EM Burnout, Solve It Here

[Birdstrike]

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•Night shifts banned at age 50+

•Shifts longer than 8 hours, banned

•Press Ganey banned

•Mandatory, meaningful recourse and redress for any administrator that threatens an ED physician over metrics (Exception: inadequate time response in emergent cases under a physicians care, and to be addressed by medical staff M&M, not administration).

•Civil Immunity for Emergency Physicans providing EMTALA based care, under good samaritan laws (criminal acts, exempted)

•Time and a half pay, for hours after 5 pm

•Double time after midnight; required by law

•Mandatory 72 hrs off after any stretch of night shifts

•Cap at 2.5 pph, enforced

•Max 15 shifts per month, 120 hours, enforced

•30 minute lunch (unless single coverage and abnormal vital signs); if nurses can do it, so can docs

•All violations of any above: $50,000 fine to hospital. 1/3 paid to physician whistleblower.

•MOC: Ended (back to 20 hr cme only, per year(

•Oral board; retired permanently.

•Board Exam fees: Cut 25% immediately and 75% discount for first time takers

 

[GonnaBeADoc2222]

Agree with all except limiting shift length to 8 hrs. I like longer shifts as it allows me to achieve my monthly hours goal while doing less shifts. I find that sometimes the actual traumatic event is the physical walking into the ED, and once I'm here for a few hours it's not so bad.

 

[turkeyjerky]

Agree with all except limiting shift length to 8 hrs. I like longer shifts as it allows me to achieve my monthly hours goal while doing less shifts. I find that sometimes the actual traumatic event is the physical walking into the ED, and once I'm here for a few hours it's not so bad.

Yeah, my preference is for 10's during the day and 8's overnight. I also don't like taking a lunch break, but to each his own. The OP is amazing though, to think if this was our actual work environment...

 

[bravotwozero]

Can eat whatever we want at our workspace. Weekly dunk tanks where we dump administrators into.

Patients don’t get to file complaints about not getting enough narcotics, food, or television not working. If they do, their complaint gets turned into a paper airplane and thrown in the garbage.


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[Vandalia]

Ban EM physicians from managing their own finances and/or getting married more than once.

The most miserable, "burnt-out", ones I know are working themselves to death because they lost a couple of million overnight investing in commodities on margin, or whose Krispy Kreme franchise went under (that was a new one) or are supporting six ex-spouses. Or both.

The greatest antidote to burnout is the ability to walk-away. You would be amazed how nice and accommodating the administrators can be when they know that tomorrow you can tell them to perform an anatomically-impossible act upon themselves.

 

[Angry Birds]

Abolish student loan debt.

 

[VA Hopeful Dr]

Ban EM physicians from managing their own finances and/or getting married more than once.

The most miserable, "burnt-out", ones I know are working themselves to death because they lost a couple of million overnight investing in commodities on margin, or whose Krispy Kreme franchise went under (that was a new one) or are supporting six ex-spouses. Or both.

The greatest antidote to burnout is the ability to walk-away. You would be amazed how nice and accommodating the administrators can be when they know that tomorrow you can tell them to perform an anatomically-impossible act upon themselves.

I think this applies to all physicians.

As to to OP, the reason y'all get paid so much more (hourly speaking) than almost anyone else is because of the schedule you work. If you're 52 and working no nights and only 8 hour shifts, expect your income to be closer to us PCP types.

 

[surely]

Therapy dogs. Big fluffy ones.

 

[bravotwozero]

with regards to lunch breaks, we have vocera speakers you can clip on to your clothing. If an nurse/whoever needs to get a hold of you while you step away from the ED, they can use that, so we can go eat whenever we want to, and it's completely tolerated at our ED. Perhaps other ED docs can look into this at their shop.

 

[namethatsmell]

•Cap at 2 pph, enforced

Fixed this for you. Love the premise of this thread.


If any individual is allowed to (and does) unilaterally make changes to staffing or scheduling they must work nights/weekends like the average doc at their site to fully understand the ramifications of their choices.

Downthrottling (or whatever moniker you like) acuity so you only pick up 4/5s for the last few hours of your shift to ease your cognitive load and allow you to get out on time and with fewer sign outs. Better/safer for patients too.

Any company who employs physicians cannot be publicly traded nor have shareholders who are not physicians.

Every administrator at the VP-level and above in the hospital shall do one shift a week in the ED where they are required to personally do service recovery at the bedside. These administrators will also be expected to ensure the ED physicians feel appropriately valued by the administration.

