Has anyone stepped "down" from the ER to UC/Telehealth and then "come back" to FT ER?

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RustedFox

RustedFox

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Title says it all.
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Wow. Thanks.
I just want a break from the constant sleep/wake disturbances and enjoy a less stress work schedule for a few months.
Actually having a PM routine like my dad had (home, kiss wife, eat dinner, watch news, read paper, fill large glass of ice water, take meds, zzz) might put years back on my life.
 
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RustedFox said:
Wow. Thanks.
I just want a break from the constant sleep/wake disturbances and enjoy a less stress work schedule for a few months.
Actually having a PM routine like my dad had (home, kiss wife, eat dinner, watch news, read paper, fill large glass of ice water, take meds, zzz) might put years back on my life.
Click to expand...

Ice water?
 
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TimesNewRoman said:
Ice water?
Click to expand...

It was probably the first "job du jour" that he gave me as soon as I was old enough to reach the ice dispenser.

"Go get daddy's big plastic cup (like, a stadium cup), fill it with ice water, and bring it to me."
"Okay, Daddy! I love you!"
 
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RustedFox said:
It was probably the first "job du jour" that he gave me as soon as I was old enough to reach the ice dispenser.

"Go get daddy's big plastic cup (like, a stadium cup), fill it with ice water, and bring it to me."
"Okay, Daddy! I love you!"
Click to expand...

My 7 year old daughter will “get daddy a Coors light.” When we went to Banff last year she said the mountains “looked like a beer can”.

/hijack
 
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RustedFox said:
Wow. Thanks.
I just want a break from the constant sleep/wake disturbances and enjoy a less stress work schedule for a few months.
Actually having a PM routine like my dad had (home, kiss wife, eat dinner, watch news, read paper, fill large glass of ice water, take meds, zzz) might put years back on my life.
Click to expand...

Are you willing to take the pay cut for it?
 
RustedFox said:
Yep. Plenty of room in that budget.
Click to expand...

Is there enough room in the budget to racket up your savings rate and push through for a few more years to just be financially independent? Working in an UC really isn’t a great option for an EM guy in my opinion. I own one and would never consider working there as an exit strategy from EM. Yes you get rid of the nights but it’s such a huge paycut and you’re still working evenings (not uncommon for UCs to be open til 7,8,9, 10ish) I’d rather just keep stockpiling and developing passive income streams.
 
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Hercules said:
Is there enough room in the budget to racket up your savings rate and push through for a few more years to just be financially independent? Working in an UC really isn’t a great option for an EM guy in my opinion. I own one and would never consider working there as an exit strategy from EM. Yes you get rid of the nights but it’s such a huge paycut and you’re still working evenings (not uncommon for UCs to be open til 7,8,9, 10ish) I’d rather just keep stockpiling and developing passive income streams.
Click to expand...

Nope. That's a bridge too far.
 
Just find a slower ER. Even in big cities there are ERs attached to specialty hospitals (or the VA) that usually aren't meat grinders.

Also, who reads the paper?
 
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Dr.McNinja said:
Just find a slower ER. Even in big cities there are ERs attached to specialty hospitals (or the VA) that usually aren't meat grinders.

Also, who reads the paper?
Click to expand...
Doesn't fix the normal day time person schedule unfortunately. I work some rural shifts, but even then I either leave the house around dinnertime or get home just before kid bedtime.

I also wonder how it's going to work for me when the kids have homework, activities, sports, or whatever kids do these days. I don't think RF has that issue, but it's the same principle.

On the one hand, maybe I could trim my hours. On the other hand, future reimbursement is unknown and now may be the best time for me to make money.
 
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Yeah, but at a slow place you can still sleep at night instead of switching your schedule around as much. You could even arrange to work all nights and still have a set routine.
UC isn't fun.
 
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Rural ER part time so not as disruptive.

If you want 9-5 you can just do regular PCP clinic work
 
Brigade4Radiant said:
Rural ER part time so not as disruptive.

If you want 9-5 you can just do regular PCP clinic work
Click to expand...

I've thought about this before and wasn't sure if it was possible. Can an ED doc switch over to primary care? Seems like we'd be bypassing an IM/FM residency.
 
Drop to 2 ED shifts/week. You'll still keep your skills up. I did this for awhile and it was magical. I went from Hyde to Jekyll.

Or do the VA. More and more folks I know who sign on there are loving it in spite of the paycut.

I wouldn't do UC unless there's a place that you could work only bankers hours M-F. And even then...
 
