How many hours are you working a month?

[Groove]

I'm sure we've had one of these polls before but I can't seem to find it...

I'm currently working about 130-140 hours a month, down from 150-165 last year and 170+ the year before. So far, it's been really really nice... More time for the gym, family and friends, reading, better sleep, etc.. However, as expected... the less I've worked over the past few years, the more I feel that I'm "working too much". Then again, I'm in my ortho's office yesterday getting a shot for subacromial bursitis in my right shoulder and it's like...6:45PM at night in an after hours MSK clinic and he's been there since 6:30a.m. He looked worn out. Talking to him, it sounds like he's working 60-70hrs a week. How much do you guys think is too much and what's the perfect amount of work per month for long term longevity in your opinion? Obviously, we can't work the hours of a surgeon with our rotating schedules and constant barrage of stress in the ED, but I'm curious what the rest of you are doing. I'm considering locking into a set number for the rest of my career and giving up my greedy years which I feel have added a lot of extra gray hair I wouldn't have normally.

One of our docs who's well into his mid-career works 18 shifts/mo routinely. 14 with us and 4 moonlighting at another ED. I don't know how he does it... He's been working 18 his entire career. We have another PRN guy that works several ERs in the area that works 20/mo and has a thriving real estate business he runs on the side. There's absolutely no way I would have the energy to work that much, so I feel these guys are an exception to the norm.

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[TooMuchResearch]

Working about 160-170/month now. Once all the debts are dead, depending on how I'm feeling and if reimbursement has taken a major hit, I see working closer to 100/month as something I'd like to try.

At 160+ it has been much more common to hit uncomfortable stretches of shifts.

 

[GonnaBeADoc2222]

I really like 120 / mo. This flexes up to 130-140 depending on if I pick up at my secondary site. At this level of work I am very able to comfortably achieve our savings goals and spend money on pretty much whatever discretionary items I want. I was able to pay off my ~200k worth of loans at this level of work < 2 years post residency graduation. We aren't big buyers of stuff per se, but we do like to take nice vacations.

I don't really like work. I would rather make a reasonable amount and spend the rest of my time with my wife, baby daughter, and doggo.

 

[Alvarez13]

I'm 2 years out, work ~180 hrs per mo, 200 in July. It's on the high side but I want my debt gone and to be well on my way to financial Independence. Once I'm there, I can cut back, laugh at that admins when they try to take my sandwich, and not work in such he'll holes. In just these 2 years I'm watching locum assignments disappear and rates fall. I predict ill trained but cheap mid-level encroachment and inappropriate residency expansion is going to exacerbate the supply/demand curve. I'm going to maximize income now and be ready should I want to leave at anytime during what could be a rocky next 5-10 years. Sorry for such a pessimistic outlook, but there's a lot to be concerned about right now.

 

[RustedFox]

I don't think you meant to type that you feel ill-trained.

 

[killdevil]

I am working 160-180 a month right now, on average. This month I'm doing well over 200 hours. This is all by choice, as I'm only contracted for 120 hours/mo for full time. I like picking up distressed shifts for extra money, and I'm only a couple years out and still getting over being poor. Once I hit some savings goals I'm going to slow down.

And my two cents would be that the locums market has not evaporated. Far from it. It's simply that >$300/hr locums gigs are not that common anymore, and EPs are no longer getting cold called and offered distressed shifts at remote facilities for $600/hr, which was a thing that happened 5-10 years ago. The market is still okay, but we do need to stop HCA from opening residency mills to tank our pay to hospitalist levels.

 

[GonnaBeADoc2222]

I sorta wish I had some y'alls drive to work more...but then as I look round the room and see my puppino to my left and baby girl to my right that feeling evaporates...

 

[TooMuchResearch]

I sorta wish I had some y'alls drive to work more...but then as I look round the room and see my puppino to my left and baby girl to my right that feeling evaporates...

I know what you mean. Luckily my otherwise lack of hobbies makes me nearly a 100% around the house family Guy when I'm not working or sleeping. I think if I had a lot of other activities (mountain climbing or whatever adventure sports EM people are supposed to like, fishing, going to the gym [I do this when it's not in the way of family stuff], etc), things might be different.

I just did a little napkin math. If my big debts were retired (mortgage, student loan), I could drop about 5-6 shifts per month and finances would be the same.

 

[Brigade4Radiant]

I would really recommend paying off loans and saving for retirement just think of it as a financial fellowship. Working 14-16 shifts a month

 

[Tenk]

126. I was working usually about 144-153 (we do 9s) but I have my loans paid off now so I went down to minimum full time of 14 a month as I just don’t care about money as much anymore!

 

[DO3]

Work 12-13 shifts and 100-110 hours and really think it’s the way to go, especially with a family.

 

[GatorCHOMPions]

What about shift duration, which do most people do and prefer? I did mostly 12s in residency and now mostly 8s as an attending. I do like 8s for giving me flexibility to do stuff before or after shift, but the simple act of coming in so much and switching more often is tiring.