 

[Hercules]

Ban EM physicians from managing their own finances and/or getting married more than once.

Please don’t enforce this one! Some of us manage our finances very well and I would hate to have someone else managing my financial interests. Might need a few exceptions on that marriage issue too...




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[Angry Birds]

Free food. Any time. Even night shift.

 

[Vandalia]

Please don’t enforce this one! Some of us manage our finances very well and I would hate to have someone else managing my financial interests. Might need a few exceptions on that marriage issue too..

If you can meet the third paragraph, you get a pass on the first paragraph.

If you are over the age of 50 (give or take) and can't meet the third paragraph, then you might want to consider the first one.

 

[TooMuchResearch]

No one is taking away my ability to pull rural 24s or manage my own finances.

 

[USCDiver]

How does the end of Oral Boards and decreasing exam fees solve burnout? Those are front end concerns!

Also, I don't think a full-fledged lunch break is needed on an 8 hour shift. Yes, the nurses get lunch breaks, but while they are gone someone else is responsible for their patients. Are you going to sign out your procedures, consults and dispos to your colleague while you sit down for half an hour to eat and watch HGTV?

 

[GonnaBeADoc2222]

How does the end of Oral Boards and decreasing exam fees solve burnout? Those are front end concerns!

Also, I don't think a full-fledged lunch break is needed on an 8 hour shift. Yes, the nurses get lunch breaks, but while they are gone someone else is responsible for their patients. Are you going to sign out your procedures, consults and dispos to your colleague while you sit down for half an hour to eat and watch HGTV?

If the patient is stable, they can wait 30 mins.

If a nurse can say "I'm on break" when I ask them to hang pressors, a doc can say "I'm on break" when the patient asks for their CT result for the 8th time.

 

[Angry Birds]

This is in actuality a thread about why not to go into EM, created by someone who got out of EM.

 

[Birdstrike]

This is in actuality a thread about why not to go into EM, created by someone who got out of EM.

I started a “Ways to make things better” thread. Your mind turned that into, “Things can never get better.” That’s your own confirmation bias, based on what you think, I’m thinking. You literally invented that, not me.

Instead of agreeing or disagreeing with specific suggestions in the post, you changed its meaning and made a not so subtle ad hominem attack against the person posting it. What that tells me, is that it was a much more profound post than I even thought. It also tells me that you haven’t figured out how to respond to the post itself.

What do you think about the actual suggestions in the post?

Would they make things better?
If not, why not?
Could some of them be implemented and how?
If not, why not?

 

[TooMuchResearch]

If the patient is stable, they can wait 30 mins.

If a nurse can say "I'm on break" when I ask them to hang pressors, a doc can say "I'm on break" when the patient asks for their CT result for the 8th time.

Whoa, even our union nurses will skip breaks for stuff like that.

 

[Angry Birds]

I started a “Ways to make things better” thread. Your mind turned that into, “Things can never get better.” That’s your own confirmation bias, based on what you think, I’m thinking. You literally invented that, not me.

Instead of agreeing or disagreeing with specific suggestions in the post, you changed its meaning and made a not so subtle ad hominem attack against the person posting it. What that tells me, is that it was a much more profound post than I even thought. It also tells me that you haven’t figured out how to respond to the post itself.

What do you think about the actual suggestions in the post?

Would they make things better?
If not, why not?
Could some of them be implemented and how?
If not, why not?

Dude I was just joking. I’m envious of you for finding a good way out. Lucky guy!

 

[Birdstrike]

Dude I was just joking. I’m envious of you for finding a good way out. Lucky guy!

It's all good. It's all good.

What do you think of the suggestions in the OP, though?

 

[The White Coat Investor]

•Night shifts banned at age 50+

•Shifts longer than 8 hours, banned

•Press Ganey banned

•Mandatory, meaningful recourse and redress for any administrator that threatens an ED physician over metrics (Exception: inadequate time response in emergent cases under a physicians care, and to be addressed by medical staff M&M, not administration).

•Civil Immunity for Emergency Physicans providing EMTALA based care, under good samaritan laws (criminal acts, exempted)

•Time and a half pay, for hours after 5 pm

•Double time after midnight; required by law

•Mandatory 72 hrs off after any stretch of night shifts

•Cap at 2.5 pph, enforced

•Max 15 shifts per month, 120 hours, enforced

•30 minute lunch (unless single coverage and abnormal vital signs); if nurses can do it, so can docs

•All violations of any above: $50,000 fine to hospital. 1/3 paid to physician whistleblower.

