How commonplace is this situation?

[DrRobert]

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A family friend who finished his EM residency this August at an average program had several job offers that really surprised me.

He ended up taking a position in a large midwest city (>1 million).

Details:
1. Private practice group that has contracts with two hospitals. I believe there are around 12 partners.
2. 1 year partnership track.
3. All benefits paid (malpractice, health, dental, etc.)
4. No overhead to speak of.
5. 4 weeks vacation first year with 8 weeks/year after partnership.
6. Must work minimum of 36/hours week. This group works 12-hour shifts. Can work up to 72 hours/week if you want (six 12-hour shifts).
7. Pay is hourly wage of $100/hour for first year, increasing to $150/hour after partnership. No bonuses.
8. Senior partners (>10 years) are making $200/hour with 12 weeks vacation/year.

 

[NinerNiner999]

We just had a lecture on this type of employment - pretty common. In fact, here in the Northeast, it may be difficult with some groups to work more than 5 shifts per week because of longevity concerns. That sounds like the typical 250K starting salary package.

 

[DrRobert]

We just had a lecture on this type of employment - pretty common. In fact, here in the Northeast, it may be difficult with some groups to work more than 5 shifts per week because of longevity concerns. That sounds like the typical 250K starting salary package.

I wasn't that surprised with the starting package. I was surprised to hear about the one year partnership track that bumped his salary up to $400K/year working five 12-hour shifts a week with 8 weeks vacation. And the eventual $200/hour with 12 weeks vacation after 10+ years. And all of this in a large city.

 

[Sessamoid]

I wasn't that surprised with the starting package. I was surprised to hear about the one year partnership track that bumped his salary up to $400K/year working five 12-hour shifts a week with 8 weeks vacation. And the eventual $200/hour with 12 weeks vacation after 10+ years. And all of this in a large city.

It's a nice deal, but not unheard of if the payor mix is good. I can almost guarantee if you work 5 12-hour shifts a week consistently, you won't be practicing emergency medicine long. At any center with decent acuity, you'll be burned out in a year or two. That's about equivalent to about 250 hours per month. You'll be burned out and/or alcoholic/drug addicted/suicidal/homicidal instead.

edit: I forgot to mention "divorced", maybe multiple times.

 

[DrRobert]

It's a nice deal, but not unheard of if the payor mix is good. I can almost guarantee if you work 5 12-hour shifts a week consistently, you won't be practicing emergency medicine long. At any center with decent acuity, you'll be burned out in a year or two. That's about equivalent to about 250 hours per month. You'll be burned out and/or alcoholic/drug addicted/suicidal/homicidal instead.

edit: I forgot to mention "divorced", maybe multiple times.

Many docs work 60+ hours/week and plenty work 80+ hours/week. Is EM really that much more stressful than Surgery, IM subspecialties, Rads, OB, etc? 60 hours/week does sound like a lot in EM, but not impossible or unheard of. I think his two hospitals are Level II/III.

 

[Sessamoid]

Many docs work 60+ hours/week and plenty work 80+ hours/week. Is EM really that much more stressful than Surgery, IM subspecialties, Rads, OB, etc? 60 hours/week does sound like a lot in EM, but not impossible or unheard of. I think his two hospitals are Level II/III.

Rotating shift work is much tougher on the body and mind than regular hours plus call nights. 60+ hours/week is nearly unheard of over any prolonged period of time for EM work. You will spend at least 1 full day out of every circadian shift cycle feeling like a zombie and trying to readjust your sleep schedule, if not more.

You can take a poll of the guys here, but doubt anybody is working anywhere near those kind of hours. I had a couple months in a row where I worked 180-190 /month due to one guy in our group getting injured. By the end of those two months, I hated medicine.

 

[Su4n2]

is working 3 12 hour shifts per week the norm not ot get burned out? if so, in your first year will u be doing mostly nights and get days as you get more senior?

 

[Sessamoid]

is working 3 12 hour shifts per week the norm not ot get burned out? if so, in your first year will u be doing mostly nights and get days as you get more senior?

I'd say between 3 and 4 shifts of 12 hours a week is about average (for me anyway). Whether you get shafted on nights when you first start depends on the group. Could go either way.

 

[roja]

Is it different? Yes.


Would I trade it for anything else? nope.

 

[DrRobert]

Rotating shift work is much tougher on the body and mind than regular hours plus call nights. 60+ hours/week is nearly unheard of over any prolonged period of time for EM work. You will spend at least 1 full day out of every circadian shift cycle feeling like a zombie and trying to readjust your sleep schedule, if not more.

You can take a poll of the guys here, but doubt anybody is working anywhere near those kind of hours. I had a couple months in a row where I worked 180-190 /month due to one guy in our group getting injured. By the end of those two months, I hated medicine.

If 36-48 hours/week is the norm, then is the $150-$200/hour this guy will be making the norm?

 

[Sessamoid]

If 36-48 hours/week is the norm, then is the $150-$200/hour this guy will be making the norm?

Depends on geography, partly. I've never job hunted in the midwest, so for all I know that's the average there. It's on the high side for California, but I know groups that make that much, and some hospitals in my group make that much. Most in California average a bit or a lot lower I think than $150 / hour, but mine is a limited sample.

 

[Chris_Topher]

...Is EM really that much more stressful than Surgery, IM subspecialties, Rads, OB, etc? 60 hours/week does sound like a lot in EM, but not impossible or unheard of.

Certainly Surgery and OB can have similar stress in terms of critical care, but most EM is literally on your feet and running for the entire shift. All of the specialties you listed have some sit-down time during the day while you round, write notes, round, read films, etc. EM is both physically and emotionally exhausting. Add that to the shift work already mentioned, and you are one tired puppy when you get home.
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