Job security in medicine

[deleted171991]

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Let me make my haters happy:
Job Security in Medicine is a Myth | Passive Income M.D.

"Imagine, if you will, that you’re an anesthesiologist. You’ve been part of a successful practice for over 10 years. You can walk down your neighborhood street and run into mothers whose epidurals you’ve helped place. You’ve established a home, a community, and your children are in a great school system.

One uneventful day, say Wednesday, you get an email from the hospital administrators announcing that there’s going to be a meeting on Friday. You’re not sure what it could be about, but you don’t give it much thought.

When Friday rolls around, you discover that the meeting was held to inform you that the contract for your group has not been renewed and a new national practice management company will be taking over all anesthesia services shortly. Details are pending, but from what you’ve heard, you will have the option to stay on board and accept 30% less than what you’re making now or move on.

Sound impossible? Unfortunately, based on several accounts from close friends and colleagues in just the past few years, this situation is more common than you’d think."

This thread is for all the premeds who are so trigger-happy when investing into a career in medicine, and for all the medical students who don't think about the realities of the specialties they are applying for.

Some of the best parts are in the comments, such as:
"Dr. Cory S. Fawcett June 26, 2018 at 11:08 am

I witnessed a doctor, who had worked for a hospital for many years, get called into the admin office and fired. No warning, no option to look into the matter, just fired.

We used to live in a society that fixed things that were broken. If you did something wrong, the company had a lot invested in you so they called you in to repair the problem. Now we live in a throw away society. If something doesn’t work right, we don’t fix it, we throw it away and get another one. Fire this guy and bring in a new one. If you find a doctor who will work for less, switch to the new doctor.

I had a bad battery in my cell phone and went in for a new one. The kid behind the counter looked at the phone and said I shouldn’t get a new battery, I should get a new phone. There was nothing wrong with my phone, but it wasn’t the latest model. He started explaining to me all the features the new model had that mine didn’t. I went somewhere else and got a new battery.

The throw away mentality makes jobs very insecure now a days. We all should feel a little bit like a fish in a blender. You never know when someone might turn on the blender and end it all. All the more reason to become financially independent as soon as possible. Then if you are dropped from the medical staff suddenly, it won’t matter."

"Nana Korsah July 3, 2018 at 3:52 pm

I love this post. Multiple streams of income with a big chunk of it being passive is the way to go. 3 years ago I was feeling burnt out due to 80-100HR work weeks, and I had 2 little children. I discovered Dave Ramsey, James Altucher, Locums, Joshua Sheets, and life coaching not necessarily in that order. I left my nephrology partnership job best decision of my life. Did locums as hospitalist worked like crazy for a year to pay off my 260K student loan. I maxed out my 401K, researched and got very interested in real estate. I think hands down that is the best path to financial freedom. Even if you do wnd up in early retirement you can access your money without penalties unlike traditional 401ks. After paying off my debt, and getting a 6 month emergency fund I cut back on locum hours, I reverse engineer the number of shifts needed based on what income I want to make annually. I ‘m still credentialed at multiple hospitals so I consistently get shifts even if it’s 2 per facility because I have 5 of them I’m able to meet my goal of 7shifts a month. The best paRt is I don’t have to travel for locums anymore. Working less shifts has given me a chance to build my side biz as a transformational life coach who works with physicians who struggle with work life balance like I did. I get to live my life through a cooperation which is one of the best ways to save on taxes. Also thanks to Joshua Sheet from radical personal finance podcast I finally moved to the income tax free state of Tx yay! I love this blog, WCI out there who have done a great job educating physicians on personal finance. Generating awareness for physicians on personal finance is the best way to take our back, and not rely on the status quo. Happy July 4th. Claim your freedom by getting your finances in order. Our field is going through an unpleasant transition, but like Dave Ramsey says we still have big shovels which can be leveraged to live life, and practice medicine on our own terms."

 

[The Physician Philosopher]

The job is definitely not as secure as people make it out to be. It shows the importance of asset protection, and not just in the sense of disability insurance.

