good hours

[atomi]

I'm glad somebody said it. What's wrong with wanting a life outside of medicine?

Because people are insecure and boost their self-worth in an attempt to add value to their otherwise empty lives by working insane hours and putting down those who don't wish to devote every waking hour to their jobs.

Usually after their 5th divorce, these type of docs start to come around and retire to Vegas or open a car dealership or something in a bizarre sort of very-late mid-life crisis.

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[248934]

Good luck finding 8-5 hours in any residency. Even PM&R pushes longer hours than any desk job.

When you become an attending or out in practice, Path and PM&R are the two that come to mind that have the most decent hours (if you allow your schedule to be). However, if you're expecting physician hours that are comparable to that of industry, you'll be in for a surprise. That said, you could theoretically find a physician practice that could offer a more "relaxed" schedule. Nothing is impossible...

 

[Steiner]

I thought Path had call at the hospital. Surgical specimens and quick decisions about resections require a quick path read. At least this was my understanding. If that's true than call for a pathologist might involve being at the hospital/OR @ 3 a.m. looking at a tissue sample under pressure. I also thought that if you own a practice and you want hospital rights you have to do call; for any specialty. I could be wrong on everything here though.

 

[Dral]

Path call is usually from home. So you could get a call to come in. Not many people are having reads on lung tumor resections at 3AM Saturday night though. However, a more likely scenario may involve something with Blood Banking. This stuff can often be taken care of over the phone as well though.

Derm can get nice hours. I work with an Internal Med doc and her hours are M 8:30 to 7; Tues, Wed, Thurs 8:30 to 5. No hospital responsibility, and she's only about 10 years into her career. So yeah, pretty much what you want to do is possible, as long as you understand that you'll have to make some sacrifices elsewhere.

 

[sacrament]

Good hour specialties or lifestyle specialties include Rads, Derm, to an extent Rad Onco. These 3 being some of the most competitive because they are both high paying and lower hours.

That is not why they are competitive.

Okay. I'm curious as to why you think they're competitive.

 

[neurolddoc]

Most of the posts here come from a skewed perspective. Med students and residents see the hospital centric world of medicine. This is a less controllable environment than office based practice. Many specialty and primary care groups are disaffiliating themselves from hospital practice for a number of reasons. Lifestyle is a big reason but compensation and liability are also significant issues.

Most primary care practices in my area no longer go to the hospitals in order to concentrate on their office practice. I think 50-60 hours including administrative time is probably typical. Call is shared among group members but that consists of fielding phone calls. If someone is really sick they are sent to the ER for evaluation.

Many IM and surgical specialties also minimize their inpatient exposure. The surgical specialties avoid hospitals and the attendant call by doing their procedures in surgery centers. My sense is that their hour are similar to the above.

My own schedule is that I am in the office by 6:30 or 7 and start patients at 7:30 and end with my last patient at 3:15. I am home by 4:00 to run, cycle etc and have dinner with the family. Call is usually fairly quiet with a couple of phone calls. Overall I am very satisfied with my situation.

Granted, I have been doing this for a while and the early years were different, but the people coming into the practice now are benefitting from what we have put in place over the years.

The bottom line is that there are many different situations that are available in the world of practice so the "average" is not really a meaningful concept. Your situation will be what you make of it.

 

[Law2Doc]

...
Granted, I have been doing this for a while and the early years were different, but the people coming into the practice now are benefitting from what we have put in place over the years.
...

This is actually precisely what ISN'T happening by and large, across the country. Folks coming out of residency now are unlikely to be able to get to the status/terms of those who came out a generation earlier. They are being hired as work horses, with less promised upside. And are less able to "hang up their own shingle" or buy into a partnership due to already being overburdened with crippling educational debt. And with a bad economy and the old guard less likely to retire, you can expect this trend to continue. The recent crop of med school grads will almost certainly have worse prospects than the prior generation. They are NOT benefiting from the trailblazing of a prior generation. They are seeing an older generation living better than they will ever attain. So don't kid yourself into thinking you made things better for those to come. Because unless your practice is pretty unique, it's likely that whoever follows in your footsteps will not achieve what you have.

 

[neurolddoc]

This is actually precisely what ISN'T happening by and large, across the country. Folks coming out of residency now are unlikely to be able to get to the status/terms of those who came out a generation earlier. They are being hired as work horses, with less promised upside. And are less able to "hang up their own shingle" or buy into a partnership due to already being overburdened with crippling educational debt. And with a bad economy and the old guard less likely to retire, you can expect this trend to continue. The recent crop of med school grads will almost certainly have worse prospects than the prior generation. They are NOT benefiting from the trailblazing of a prior generation. They are seeing an older generation living better than they will ever attain. So don't kid yourself into thinking you made things better for those to come. Because unless your practice is pretty unique, it's likely that whoever follows in your footsteps will not achieve what you have.

As far as status/terms of employment: All the groups in my specialty in the local metropolitan area offer the same form of employment to partnership track that they did in in the early 90's.

Shingle hanging: Three seperate solo practioners in my specialty have set up shop in our metro area in the last 5 years.

