How many hours is considered full-time at your ED?

[han14tra]

Right now, I'm working anywhere between 130-140 hours/month. All I know is that working four 10-12 hour shifts in a row is murderous in a 2pph min place. I also like to have a week off each month to decompress, travel, etc. I selfishly want to cut back my hours to a max of 120/month now that the student loans are gone. Am I asking too much? What's everyone else working? What do you all think is a sustainable or ideal number of shifts/hours for you?

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[RustedFox]

120 has been full-time with every place I've ever worked at.

 

[BoardingDoc]

Right now, I'm working anywhere between 130-140 hours/month. All I know is that working four 10-12 hour shifts in a row is murderous in a 2pph min place. I also like to have a week off each month to decompress, travel, etc. I selfishly want to cut back my hours to a max of 120/month now that the student loans are gone. Am I asking too much? What's everyone else working? What do you all think is a sustainable or ideal number of shifts/hours for you?

I work 128 hrs/mo and I am tied with one other doc for most clinical hours/mo in our dept. Cutting back to 120/mo sounds completely reasonable.

Our "full time" docs range from 72 - 128 hrs/mo.

 

[Porfirio]

Full time is 120 hrs a month. I average 220-230 hrs per month. 48 hrs of that are very low volume (sleep 4-6hrs on overnight). I have been doing this for about 4.5 years.

 

[hopeful22213]

Full time is 120 hrs a month. I average 220-230 hrs per month. 48 hrs of that are very low volume (sleep 4-6hrs on overnight). I have been doing this for about 4.5 years.

220-230 as a one off is a lot. I was fried after approaching 200. As a multi-year average, it's insane.

Are you seeing like 0.4 PPH? Do you have a spouse/kids? Have you positioned yourself to retire really early?

 

[Porfirio]

I work at multiple hospitals (full time one hospital, part time at another, and PRN at 3 hospitals).

My full time hospital is the absolute worst dumpster fire of an ED you can possibly imagine. The main hospital I see 1.8 pph (which is like moving 2.5 pph because of the hospital is total crap). The freestanding I see 2.5 pph. This freestanding sees 40,000 patients per year out of 8 beds. Sometimes I am seeing 4-6 patients per hr for multiple hours (4-6 hrs). The freestanding acuity is more of urgent care with needle in a haystack ER patient. I work 120-180 hours between main hospital and freestanding.

My part time hospital is a rural 0.5-0.7 pph, 6 bed ED. I work 48 hrs here (24 hr then 12 overnight then 12 overnight).

My PRN hospitals are decent and I see 2 pph. Anywhere from 10-60 hours a month.

Remember 220-230 per month is my average, I sometimes work 240-260 hours a month.

I am happily married for 7 years, and have two children. I take plenty of vacations and I have plenty of holidays off (Christmas this year). You are right that I do not have a lot of free time for my own hobbies. But my wife and kids fill my life enough to not need personal hobbies. I also pay “people” to do all the mundane things in my life (maid, lawn mower, etc).

I save a ton of money, and my IRA/HSA/401ks are full every year plus 529s/wedding funds/inheritance funds for my kids and an additional brokerage account for me. I live in a “dream home” for normal people but nothing special for my Top 1% peers. My wife and I drive normal people vehicles. I live in a low cost area and no income tax state. I have no plans to retire early but I could retire today. My wife is a trust fund baby, but we live off my earnings.

It works for now but I will probably cut back to 180 hrs in 1.5 years then do that for 5 years.

 

[Tenk]

I work at multiple hospitals (full time one hospital, part time at another, and PRN at 3 hospitals).

My full time hospital is the absolute worst dumpster fire of an ED you can possibly imagine. The main hospital I see 1.8 pph (which is like moving 2.5 pph because of the hospital is total crap). The freestanding I see 2.5 pph. This freestanding sees 40,000 patients per year out of 8 beds. Sometimes I am seeing 4-6 patients per hr for multiple hours (4-6 hrs). The freestanding acuity is more of urgent care with needle in a haystack ER patient. I work 120-180 hours between main hospital and freestanding.

My part time hospital is a rural 0.5-0.7 pph, 6 bed ED. I work 48 hrs here (24 hr then 12 overnight then 12 overnight).

My PRN hospitals are decent and I see 2 pph. Anywhere from 10-60 hours a month.