Asset protection also includes side hustle income, real estate income, locums opportunities, and an emergency fund to bridge the gap if it ever becomes necessary.

I know some people aren't a proponent of emergency funds for docs. Unless you have a ton of passive income coming in or you are married to another high income earner, I've always found this foolish.

The only person who is going to truly look out for your own self interest is you.

Sent from my XT1710-02 using Tapatalk

 

[pgg]

My job is totally secure. Why, it's so secure, that if I quit, they'd come looking for me to bring me back. That's how much they appreciate me.

 

[deleted126335]

My job is totally secure. Why, it's so secure, that if I quit, they'd come looking for me to bring me back. That's how much they appreciate me.

And you great benefits. In addition to the enhanced job security, you are being paid less than a civilian, separated from your family for long stretches of time, and the off chance of being killed.

 

[deleted171991]

The worse a job is, the more secure (usually).

 

[NITRAS]

I think it is healthy to realize that security is an illusion, and our only job security is our ability to monetize our gifts, talents, and skills.

Times change. I like my job, but most likely won’t be in this job or in this house in ten years. That’s ok. Specialities are going to change. It wasn’t too long ago Derm, EM, and anesthesia were for people who couldn’t hack surgery or IM. Not the case anymore.

The more debt you have, the more you paint yourself into a corner.

 

[deleted126335]

The worse a job is, the more secure (usually).

Ding. Ding. You named the most common characteristic of job security in anesthesia today.

 

[deleted875186]

I think people are misunderstanding job security. Medicine still has a lot of security. If you loose your job, there is a high likelihood you can find another more easily than many other types of careers. And youre more likely to be able to find a job throughout he country, rather than just in big cities.

 

[pgg]

And you great benefits. In addition to the enhanced job security, you are being paid less than a civilian, separated from your family for long stretches of time, and the off chance of being killed.

Well, yeah, there's all that. 🙂

I am 8,456 miles from home right now ...

 

[Consigliere]

Job security in medicine is an oxymoronic statement and FFP, as is often the case, is right.

 

[IMGASMD]

I think there is also the fact that anesthesia, Rads, EM and even hospitalist is what I considered as “service” subset of medicine. We don’t bring any patients to the hospital, we will always be at the mercy of the big brother.

IM, FM, surgery and even Peds can always go concierge. I do remember someone mentioned s/he still does a lot of cash for service at endoscopy centers. I do recognize there are different levels of job security that we are talking about here tho.

 

[thinkorswim]

You guys are confusing "job" security with "income and lifestyle" security.

Can our incomes and work hours change on the whim of a boardroom meeting? Sure. But this is also true for just about any other career out there.

Will we as physicians ever face a sky high unemployment rate in the event of a recession? Unlikely. We will always have a job, with some form of income, to put food on the table and a roof over our heads. Count your blessings on that one.

 

[deleted87051]

Anesthesia and medicine in general are still one of the most secure jobs around. For example, even in a worst case scenario like Charlotte, I doubt any of the displaced Mednax anesthesiologists will remain unemployed for long. There is essentially a 0% unemployment rate for anesthesiologists and the demand is still growing.

 

[AdmiralChz]

You guys are confusing "job" security with "income and lifestyle" security.

Can our incomes and work hours change on the whim of a boardroom meeting? Sure. But this is also true for just about any other career out there.

Will we as physicians ever face a sky high unemployment rate in the event of a recession? Unlikely. We will always have a job, with some form of income, to put food on the table and a roof over our heads. Count your blessings on that one.

Yes. This thread is so negative and doom/gloom it’s funny/sad. Surely some of you guys have friends in business (ESPECIALLY banking) and law - they can literally be without a job by the end of the day and have zero offer to stay on, benefits ended at the whims of the executive suite. Not so easy in medicine.

Hard to take this thread seriously.

 

[AdmiralChz]

And yes, there are bad jobs out there. Jobs where you’re a cog, working a lot. But you’ll still make a boatload and are guaranteed to find something if you’re flexible.

This isn’t true in other professional fields, especially as one ages.

