Emergency Medicine Longevity and Critical Care Medicine...

[Jack is Back]

Are there many physicians who are able to practice emergency medicine beyond 50s or 60s?

What are the ways to increase logevity? I've heard that some will do a CCM fellowship and then they would be able to do more intensivist care later in their career.

Thoughts, comments, ideas?

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[cgjock80]

Having spoken with intensivists on the vary topic, they replied that being an intensivist isn't necessarily a step down from the fatigue of an EM life. Being on for an entire week (including call) has its own rigors. Just my two cents

 

[Jack is Back]

I guess my question is, if you really love emergency medicine but also want to do it for 30-40 years, is that feasible?

I read so many posts about people wanting to retire around 50 something, but I came into medicine looking for a career to keep my busy and active unitl 70+.

 

[gro2001]

I guess my question is, if you really love emergency medicine but also want to do it for 30-40 years, is that feasible?

I read so many posts about people wanting to retire around 50 something, but I came into medicine looking for a career to keep my busy and active unitl 70+.

I think there are two related but separate questions here:

1) Is it possible to practice EM when you are 70?
2) What kind of career change options are open to EM physicians who cant/dont want to practice EM any more?


Re 1), I think it depends on what kind of a 70 year old you are going to be. I know a septagenerian who sky dives every other weekend (among other things). Had they been an EM physician, I am sure that they'd still be able to practice had they chosen to.

Re 2), if you are looking for a less exhausting 'back up career' in a fellowship, CCM is probably less than an ideal choice. Perhaps sports medicine, palliative care, or something like that would serve the purpose better.

 

[Jack is Back]

I think there are two related but separate questions here:

1) Is it possible to practice EM when you are 70?
2) What kind of career change options are open to EM physicians who cant/dont want to practice EM any more?


Re 1), I think it depends on what kind of a 70 year old you are going to be. I know a septagenerian who sky dives every other weekend (among other things). Had they been an EM physician, I am sure that they'd still be able to practice had they chosen to.

Re 2), if you are looking for a less exhausting 'back up career' in a fellowship, CCM is probably less than an ideal choice. Perhaps sports medicine, palliative care, or something like that would serve the purpose better.

Thanks for the response.

You have pretty much narrowed down my concerns. I definitely will be a super active older person, so I don't have any concerns about that. I guess I was more thinking about staying up over night (graveyard shifts) @ 70 would be tougher. How would sports medicine fellowhsip work? You then work with a sports clinic or something on the side, or like with an orthopedics shop or something?

 

[gro2001]

Thanks for the response.

You have pretty much narrowed down my concerns. I definitely will be a super active older person, so I don't have any concerns about that. I guess I was more thinking about staying up over night (graveyard shifts) @ 70 would be tougher. How would sports medicine fellowhsip work? You then work with a sports clinic or something on the side, or like with an orthopedics shop or something?

Different people use the fellowship for different things. Some people do outpatient sports medicine (either independently or as part of a group, sometimes working along side orthopedic surgeons (not in the OR, but for the outpatient part)) while others do the team physician kind of thing.

 

[Lysinee]

How common is it for EM doctors in their 50-60's to decrease their hours?

Also, it is common to go into more administrative or management work in EM when in their 50-60's?

 

[deleted6669]

I know several em docs age 65-70 who still practice.
most of them work the min # of shifts required to stay "full time with benefits" and do a lot of volunteering on the side(cruise ships, antarctica team doc, everest base camp, overseas medical missions, etc).
I work with a guy from the first em residency class at denver and he is still going strong in his late 60's.

 

[Birdstrike]

I think it's great that you're thinking about EM longevity early on in (or even before) you EM careers. Although there are the occasional example of the sky diving, night shift working, octogenarian ER doctor that sees 3 patients per hour shift after shift, generally these people are the exception, not the rule much like the 70 year old marathon runner. I believe longevity in EM is a serious issue that has not been dealt with by EM leadership. In fact, it has been swept under the rug and hidden by biased research supposedly show that EM burnout is a "myth" so as not to discourage potential recruits. It's not a myth. I think its great that some of you are concerned about it early in your careers. That's better than thinking about it tens years into your career and all of a sudden feeling trapped. Keep up the good work.

 

[TrumpetDoc]

I would say for sure EM burnout is NOT a myth, even for residency trained docs. I say this fully hoping and trying to convince myself I am/cannot be burned out so soon after residency.
I am not a very convincing person evidently


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[Jack is Back]

Don't most challenging specialties burn out?

I mean, what about a general or vascular surgeon? They work 80 hrs with call during residency. Comparably, doesn't EM have it pretty good or no?

I like EM but it is always scary hearing of all these people burning out so quickly (5 to 15 years).