Remember 220-230 per month is my average, I sometimes work 240-260 hours a month.

I am happily married for 7 years, and have two children. I take plenty of vacations and I have plenty of holidays off (Christmas this year). You are right that I do not have a lot of free time for my own hobbies. But my wife and kids fill my life enough to not need personal hobbies. I also pay “people” to do all the mundane things in my life (maid, lawn mower, etc).

I save a ton of money, and my IRA/HSA/401ks are full every year plus 529s/wedding funds/inheritance funds for my kids and an additional brokerage account for me. I live in a “dream home” for normal people but nothing special for my Top 1% peers. My wife and I drive normal people vehicles. I live in a low cost area and no income tax state. I have no plans to retire early but I could retire today. My wife is a trust fund baby, but we live off my earnings.

It works for now but I will probably cut back to 180 hrs in 1.5 years then do that for 5 years.

 

[Porfirio]

View attachment 377767

I grew up bottom middle class and worked hard all my life. I have seen all classes of people - old money ultra wealthy, middle class, and poor. My wife grew up old money wealthy. I have found them to have many problems in life because of lack of physical/mental challenge. I believe the mind will create challenge when not challenged on its own. I would rather work hard than deal with drugs, alcohol, depression, anxiety, boredom, social climbing stress, marital affairs, and failure loser children. When I met my wife, she had many problems. Now she has a mild amount (anxiety) and she is happy. We are happy. Our kids are happy. I am happy.

 

[cyanide12345678]

Right now, I'm working anywhere between 130-140 hours/month. All I know is that working four 10-12 hour shifts in a row is murderous in a 2pph min place. I also like to have a week off each month to decompress, travel, etc. I selfishly want to cut back my hours to a max of 120/month now that the student loans are gone. Am I asking too much? What's everyone else working? What do you all think is a sustainable or ideal number of shifts/hours for you?

We get full benefits and are full time at 0.6 FTE.

So that’s 8 x 12 hour shifts at my rural shop. 1 FTE at my rural shop is 13 x 12 hour shifts.

I’m personally down to 10 shifts with a plan to go down to 8 after 3 years.

 

[Janders]

Since we eat-what-we kill, you can work part time / half time and the rest of the group doesn't mind. Since some of your benefits are fixed-cost, you effectively make less $/hr if you work under full time, but its not a big deal when you change from 10 to 14 shifts.

I wouldn't purposefully hire someone that wanted to primarily work <50% FTE, though I'm sure appropriate versions of that exist. I would have some clinical concern if you wanted to, say, work 0.25FTE and didn't work elsewhere for an extended period.

Currently, people work from 6-14 x 9hr shifts month, with some getting other shifts elsewhere but most happy around 12.

 

[ScepticSkeksis]

I've often wondered about this "full time" nonsense. We aren't cubicle workers who have to be in the office every day for work. Shift workers should be able to choose how much they work. We'd have a lot less burnout in EM if people could work 4, 6, 10 or however shifts they want monthly at a job. The fixation on full time seems old fashioned and unnecessary in our field.

 

[xaelia]

I've often wondered about this "full time" nonsense. We aren't cubicle workers who have to be in the office every day for work. Shift workers should be able to choose how much they work. We'd have a lot less burnout in EM if people could work 4, 6, 10 or however shifts they want monthly at a job. The fixation on full time seems old fashioned and unnecessary in our field.

Adverse effect from the employer-sponsored benefit expectation typically associated with being "full time".

As noted above, there are fixed-cost outlays associated with benefits (malpractice, health insurance, etc.) degrading the palate for fractional workers.

Not to mention it's more difficult to manage a larger group of less-engaged workers.

 

[AlmostAnMD]

I've often wondered about this "full time" nonsense. We aren't cubicle workers who have to be in the office every day for work. Shift workers should be able to choose how much they work. We'd have a lot less burnout in EM if people could work 4, 6, 10 or however shifts they want monthly at a job. The fixation on full time seems old fashioned and unnecessary in our field.

From an administrative standpoint it has to do with benefits. This can cost a lot of money. Ours is exceptionally good--10k year CME, free excellent healthcare 10k on a loaded HSA card that can roll over from year to year--so if you have set 50 hrs as a minimum/month for full time docs vs 150 your benefits payments are going to be astronomical.

that's why when you're 1099 you just work....whatever you want. No bennies.