Do we have perfect job security and never have to worry? Of course not. But find me a lawyer, banker, broker, etc that wouldn’t kill for the security we do have.

 

[aneftp]

Had long discussion with the mba/md who’s been around the block. They do cost analysis for many hospitals.

The bottom line is if you are a good doctor. You are gonna to stil have a job. Even if they cut cost and let you go. You will find another job easy if you are a competent doctor.

It’s the incompetent doctors who ride out for years and years. Than they get let go. They will be screwed.

So as anesthesiologists. Keep up your skills. Even if you are 99% supervising. Nothing wrong with starting a case on ur own or doing ur own intubations once in a while. Don’t get lazy. But I’ve seen some MD go 5 years without intubations. It’s crazy. Than they turn 60 and haven’t done their own cases and get let go. They screwed.

 

[deleted643396]

Yes. This thread is so negative and doom/gloom it’s funny/sad. Surely some of you guys have friends in business (ESPECIALLY banking) and law - they can literally be without a job by the end of the day and have zero offer to stay on, benefits ended at the whims of the executive suite. Not so easy in medicine.

Hard to take this thread seriously.

I don’t think this thread is negative at all. It’s realistic. If anything, it’s optimistic. **** happens, but if you prepare you will be just fine. There’s good advice here. Maybe change the title to “life security” instead of “job security.” Change is inevitable. Those who prepare are the ones who can weather any storm.

 

[shepardsun]

On a somewhat tangential note, does anyone have any interesting/productive side hustles other than the standard investing and/or real estate games? Always on the look out for them, particularly as a resident without the capital for significant forays into the aforementioned standard ones.

 

[pgg]

On a somewhat tangential note, does anyone have any interesting/productive side hustles other than the standard investing and/or real estate games? Always on the look out for them, particularly as a resident without the capital for significant forays into the aforementioned standard ones.

The best side hustle is moonlighting as a locums anesthesiologist, followed by spending less money / living below your means. 🙂

Hard to beat our hourly rate.

 

[anbuitachi]

On a somewhat tangential note, does anyone have any interesting/productive side hustles other than the standard investing and/or real estate games? Always on the look out for them, particularly as a resident without the capital for significant forays into the aforementioned standard ones.

There are anesthesiologists who run IV business for hangovers

 

[narcotics999]

Yes. This thread is so negative and doom/gloom it’s funny/sad. Surely some of you guys have friends in business (ESPECIALLY banking) and law - they can literally be without a job by the end of the day and have zero offer to stay on, benefits ended at the whims of the executive suite. Not so easy in medicine.

Hard to take this thread seriously.

When people in other fields are laid off, they often get a package, a couple months of salary.

When we are let off, we get nothing. Looking for another job and credentialing takes a long time. Fortunately we often have some kind of advance notice.

 

[deleted87051]

The best side hustle is moonlighting as a locums anesthesiologist, followed by spending less money / living below your means. 🙂

Hard to beat our hourly rate.

Or pick up extra work at your primary job. It’s easy and convenient.

 

[deleted87051]

When people in other fields are laid off, they often get a package, a couple months of salary.

When we are let off, we get nothing. Looking for another job and credentialing takes a long time. Fortunately we often have some kind of advance notice.

If you’re in PP you’ll have several months of accounts receivable.

 

[shepardsun]

Or pick up extra work at your primary job. It’s easy and convenient.

The best side hustle is moonlighting as a locums anesthesiologist, followed by spending less money / living below your means. 🙂

Hard to beat our hourly rate.

I'm still a resident and my program doesn't allow moonlighting, which is doubly unfortunate because I'm also a pediatrician and could very easily make a dent in my student loans on the weekend doing hospitalist work as well.

There are anesthesiologists who run IV business for hangovers

I wonder if you need license/malpractice insurance for this?

 

[narcotics999]

If you’re in PP you’ll have several months of accounts receivable.

Well, yes, the income after termination is not zero. However, when you join another pp, in the first few months the income is low. The net loss is the same.

 

[IMGASMD]

I'm still a resident and my program doesn't allow moonlighting, which is doubly unfortunate because I'm also a pediatrician and could very easily make a dent in my student loans on the weekend doing hospitalist work as well.