•MOC: Ended (back to 20 hr cme only, per year(

•Oral board; retired permanently.

•Board Exam fees: Cut 25% immediately and 75% discount for first time takers

I'm sorry that's all a dream for many of you. I think I've got about half of that. The differentials are a little higher than we've found they need to be 1.25 after 5 pm and 1.5 after midnight should be sufficient to get volunteers to work them preferentially. And I think 2.5 pph is a little high as an average, but I guess if you had a really efficient place it might not be too bad.

 

[GonnaBeADoc2222]

I'm sorry that's all a dream for many of you. I think I've got about half of that. The differentials are a little higher than we've found they need to be 1.25 after 5 pm and 1.5 after midnight should be sufficient to get volunteers to work them preferentially. And I think 2.5 pph is a little high as an average, but I guess if you had a really efficient place it might not be too bad.

Yup. We know your job is amazinggg.

 

[throckmortonDO]

OK, so where are these unicorn jobs? I can barely find ads for SDG's anymore. everything seems to be CMG.

I currently work for a CMG, at an academic program no less, and my salary is very low (comparably), without the benefits of a tenured position because the CMG holds the contract through the university. 20% of my salary is tied to metrics, which makes no sense with a residency program present, goes without saying I can't meet them all.

I get hassled by recruiters all day long, but they all have job offers that give more $$ but sound miserable, which makes sense that they are aggressively recruiting. so where do you suggest one starts looking? Practicelink? AAEM/ACEP job banks? call a place direct? what?.

 

[GonnaBeADoc2222]

OK, so where are these unicorn jobs? I can barely find ads for SDG's anymore. everything seems to be CMG.

I currently work for a CMG, at an academic program no less, and my salary is very low (comparably), without the benefits of a tenured position because the CMG holds the contract through the university. 20% of my salary is tied to metrics, which makes no sense with a residency program present, goes without saying I can't meet them all.

I get hassled by recruiters all day long, but they all have job offers that give more $$ but sound miserable, which makes sense that they are aggressively recruiting. so where do you suggest one starts looking? Practicelink? AAEM/ACEP job banks? call a place direct? what?.

People will tell you about their $500/hr job where they see 1.5 pph and the nurses bring you coffee but they will not tell you where they are, or tell you they're not hiring, or tell you "just move to Texas."

 

[miacomet]

There are unicorn jobs in Portland, OR (good luck), Seattle (uh-huh), Salt Lake, Boise, Colorado Springs, Albuquerque, the entire state of Texas outside the major cities, Birmingham, Wisconsin, Phoenix, Tucson, Maryland, and rural California. There are no unicorn jobs in Denver, Boston, NYC, SF, San Diego, DC, or Philly.

Some places are so unicorny that there are waiting lists and it's nearly impossible to get a job. These include Jackson Hole and Bozeman.

 

[coachB]

There are unicorn jobs in Portland, OR (good luck), Seattle (uh-huh), Salt Lake, Boise, Colorado Springs, Albuquerque, the entire state of Texas outside the major cities, Birmingham, Wisconsin, Phoenix, Tucson, Maryland, and rural California. There are no unicorn jobs in Denver, Boston, NYC, SF, San Diego, DC, or Philly.

Some places are so unicorny that there are waiting lists and it's nearly impossible to get a job. These include Jackson Hole and Bozeman.

Sorry, the unicorns are extinct in Tucson. Phoenix too, I think.

 

[miacomet]

Sorry, the unicorns are extinct in Tucson. Phoenix too, I think.

All the SDGs are gone? I thought I saw some recruiting recently in Phoenix.

 

[miacomet]

I know I get flack for this, but with epic burnout levels, we really need to aggressively counsel med students, and I think PDs really need to do a better job of counseling residents on the importance of an exit strategy, which I didn't hear a word of in my residency. Everyone but me is now in UC, FWIW. I think they also need to emphasize taking a high paying job right out of residency. PDs focus on good medicine, but they need to focus on their residents' health, happiness, and financial security.

 

[Hercules]

I know I get flack for this, but with epic burnout levels, we really need to aggressively counsel med students, and I think PDs really need to do a better job of counseling residents on the importance of an exit strategy, which I didn't hear a word of in my residency. Everyone but me is now in UC, FWIW. I think they also need to emphasize taking a high paying job right out of residency. PDs focus on good medicine, but they need to focus on their residents' health, happiness, and financial security.

