we don't all know folks who went into peds or psych and only work a "part time" 40 hour/week schedule. But these same folks often net half of what they would be earning if they worked 60 hours/week, and are often not regarded as future-partner material by their current or future employers, and at risk of being replaced if the employer finds someone willing to work full time (given that the overhead costs are the same). So it's a huge trade-off.

If someone isn't willing to entertain the notion of working long hours, I couldn't with a straight face and good conscience advise them to go to med school. The profession simply isn't as conducive to short hours as folks on pre-allo like to believe.

 

[T12]

With a moderate amount of business sense and a willingness to put in the long hours early on in a career, medicine's work-to-profit ratio, like any other profession's, can be minimized.

This is in theory, and I only have anecdotal evidence of its truth, but I see no reason why one would be unable to develop a regular hour career making just as much money.

One of those anecdotes:

I know a surgeon who graduated from a mid-tier school, proceeded through residency and settled in at his first job as one of only two general surgeons at a small hospital in a small town making a little under 300k a year. This was the time in his life when he sewed the seeds of that supposed non-existent career in which a doctor can work part time and completely BANK. He worked for nearly 10 years, 60+ hours a week and on-call 24/7. Hard, fruitful labor. Just last year he left his position at the hospital and, with his savings, opened his own practice.

He now performs nothing but lap-band surgeries working half days 4 days a week and, from what his wife told me, makes an amount I found hard to believe. An extraordinary amount.

This is just one anecdote and may not be the 'norm', but there is no reason why one wouldn't be able build a career like this. Like anything else, early sacrifices will pay off in the end.

 

[mikedc813]

Definitely looking into lifestyle specialties, along with everyone else on these boards.

I think lifestyle is a perfectly legitimate factor in what you eventually specialize in. And why shouldn't it be? Why shouldn't it be ok to actually want a life outside of work? For the people who want to work 100+ hours a week, go right ahead. But not me! I can work my 50-60 hours per week and go home knowing I've made a difference and enjoy spending time with my family. Lifestyle is a great reason to choose certain fields, but you obviously need to enjoy what you're doing too.

 

[TexasPhysician]

There are definitely ways to set yourself up to work less.

First to minimize debt. You can't work 30hrs/week in FP if you want to pay off $300,000 in debt (at least I'm not sure of a way). Start by going to the cheapest school you can. Here in TX, tuition is around $10,000/year. 2nd: live cheaply. A friend of mine topped everyone I've ever heard of by living in a trailer park through med school. It was a fairly nice one, and I think it cost him $200 for rent and everything included. 3rd: Schools like TT provide most of the books needed in the student affairs office for loan each year = Minimal book costs.

So once you've minimized debt, pick a lifestyle field or primary care. Ever heard of CareNow in DFW area? They have many clinics set-up and hire EM, FP, and IM docs to work whatever hours/week you want I believe. It is basically shift work like EM, but no overnight hours (open til 10 or 12 midnight I think). They recruit at many residency fairs in TX. My friend's father worked his way to be the director of one of the clinics and makes approx. $300,000/year as an FP doc. I'm not sure of his hours though. He does have 6 kids, so he was at least home enough along the way to produce 6 kids and convince his wife to do it. I'm not positive that the pay is amazing to start, but if you want to work reasonable hours, definitely doable.

Many psychiatrists in academia don't make much, but they can make $130,000 working 40 hours pretty easily.

 

[Law2Doc]

Just last year he left his position at the hospital and, with his savings, opened his own practice.

He now performs nothing but lap-band surgeries working half days 4 days a week

In general, when you work for yourself, you are going to spend a TON of time dealing with non-medicine things like marketing, accounting, employee issues, and paperwork. Having come from a career that helped people set up businesses, I know of almost no one who moved from an employee situation to a self employment or employer situation and ended up working less during the first decade or so of practice. You may be in the OR a smaller proportion of your time, but to build a thriving practice takes hard work and running a business is a bit more time consuming than you seem to think. People tend to do this either to not have to settle for a slice of the pie rather than the whole pie, and not have to answer to a boss, but I think anyone who says they aren't spending a significant amount of time on non-medicine things when running a business is either kidding you, or have cut back their income generation hours (and income) enormously to spend that time doing the G&A (general and administrative) stuff. You see the latter a lot in things like psych, where some folks choose to work a handful of hours a week and see a few key patients, but probably don't earn that much (and tend to rely on a family's second income).

 

[T12]

These help.
1) good business sense
2) more than adequate savings

With these, one can afford to open up shop and succeed without the long hours.

Again, purely anecdotal, but something about that brand new private jet and pilot's license tells me he's not kidding anyone about the abundance of money or free time.

 

[sherruns]

Interviewing with CareNow! Thanks for the strong recommendation!

 

[Law2Doc]

Interviewing with CareNow! Thanks for the strong recommendation!

Necro-bump alert! It's bad form to bump a six year old thread without acknowledging you are doing so.

 

[Heplayer92]

My PI (MD only) when she ran our research lab...

Monday: Research Lab/Office/Meetings
Tuesday: Research Lab/Office/Meetings
Wednesdays: Clinicals
Thursdays: Surgery
Fridays: "Work from home" lol

So yeah, definitely can be done. Last I checked she made $175,000+ from the University alone.