 

[bravotwozero]

Roughly 130 hours 15 8-9 hr shifts a month

 

[gamerEMdoc]

100 hrs/mo clinically
20-40 hrs/mo doing academic/teaching/student/APD stuff

 

[killdevil]

12s are where it's at. My day is equally destroyed with an 8 or a 12, so why not go for a 12? Many fewer days per month are ruined.

 

[TooMuchResearch]

What about shift duration, which do most people do and prefer? I did mostly 12s in residency and now mostly 8s as an attending. I do like 8s for giving me flexibility to do stuff before or after shift, but the simple act of coming in so much and switching more often is tiring.

I work a mix of 8s, 10s, 12s, 14-16s, 24s.

For family life, the 7a-7p is probably the worst.

 

[Alvarez13]

I would really recommend paying off loans and saving for retirement just think of it as a financial fellowship. Working 14-16 shifts a month

Yes, I'm doing a financial fellowship.

I'd also recommend any new grad sign on for as few hrs as possible to get benefits, usually 100-120 hrs/mo then pick up extras at home or a nearby shop for bonus. Idiot graduate that's starting next mo is working 18 x 10 hr shifts for the base rate and has agreed to that in his contract for a year. The hospital hit jack pot on that one. I'm usually getting 1.5 x base after 14 shifts, otherwise I back off.

 

[RPedigo]

Roughly 16-20 hours a week clinically (64-80 hours a month clinically), probably 20-30 hours a week non-clinically (education, research, administration, etc.). As a caveat, I make a lot less money than most people on this forum.

 

[RustedFox]

Debt retired.

340K in 6.5 years.

[had to post it somewhere, sorry]

 

[Listen2Savage]

Debt retired.

340K in 6.5 years.

[had to post it somewhere, sorry]

Is it difficult to do this in <2 years?

 

[p1acebo]

132 full time, a mix of 8s and 9s, with the occasional 10.

 

[GonnaBeADoc2222]

Is it difficult to do this in QUOTE]If your willing to actually live like a resident it shouldn't be. I did not live like a resident but was able to pay my 200k off in 18 months.

 

[RoyBasch]

120-144 hrs/month

 

[RustedFox]

Is it difficult to do this in <2 years?

At 340K of debt? Yeah, its difficult.
I chose not to "live like a resident" any longer, because I have seen docs younger than me "get sick and die".
If I cut back on things like paying for my wedding upfront, upgrading our living space, and buying a new car (had to, old one up and died), then I could have been out in say... 3-4 years.

 

[BoardingDoc]

12s are where it's at. My day is equally destroyed with an 8 or a 12, so why not go for a 12? Many fewer days per month are ruined.

If your days are equally destroyed, sure. Not the case for me or most of the crew I work with. I work 8s and 9s and I get plenty done on those days. If I'm working a 12, I work, eat, sleep and that's about it. I would infinitely prefer working 15 8s/9s to working 11 12s

 

[gamerEMdoc]

If your days are equally destroyed, sure. Not the case for me or most of the crew I work with. I work 8s and 9s and I get plenty done on those days. If I'm working a 12, I work, eat, sleep and that's about it. I would infinitely prefer working 15 8s/9s to working 11 12s

I totally agree. 12's ruin any life you have outside of medicine. There's no way you would work 12 hr shifts, and get other admin stuff done, or workout daily, etc. Its work, sleep, eat on those days. Not at all worth the extra few days off. The only caveat to this is if its 12s at a really slow sleepy place where you can sleep most of the night anways.

 

[BoardingDoc]

I find the rush to pay off loans interesting. To give a different approach: I am still paying off my loans and plan on doing so for another several years. My reasons for doing this are several fold.
1: My loans are all refinanced at 2.45%
2: This allows me a higher quality of life than I would have by living like a resident
3: While some of the $ goes towards #2, most of it goes towards retirement / investment accounts.

As someone who is a bit less risk averse, I see this approach as significantly more financially beneficial than early loan repayment. In essence, aside from simply spending more money as noted in #2 (I can't defend this from a financial POV, just a personal happiness one), I'm trading a guaranteed 2.45% rate of return for a likely long term average 7% rate of return. Yes, historical performance is no guarantee of future earnings, but I'm willing to roll those dice. Some people aren't and I get that, but I thought it might be useful to put a different approach out there.

 

[EthylMethylMan]

Sorry if this is off-topic, but after reading these varied responses I'm curious. How much say do you have as an attending in how many hours per month you work? I presume the average patient flow and amount of other attendings on staff affect this?

 

[Uranium678]

I was working 170hrs/month but I both paid off my loans and got burned out. I went to 120/hr which is much better. 12 9s.- 2 years out.

 

[BoardingDoc]

Sorry if this is off-topic, but after reading these varied responses I'm curious. How much say do you have as an attending in how many hours per month you work? I presume the average patient flow and amount of other attendings on staff affect this?

It depends entirely on the job. Places which are easy to staff will require that you work x hours per month or else you don't work there at all. This is assuming you even get the job. As the site becomes less popular and harder to staff, you hold more negotiating power and can dictate your hours within reason.

 

[RuralEDDoc]

Is it difficult to do this in <2 years?