I don’t think anyone wants to give you flack; it’s just that your message has been repetitive. It sounds like you have had a really rough time and we all feel for you. There are great jobs, there are average jobs, and there are terrible jobs that no one should be willing to work. Most good residents don’t need education on an exit strategy as much as they need education on ferreting out the unicorns and avoiding the cess pools.

As far as the previous poster’s question about finding the unicorn jobs, that can be tough. Most of them don’t advertise because they don’t need to. I have a unicorn job and my group doesn’t really advertise when we hire. Now that an EM residency is likely opening up in our city, we will probably be even less likely to ever advertise. My best advice is to cold call and get the contact info for whomever handles hiring for the group if you know of a unicorn job in a location you are interested in. Express your interest. Don’t wait on an ad that will likely never happen.


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[miacomet]

I don’t think anyone wants to give you flack; it’s just that your message has been repetitive. It sounds like you have had a really rough time and we all feel for you. There are great jobs, there are average jobs, and there are terrible jobs that no one should be willing to work. Most good residents don’t need education on an exit strategy as much as they need education on ferreting out the unicorns and avoiding the cess pools.

As far as the previous poster’s question about finding the unicorn jobs, that can be tough. Most of them don’t advertise because they don’t need to. I have a unicorn job and my group doesn’t really advertise when we hire. Now that an EM residency is likely opening up in our city, we will probably be even less likely to ever advertise. My best advice is to cold call and get the contact info for whomever handles hiring for the group if you know of a unicorn job in a location you are interested in. Express your interest. Don’t wait on an ad that will likely never happen.


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I agree job search counseling is HUGE, but I don't think there are enough unicorn, or even marginally nonmalignant/non CMG jobs for all the EM docs out there, and there are fewer every year. If I'm wrong, that's great. But are there really enough non cesspool/partial unicorn jobs out there?

 

[coachB]

All the SDGs are gone? I thought I saw some recruiting recently in Phoenix.

All gone in Tucson. Things flipped completely from 2012-17. A real shame. You are right in that there is at least one SDG in Phoenix, I don't have any insight into the quality of the job. There may even be a few more. But a couple of the big ones sold out.

 

[WilcoWorld]

I know I get flack for this, but with epic burnout levels, we really need to aggressively counsel med students, and I think PDs really need to do a better job of counseling residents on the importance of an exit strategy, which I didn't hear a word of in my residency. Everyone but me is now in UC, FWIW. I think they also need to emphasize taking a high paying job right out of residency. PDs focus on good medicine, but they need to focus on their residents' health, happiness, and financial security.

I disagree.

I think that financial education is a good thing for residents. Every program I've been affiliated with provides some form of it, but that's not the point of residency.

The purpose of residency is to teach you how to practice Emergency Medicine. If your PD gets you to competence in 3 years, then they've done their job. The rest is up to you.

 

[miacomet]

I guess I consider the job market and financial education as important not so much for the individual but for the future of the specialty. If we have naive residents taking CMG jobs we will probably fare poorly as a field.

 

[The White Coat Investor]

OK, so where are these unicorn jobs? I can barely find ads for SDG's anymore. everything seems to be CMG.

I currently work for a CMG, at an academic program no less, and my salary is very low (comparably), without the benefits of a tenured position because the CMG holds the contract through the university. 20% of my salary is tied to metrics, which makes no sense with a residency program present, goes without saying I can't meet them all.

I get hassled by recruiters all day long, but they all have job offers that give more $$ but sound miserable, which makes sense that they are aggressively recruiting. so where do you suggest one starts looking? Practicelink? AAEM/ACEP job banks? call a place direct? what?.

Yes. Call direct. Why would one need to advertise a good job? I can't recall ever seeing a good job advertised. By definition, given how few positions in EM are filled by BCEM docs, none of the good jobs are ever advertised.

Open up your latest Annals or ACEP NOW or EP Monthly or whatever and thumb through the ads. See any good jobs? I don't either.

 

[The White Coat Investor]

I agree job search counseling is HUGE, but I don't think there are enough unicorn, or even marginally nonmalignant/non CMG jobs for all the EM docs out there, and there are fewer every year. If I'm wrong, that's great. But are there really enough non cesspool/partial unicorn jobs out there?