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So far I think everyone has unanimously advised against UC. That should probably be your answer as far as transitioning to UC.
 
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I'm sure there's someone out there who would be happier with UC, but I doubt @RustedFox is that person.

If the "#1 source of burnout" for you is the patients, then UC will be like a high-efficiency incinerator.
 
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I'm pretty sure if you go this route, it's going to be a one-way street. Would be difficult to transition back to the ED.
 
WilcoWorld said:
I'm sure there's someone out there who would be happier with UC, but I doubt @RustedFox is that person.

If the "#1 source of burnout" for you is the patients, then UC will be like a high-efficiency incinerator for you.
Click to expand...
Unless it’s the acuity that’s burning you out, UC isn’t really going to be a solid answer. UC has all the nonsense complaints, lack of follow up, patient expectations, and higher volume then the ED with less resources and way less pay. Owning a UC as a passive revenue stream? Sure. Working in one? Hard pass.
 
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Backpack234 said:
I've thought about this before and wasn't sure if it was possible. Can an ED doc switch over to primary care? Seems like we'd be bypassing an IM/FM residency.
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I mean you can, we all have licences to practice medicine without specifications beyond that.

Would you be any good at it? You could be if you read up and went to a few good meetings.
 
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RustedFox said:
Title says it all.
Click to expand...

One of my best friends got burned out on EM and does urgent care full time. He’s never looked back. We recently opened one together with another buddy and I’m there a few days a month. People love to crap on UC work but I find it quite enjoyable. Nice people who typically have straightforward complaints and want to get better. The hours are 9-7 but we’ll work half days as well sometimes which is really nice. We will do IV’s, fracture care, sutures, abscesses and more than the typical APP in the box. Maybe find a part time gig and see if you like it?
 
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I'm sure the truth lies somewhere in the middle. We had a doc in our group who was neurotic about fairly mundane presentations. She trained at a top tier program, very smart. Just went crazy on her work ups and was miserable to sign out to. Ended up leaving after a couple years, went UC. Seems much happier, less crazy. EM isn't for everyone.

In my experience moonlighting in UC during residency, I enjoyed the quick turnovers and singular complaints. Everyone enjoys clicking the discharge button. However, I enjoy doing critical care and taking care of sick folks too much to consider ever going that direction. At least for now...
 
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One never knows what will wander into an UC. From alopecia to zoonosis.
 
RustedFox said:
Wow. Thanks.
I just want a break from the constant sleep/wake disturbances and enjoy a less stress work schedule for a few months.
Actually having a PM routine like my dad had (home, kiss wife, eat dinner, watch news, read paper, fill large glass of ice water, take meds, zzz) might put years back on my life.
Click to expand...

Unless you plan on making a long term transition, I'd just scale back your shifts to say... 6-8/mo. That would minimize the hara-kiri you're about to do on your compensation and prevent skill atrophy. That would also allow you enough spare time to explore other ventures to see if you would enjoy doing anything else.

Another option would be to make a switch to academics or something with a decreased clinical load. VA is also a good option. It would be much less stress, much more pleasant pt population though I'm not sure it would decrease your clinical time. It def would be for less money...
 
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I know that other ER docs look down on urgent care docs trying to work in an ER whether they are EM trained or not. I think it’s mostly skepticism and that you can get a job but it may depend on connections. But I wouldn’t plan on coming back due to people being so biased against it.
 
I view the transition from ED -> urgent care like ED -> upstairs for an admission. It's a one way street. Once you go upstairs, you don't come back down. If you need a different room or a different bed, you stay where you are until they find one. The same is true of going to urgent care. The docs I've known to go to urgent care have quickly lost their skills and did not function well with the pace when picking up PRN shifts.
 
pencilcase said:
I know that other ER docs look down on urgent care docs trying to work in an ER whether they are EM trained or not. I think it’s mostly skepticism and that you can get a job but it may depend on connections. But I wouldn’t plan on coming back due to people being so biased against it.
Click to expand...
The worst thing about the UC to ED doc is that they wrap their inability to effectively do the job in the language of the valid criticisms of the profession. Slow as molasses? Admin is making you rush. Horrific patient sat because you treat patients like they’re a—h&$@s? It’s because you’re not a candy man or waiter. And then we're all left with trying to figure out did a good doc lose their job because of complete nonsense or did they get let go because they were reading A Tale of Two Cities* on shift instead of seeing patients? Like when you hear a whistleblower expose what sounds like a horrible/unsafe system and then find out they were seeing 0.7 patients per hour.

*Name of novel changed to protect anonymity of that particular physician.
 
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