Ours is 135/month.

 

[Groove]

FT is 120 where I’m at. I work an average of 150 or so.

 

[Torsion]

130 hours for our employees - mainly dictated by hour health insurance provider. You can work part-time and get retirement benefits but not health care. Partners can work as little as they want within reason.

 

[Mount Asclepius]

I agree ‘full time’ is a little bit of an antiquated term. Also doesn’t really apply to physicians and specifically not to EPs. However, I don’t like the premise of trying to work as little as possible. There is value of work in life.

I think the philosophical approach boils down to whether or not you are an employee or an owner. Physicians should be owners in my opinion. It’s a profession and shouldn’t be marginalized by the broader business community. Employment benefits are primarily offered to entice employees to pick a position over alternative options. As physicians we obtain those benefits either way given our higher compensation. Just depends on if part of a total benefits package or paying for separately out of pocket after being paid.

Work as much or as little as you want. The main difference is total compensation. My personal opinion is that one should work a graded number of hours over their career gradually decreasing number of hours allowing for more freedom to choose how you spend your time when you are older. For example, work greater than ‘full time’ first 5-10 years out of residency, full time for the next 5-10, then potentially part time until you hang it up.

Don’t work 200+ hours a month long term. You won’t have the reward of spending that money in your golden years or having ‘free time’ then if you unluckily get cancer or die from accidental trauma at a young age. Find the right balance during every phase.

 

[Tenk]

I grew up bottom middle class and worked hard all my life. I have seen all classes of people - old money ultra wealthy, middle class, and poor. My wife grew up old money wealthy. I have found them to have many problems in life because of lack of physical/mental challenge. I believe the mind will create challenge when not challenged on its own. I would rather work hard than deal with drugs, alcohol, depression, anxiety, boredom, social climbing stress, marital affairs, and failure loser children. When I met my wife, she had many problems. Now she has a mild amount (anxiety) and she is happy. We are happy. Our kids are happy. I am happy.

That’s actually great that you have that mentality. I grew up poor. My dad left my mom and she raised me and my sister. You aren’t wrong, it’s good to have drive.

However, working that much in the ED when you don’t need to is literally destroying your body. There’s enough studies out there that show shift work shortens lives. Also, I have no idea how much you exercise, but I have trouble fitting in all my work outs with just 140 hours a month, 220-230 would be nearly impossible. You don’t have to fill the 100 hours you could potentially shave off with drugs or vice either. You could just pick up a sport or exercise and just have a healthier, even happier life. Just something to think about.

 

[ScepticSkeksis]

From an administrative standpoint it has to do with benefits. This can cost a lot of money. Ours is exceptionally good--10k year CME, free excellent healthcare 10k on a loaded HSA card that can roll over from year to year--so if you have set 50 hrs as a minimum/month for full time docs vs 150 your benefits payments are going to be astronomical.

that's why when you're 1099 you just work....whatever you want. No bennies.

Ours is 135/month.

Just assign a dollar amount to benefits and employer payroll tax, and pro-rate that based on hours worked. It doesn't sound like it's astrophysics to figure it out.

 

[gutonc]

Just assign a dollar amount to benefits and employer payroll tax, and pro-rate that based on hours worked. It doesn't sound like it's astrophysics to figure it out.

Every (ok...both) health system I have worked for pro-rates benefits based on FTE. This includes insurance coverage, retirement contributions, basically everything except for malpractice. It's pretty easy to figure out. Some health systems/employers are willing to do it, others (Kaiser...cough) aren't.

 

[Porfirio]

That’s actually great that you have that mentality. I grew up poor. My dad left my mom and she raised me and my sister. You aren’t wrong, it’s good to have drive.

However, working that much in the ED when you don’t need to is literally destroying your body. There’s enough studies out there that show shift work shortens lives. Also, I have no idea how much you exercise, but I have trouble fitting in all my work outs with just 140 hours a month, 220-230 would be nearly impossible. You don’t have to fill the 100 hours you could potentially shave off with drugs or vice either. You could just pick up a sport or exercise and just have a healthier, even happier life. Just something to think about.

Thank you for the suggestion. I do not exercise as much as I wish I could (twice a week). But I do have a nice home gym - rower, treadmill, all the free weights, peloton (wife’s), recumbent bike, squat rack, etc. I do have a bit of a dad bod these days compared to medical school and residency.