When docs refuse to work for CMGs, CMGs will cease to exist. The rare commodity is the doc, not the contract. When CMGs can't get docs, they can't staff EDs. When they can't staff EDs, they lose contracts. Wouldn't it be great to see all the ads at the back of Annals are hospitals offering a big fat stipend for a small democratic group of docs to come staff their ED?

 

[BAM!]

When docs refuse to work for CMGs, CMGs will cease to exist. The rare commodity is the doc, not the contract. When CMGs can't get docs, they can't staff EDs. When they can't staff EDs, they lose contracts. Wouldn't it be great to see all the ads at the back of Annals are hospitals offering a big fat stipend for a small democratic group of docs to come staff their ED?

I agree, but how is this ever going to happen? Through a national CMG ED Doc strike? Docs have families to support, loans to repay, and lives to pay for. They need the money.

There is a clear pathway for SDGs to metamorphose into CMGs, but not the other way around.

 

[Birdstrike]

I agree, but how is this ever going to happen? Through a national CMG ED Doc strike? Docs have families to support, loans to repay, and lives to pay for. They need the money.

There is a clear pathway for SDGs to metamorphose into CMGs, but not the other way around.

It's 100% legal for employed physicians to strike. The fact that physicians have "families to support, loans to repay, and lives to pay for" is irrelevant to whether or not they unionize and strike or not. You don't think teachers have bills? You don't think autoworkers have bills? Pilots? Coal miners?

Countless lower paid workers have found a way to strike. It's not hard. You pay some dues to your union and they set aside some money to help you get through the work stoppage. You also can set aside your own money, but that’s not required.

Having bills to pay also hasn't stopped doctors in the U.K. or other countries from going on strike and demanding change. It hasn't stopped professional baseball, hockey, football and basketball players all from going on their own strikes.

When doctors want change bad enough, they'll get it. When doctors get angry, confident and self-respecting enough, things will change. When they get angry enough to demand change, and refuse to take, "No" or “That’s impossible” for an answer, things will change and they'll change so fast your head will spin. All of a sudden, you'll stop hearing, "No. We can't. That's not possible," and you'll start hearing, "How can we make things better? Let's work something out."

Physicians have tremendous, tremendous untapped power they've so far been afraid and unwilling to use. Physicians can stop the bulls**t on a dime, when they decide they want to, and when they decide demanding it is better than complaining and moving forward as things are.

 

[Janders]

There are no unicorn jobs in Denver, Boston, NYC, SF, San Diego, DC, or Philly.
Some places are so unicorny that there are waiting lists and it's nearly impossible to get a job. These include Jackson Hole and Bozeman.

There are still SDGs in the Boston area. A couple of nice ones, I would add. As well there are bigger groups that function as SDGs (fully open books from day 1, no big buy-in, eat-what-you-kill, etc). There are also crappy hospital-employed jobs. 🙂

 

[The White Coat Investor]

I agree, but how is this ever going to happen? Through a national CMG ED Doc strike? Docs have families to support, loans to repay, and lives to pay for. They need the money.

There is a clear pathway for SDGs to metamorphose into CMGs, but not the other way around.

The group doesn't have to transform. It just has to lose the contract. We (ACEP, AAEM, SAEM, residencies) need to provide more resources to new, start-up SDGs.

 

[miacomet]

The group doesn't have to transform. It just has to lose the contract. We (ACEP, AAEM, SAEM, residencies) need to provide more resources to new, start-up SDGs.

ACEP is completely in the pocket of CMGs, which is a huge issue.

 

[The White Coat Investor]

ACEP is completely in the pocket of CMGs, which is a huge issue.

EPs don't care. If they did, they wouldn't let CMG bigwigs get all the ACEP leadership positions. Like a lot of things in life and medicine, it's a coalition of the willing. EPs complain about the cost of ACEP membership and the ACEP SA, but what would the cost be without dollars from CMGs? Certainly higher. So when docs are willing to serve and pay more, then they have a chance of "taking ACEP back," but it'll be a pretty hard fought battle! Clearly just starting AAEM wasn't enough. EPs didn't defect in large enough numbers to make any sort of difference.

 

[enalli]

It's 100% legal for employed physicians to strike. The fact that physicians have "families to support, loans to repay, and lives to pay for" is irrelevant to whether or not they unionize and strike or not. You don't think teachers have bills? You don't think autoworkers have bills? Pilots? Coal miners?