Not only difficult but also not a reasonable expectation. Remember loan repayment is done in post-tax dollars. Could you pay off $170k a year if you had no taxes? Probably but it would still require living like a resident. With taxes, it’s just not reasonable.

 

[Groove]

Interesting spread. #15, 9's here.. Personally, I think 10h shifts are the sweet spot.

 

[Groove]

Sorry if this is off-topic, but after reading these varied responses I'm curious. How much say do you have as an attending in how many hours per month you work? I presume the average patient flow and amount of other attendings on staff affect this?

It depends. Most gigs are looking to staff with FT docs and get rid of PRN (unreliable from mo to mo). All will generally have a minimum amount of shifts to qualify for FT. (12-14). We have a productivity bonus equaling about $30/hr that goes to the FT docs, so...if you want to work say 8 shifts/mo, that's fine...but you won't get your bonus. Therefore, most docs will work the bare minimum at the very least. Meanwhile, you've got the young, hungry, indebted docs who want extra shifts per month (16-18, etc..) The best thing to do is figure out from the get go how many shifts you want to work and negotiate that on the front end when you take the job. I negotiated 12/mo in my original contract because I wanted the option of working less and still qualifying for FT. That being said, I've never worked 12/mo and generally work more but it's difficult to work say...17 shifts/mo one year and suddenly scale back to 12/mo the next year and vice versa. If too many people are working the minimum, then they will just hire another physician to staff the ED more appropriately and then when you want to suddenly pick up an extra 4 shifts/mo it can be difficult to find any that are available.

All that being said, there's usually some wiggle room. We have an older doc who is nearing retirement and over the past few years he has scaled back from 14/mo to 10/mo and the CMG has kept him FT. Meanwhile we have a lot of younger docs working more shifts than average, so it all works out.

 

[sylvanthus]

Where are all the other fools like me who are working 180+?

 

[Groove]

Where are all the other fools like me who are working 180+?

Sounds rough, but the paycheck must be nice.

 

[TooMuchResearch]

Where are all the other fools like me who are working 180+?

Whoa. What kind of setting?

My average is about 160 (though it's about 210 this month), but that's a mix of high acuity 8-9 hour shifts and probably 90+ hours of 12-24s in places with 6k annual volume or less.

I wouldn't attempt 160 hours at our high acuity referral center.

 

[RuralEDDoc]

It’s important to count “after hours” charting in hours worked. I currently work 16 10s a month, and not a second is spent after the shift charting, or in the rare occasion that it is, I’m paid for it. So including group meeting and a committee, I work 166 hours a month.
Previous job was 14 supposedly 9 hour shifts a month. 3 hours per shift was spent afterwards charting so in reality it was 14 12s, which was much more demoralizing as the charting time was essentially unpaid.

 

[RustedFox]

Where are all the other fools like me who are working 180+?

Yeah, but don't you split time between CC and EM?
I can be totally confusing you with someone else, please take no offense.
Gotta compare apples to apples.

 

[sylvanthus]

Whoa. What kind of setting?

My average is about 160 (though it's about 210 this month), but that's a mix of high acuity 8-9 hour shifts and probably 90+ hours of 12-24s in places with 6k annual volume or less.

I wouldn't attempt 160 hours at our high acuity referral center.

Ehh its a combo, mostly 12s at a low volume ED critical access hospital, roughly 40 patients in 24 hours on a bad day, also a week of 12 hour night shifts in the ICU per month. Will reevaluate in a year and see what job to keep and what to go PRN since both will now qualify for PSLF.

 

[hundreddaysoff]

Where are all the other fools like me who are working 180+?

I try, but it's slow going convincing the wife. My contract needs >135/mo, at 150h this month, finally convinced her to go up to 180/mo in a couple months. We'll see if that's sustainable for her as I'm a nocturnist.

Agree w/ Alvarez that there's too much potential for bad things happening to our specialty in the next few years for me to take it easy now. Would rather work my butt off now while I have the energy and my kid is still vegetative. Then hope to ramp down to 1-2 shifts/week in about 4 years once house+retirement is paid for and Stay At Home Dad the rest of the time while wife pursues her slower and saner career path.

 

[bravotwozero]

Is it difficult to do this in <2 years?

Did it in 2.5. Rented a 2 bedroom apartment, paid off old car, small vacations here and there.

 

[Listen2Savage]

Did it in 2.5. Rented a 2 bedroom apartment, paid off old car, small vacations here and there.

how many hours a month, hourly, what region?

 

[bravotwozero]

120-130 hrs/month 250-280/hr IC houston

 

[Hercules]

120 hrs/mo. 8hr shifts on weekdays and 10hr shifts on weekends (we staff with 4 docs on weekdays and 3 docs on weekends so we have more weekends off). Would switch jobs if forced to do 12s. I felt differently when I was single, but 12s are a wrecking ball if you have a spouse and children.

 

[namethatsmell]

Lately I've been working 70-90hrs of EM/month and 40-50hrs of non-EM work/month.

Agree on the 12s -- they're awful unless the shop is very slow/well staffed and 99% of the time you're walking out exactly when your shift ends with all notes signed. At the rare shop like that, 12s are great.