Work horse: I know of no primary care or speciatly group in my area that dumps disproportionate call on new hires. I'm sure some do. See how you feel about it when you are mid career. Most practices have some sort of productivity incentive so the more you work the more you make. You should have such problems of being too busy.

Poor prospects: The upcoming generation will be caring for the aging Baby Boomers with unprecedented demand for service.

Generation to come: I didn't realize that our purpose was to make things easier for you. I can only speak for my group in that we have dealt with new hires in a straight forward fashion. We have a period of employment with salary plus incentive followed by a very modest puchase of stock to become a shareholder in the corporation. Our two most recent hires have bought houses at least as big as mine. One is now a partner and the other will be this summer.

Undoubtedly there are some less scrouplous practices out there but I do not think we are unique.

 

[badasshairday]

I heard neurosurgery has pretty good hours.

 

[anesthesiadoc]

What about EM? I heard they usually only work close to 40 hours a week, where some work three 12 hour shifts. Obviously, as a resident, you'd be working more

EM works more than 40hrs/week.

Pathology you may be able to do it.

Please nobody say anesthesiology. b/c that would be incorrect (99% of the time).

 

[number]

Atomi,

I would like to second this??? Why else would a field as boring as dermatology be more competitive if it was not for the easier hours and far larger pay ends??

An additional factor is the competitive nature of medical students. Most medical students desire to out do their peers. Once the field becomes competitive, a positive feedback mechanism continues to increase the competiveness. The money and hours are second to making everyone aware of their greatness.

 

[danzman]

An additional factor is the competitive nature of medical students. Most medical students desire to out do their peers. Once the field becomes competitive, a positive feedback mechanism continues to increase the competiveness. The money and hours are second to making everyone aware of their greatness.

I also think this is just as important as the money/time issue. Ego and vanity are huge factors. Ask any class of first year medical students what they want to be, not a single one will have had any real experience with ANY type of medicine, and all will answer either, plastics, ent, derm, ortho, or some nonsense about interventional pediatric neuro/cardio surg. First week of classes I had a girl tell me, with a straight face, that she wanted to become triple board certified in pediatric CT surg, OB-gyn, and pediatric neurology, then she wanted to move to Africa to set up a free clinic to remove brain tumors, fix kids hearts, AND deliver children. You could see her face just glow with pride as she waited for me to tell her how amazing that her dream was. I told her I wanted to open up abortion clinics on every street in inner cities and she has yet to say a word to me since. I thought she was joking, but it turns out she was no crazier than half my class. Word on the street is that she made a B average her first semester, which would put her about middle of the class, but she was so upset that she started seeing a psych and is now on ADD meds. Im telling you, you couldn't make this stuff up if you tried.

 

[badasshairday]

I also think this is just as important as the money/time issue. Ego and vanity are huge factors. Ask any class of first year medical students what they want to be, not a single one will have had any real experience with ANY type of medicine, and all will answer either, plastics, ent, derm, ortho, or some nonsense about interventional pediatric neuro/cardio surg. First week of classes I had a girl tell me, with a straight face, that she wanted to become triple board certified in pediatric CT surg, OB-gyn, and pediatric neurology, then she wanted to move to Africa to set up a free clinic to remove brain tumors, fix kids hearts, AND deliver children. You could see her face just glow with pride as she waited for me to tell her how amazing that her dream was. I told her I wanted to open up abortion clinics on every street in inner cities and she has yet to say a word to me since. I thought she was joking, but it turns out she was no crazier than half my class. Word on the street is that she made a B average her first semester, which would put her about middle of the class, but she was so upset that she started seeing a psych and is now on ADD meds. Im telling you, you couldn't make this stuff up if you tried.

Wow. Just wow. Now she has the magic study pill because she wasn't at the top of the class...

 

[franklinave]

This is actually precisely what ISN'T happening by and large, across the country. Folks coming out of residency now are unlikely to be able to get to the status/terms of those who came out a generation earlier. They are being hired as work horses, with less promised upside. And are less able to "hang up their own shingle" or buy into a partnership due to already being overburdened with crippling educational debt.

Is this informed by statistical evidence or is it merely theoretical?

 

[PeepshowJohnny]

I also think this is just as important as the money/time issue. Ego and vanity are huge factors. Ask any class of first year medical students what they want to be, not a single one will have had any real experience with ANY type of medicine, and all will answer either, plastics, ent, derm, ortho, or some nonsense about interventional pediatric neuro/cardio surg. First week of classes I had a girl tell me, with a straight face, that she wanted to become triple board certified in pediatric CT surg, OB-gyn, and pediatric neurology, then she wanted to move to Africa to set up a free clinic to remove brain tumors, fix kids hearts, AND deliver children. You could see her face just glow with pride as she waited for me to tell her how amazing that her dream was. I told her I wanted to open up abortion clinics on every street in inner cities and she has yet to say a word to me since. I thought she was joking, but it turns out she was no crazier than half my class. Word on the street is that she made a B average her first semester, which would put her about middle of the class, but she was so upset that she started seeing a psych and is now on ADD meds. Im telling you, you couldn't make this stuff up if you tried.

This post made me laugh uncontrollably, especially this part.