Will NEVER happen in America. The moment you even suggest a strike, there will be no shortage of sanctimonious physicians tripping over themselves to question your moral character while saying cookie-cutter phrases like "how dare you endanger patients", "you took an oath", "medicine is a calling", etc. The story would immediately turn from physicians vs. greedy corporations to saintly physicians vs. greedy physicians. *shudder*

 

[Birdstrike]

Will NEVER happen in America. The moment you even suggest a strike, there will be no shortage of sanctimonious physicians tripping over themselves to question your moral character while saying cookie-cutter phrases like "how dare you endanger patients", "you took an oath", "medicine is a calling", etc. The story would immediately turn from physicians vs. greedy corporations to saintly physicians vs. greedy physicians. *shudder*

I agree that there are a lot of physicians that would be dripping with sanctimonious virtue signaling at any serious discussion of a "strike." And that's exactly what happens when the discussion comes up. You know what that means, when someone is more concerned about their profession’s reputation in the media than their pay and working conditions?

It means they're not pissed off enough yet, and their bank accounts too fat enough still, for their complaining to overcome their inertia. It means that either consciously or subconsciously, they have decided things are good enough to not want to rock the boat. And that's a good thing. If you ever start to see the phony virtue signaling replaced with an unhinged, rebel attitude that they just won't take it anymore, then you know there's been a shift. In 2018, I think we're a long way off for that. But that doesn't mean we don't have the power. We do.

But all in all, if people are happy enough that they can preen around in their white coats from an ivory tower of sanctimonious superiority, as irritating as that posture is, then I suppose that means the positives outweigh the negatives for most people. On balance, I think that's a good thing. But it doesn't mean a strike never could happen. It just means it's not going to happen now, because it's not the right strategic play or the right action, at this time.

There's also a compromise stance, where you forcefully fight to change things you think need improvement, while working at the same time to preserve what is working. Since on balance, I think the positives far outweigh the negatives for most physicians in 2018, I believe this is where we need to focus our energy. We're certainly not at the point we want to bite of our own noses to spite our face.

 

[Birdstrike]

Do you ----ing job ACEP

•Night shifts banned at age 50+

•Shifts longer than 8 hours, banned

•Press Ganey banned

•Mandatory, meaningful recourse and redress for any administrator that threatens an ED physician over metrics (Exception: inadequate time response in emergent cases under a physicians care, and to be addressed by medical staff M&M, not administration).

•Civil Immunity for Emergency Physicans providing EMTALA based care, under good samaritan laws (criminal acts, exempted)

•Time and a half pay, for hours after 5 pm

•Double time after midnight; required by law

•Mandatory 72 hrs off after any stretch of night shifts

•Cap at 2.5 pph, enforced

•Max 15 shifts per month, 120 hours, enforced

•30 minute lunch (unless single coverage and abnormal vital signs); if nurses can do it, so can docs

•All violations of any above: $50,000 fine to hospital. 1/3 paid to physician whistleblower.

•MOC: Ended (back to 20 hr cme only, per year(

•Oral board; retired permanently.

•Board Exam fees: Cut 25% immediately and 75% discount for first time takers

Above changes still needed! Do your job ACEP. Stand up for your doctors. Protect them. Serve them represent them. Fight for them!

Medscape: Medscape Access

 

[solitarius]

Allow EPs to work in environments outside the ED.

Nephro is not burned out? I don't believe this survey at all.
Why is urology the most burned out?

 

[RustedFox]

Allow EPs to work in environments outside the ED.

Nephro is not burned out? I don't believe this survey at all.
Why is urology the most burned out?

Because they spend all day looking at wankers.

 

[emergentmd]

EM docs Make alot or can make alot of $$$.
Save 30-50% of your salary
Invest in passive income products
Work hard for 10 yrs until you are 40 where you passive income makes 50-75% of your income
Work 25-50% of your typical shift

You will not be burned out at 40.

If you spend over your means, have to work full time past 50 yrs old, then YES you likely will get burned out.

 

[Brigade4Radiant]

Allow EPs to work in environments outside the ED.

Nephro is not burned out? I don't believe this survey at all.
Why is urology the most burned out?

Why don’t you believe nephro is burned out a lot of the nephrologist I know practice as a hospitalist...full time and they are not going back.

 

[Brigade4Radiant]

Allow EPs to work in environments outside the ED.

Nephro is not burned out? I don't believe this survey at all.
Why is urology the most burned out?

Why don’t you believe nephro is burned out a lot of the nephrologist I know practice as a hospitalist...full time and they are not going back.