 

[TrumpetDoc]

It's really not a simple answer. It will vary completely from person to person.
There are MANY who go through without a problem. Myself, I went through residency without any prob.
Cannot compare apples to oranges though. Raw number of hours and call are not relevant in the real world. Our schedules flip on a daily basis from varying day shifts-evening-nights, etc.
There is MUCH more than schedule alone that will lead to burn out:
Number of shifts, how malignant your med staff is, your nursing staff, hospital/group support, etc.

 

[EM_Rebuilder]

I have said this in other threads and will post it once again...

I dont know if burn out exists or not, but logically, I can tell you that a 'surgeon' simply cannot work 1 day a week and make a living. They will not get enough cases and they cannot FU their patients close enough. I think a 70 year old surgeon has it much worse than we do.

With that said, I assure you that 70 year old EM physicians CAN work 1 day a week. Even if you say well its really tough so you work ONE EIGHT HOUR shift per week. And lets say you are at about the lowest pay scale in the country and make $90 per hour... that is almost 40K per year. We are talking rural EM at that number and slow with super low acuity. This is the worse case if you ask me.

I work 12 to 15 twelve hour shifts currently at the start of my career in a busy Leve I trauma center. I make great money and way more than I need to make when I am 60. I am very confident when I hit the 50-60+ age range, I will be comfortable working a much less to supplement whatever retirement accounts I have built by then plus keep me interested in life.

Also, what gets me is that where are you guys working that have all these 70 year old people working? Sure, we have the isolated old person that still shows up on occasion and dates 18 year old woman, runs marathons, etc. Generally, most of the doctors I work with (in other specialties) are probably in their later 50s at the most...?

 

[southerndoc]

I used to work 18-20 11 and 12 hour shifts every month, but since becoming associate medical director I've scaled back to 12-14/month. Occasionally I'll pick up extra shifts if I don't have much going on that month (I also work for a hedge fund and I'm an EMS medical director, so my time available is limited).

Although I've always been a workaholic, I don't foresee myself maintaining this busy pace for more than ten years. I will probably scale back to 8 shifts/month or give up clinical work entirely in the next ten years.

We have docs in our group who still see 2.5+ PPH and work 12 night shifts who are 55+. I'm only 36 and I'm starting to feel the night shifts. I used to love them, but now I dread them.

 

[Jack is Back]

I used to work 18-20 11 and 12 hour shifts every month, but since becoming associate medical director I've scaled back to 12-14/month. Occasionally I'll pick up extra shifts if I don't have much going on that month (I also work for a hedge fund and I'm an EMS medical director, so my time available is limited).

Although I've always been a workaholic, I don't foresee myself maintaining this busy pace for more than ten years. I will probably scale back to 8 shifts/month or give up clinical work entirely in the next ten years.

We have docs in our group who still see 2.5+ PPH and work 12 night shifts who are 55+. I'm only 36 and I'm starting to feel the night shifts. I used to love them, but now I dread them.

I guess my question is, do you feel like when your in your 60s you will still be doing EM? Will you attempt to do some sub specialty after all this hard work, or do you see yourself able to happily work past 60 as a clinician in EM?

When one, "gives up clinical work entirely", what does one do after this?

 

[southerndoc]

When one, "gives up clinical work entirely", what does one do after this?

I work for a hedge fund also. If I quit clinical EM, then I can continue doing that.

FWIW, I don't plan to work at all past 55 unless I enter politics. I hope to retire by 55 and perhaps volunteer some time providing relief work overseas.

 

[inspirationmd]

I work for a hedge fund also. If I quit clinical EM, then I can continue doing that.

FWIW, I don't plan to work at all past 55 unless I enter politics. I hope to retire by 55 and perhaps volunteer some time providing relief work overseas.

How did you get your job with the Hedge Fund? I have an undergrad business degree in operations and strategic management and would love to have a business component to my career beyond admin. Did you need an MBA?

 

[Renaissance Man]

How did you get your job with the Hedge Fund? I have an undergrad business degree in operations and strategic management and would love to have a business component to my career beyond admin. Did you need an MBA?

+1, that is really interesting. I would love to know more about this Southerndoc (not to hijack thread).

 

[southerndoc]

+1, that is really interesting. I would love to know more about this Southerndoc (not to hijack thread).

I can talk more about this privately if you'd like. Basically it's all about connections. I don't have an MBA. I mainly evaluate FDA proposals for new devices and drugs and give opinion of whether things will be recommended for approval, rejection, taken off the market, new indications, etc. I do have to read balance sheets, 10-Q's, etc. and make projections on revenue/profit.

 

[Renaissance Man]

I can talk more about this privately if you'd like. Basically it's all about connections. I don't have an MBA. I mainly evaluate FDA proposals for new devices and drugs and give opinion of whether things will be recommended for approval, rejection, taken off the market, new indications, etc. I do have to read balance sheets, 10-Q's, etc. and make projections on revenue/profit.

I sent you a private message southerndoc, I would love some more information if you are willing to share with me.

 

[Jack is Back]

lol, what happened to this thread?

From emergency medicine to hedge funds...