I wonder if you need license/malpractice insurance for this?

Not allowed? There should be institution or state laws about this right?

 

[shepardsun]

Not allowed? There should be institution or state laws about this right?

GME rules for the institution state that moonlighting is allowed with PD approval, PD chooses not to approve.

 

[urge]

Let me make my haters happy:
Job Security in Medicine is a Myth | Passive Income M.D.

"Imagine, if you will, that you’re an anesthesiologist. You’ve been part of a successful practice for over 10 years. You can walk down your neighborhood street and run into mothers whose epidurals you’ve helped place. You’ve established a home, a community, and your children are in a great school system.

One uneventful day, say Wednesday, you get an email from the hospital administrators announcing that there’s going to be a meeting on Friday. You’re not sure what it could be about, but you don’t give it much thought.

When Friday rolls around, you discover that the meeting was held to inform you that the contract for your group has not been renewed and a new national practice management company will be taking over all anesthesia services shortly. Details are pending, but from what you’ve heard, you will have the option to stay on board and accept 30% less than what you’re making now or move on.

Sound impossible? Unfortunately, based on several accounts from close friends and colleagues in just the past few years, this situation is more common than you’d think."

This thread is for all the premeds who are so trigger-happy when investing into a career in medicine, and for all the medical students who don't think about the realities of the specialties they are applying for.

Some of the best parts are in the comments, such as:
"Dr. Cory S. Fawcett June 26, 2018 at 11:08 am

I witnessed a doctor, who had worked for a hospital for many years, get called into the admin office and fired. No warning, no option to look into the matter, just fired.

We used to live in a society that fixed things that were broken. If you did something wrong, the company had a lot invested in you so they called you in to repair the problem. Now we live in a throw away society. If something doesn’t work right, we don’t fix it, we throw it away and get another one. Fire this guy and bring in a new one. If you find a doctor who will work for less, switch to the new doctor.

I had a bad battery in my cell phone and went in for a new one. The kid behind the counter looked at the phone and said I shouldn’t get a new battery, I should get a new phone. There was nothing wrong with my phone, but it wasn’t the latest model. He started explaining to me all the features the new model had that mine didn’t. I went somewhere else and got a new battery.

The throw away mentality makes jobs very insecure now a days. We all should feel a little bit like a fish in a blender. You never know when someone might turn on the blender and end it all. All the more reason to become financially independent as soon as possible. Then if you are dropped from the medical staff suddenly, it won’t matter."

"Nana Korsah July 3, 2018 at 3:52 pm

I love this post. Multiple streams of income with a big chunk of it being passive is the way to go. 3 years ago I was feeling burnt out due to 80-100HR work weeks, and I had 2 little children. I discovered Dave Ramsey, James Altucher, Locums, Joshua Sheets, and life coaching not necessarily in that order. I left my nephrology partnership job best decision of my life. Did locums as hospitalist worked like crazy for a year to pay off my 260K student loan. I maxed out my 401K, researched and got very interested in real estate. I think hands down that is the best path to financial freedom. Even if you do wnd up in early retirement you can access your money without penalties unlike traditional 401ks. After paying off my debt, and getting a 6 month emergency fund I cut back on locum hours, I reverse engineer the number of shifts needed based on what income I want to make annually. I ‘m still credentialed at multiple hospitals so I consistently get shifts even if it’s 2 per facility because I have 5 of them I’m able to meet my goal of 7shifts a month. The best paRt is I don’t have to travel for locums anymore. Working less shifts has given me a chance to build my side biz as a transformational life coach who works with physicians who struggle with work life balance like I did. I get to live my life through a cooperation which is one of the best ways to save on taxes. Also thanks to Joshua Sheet from radical personal finance podcast I finally moved to the income tax free state of Tx yay! I love this blog, WCI out there who have done a great job educating physicians on personal finance. Generating awareness for physicians on personal finance is the best way to take our back, and not rely on the status quo. Happy July 4th. Claim your freedom by getting your finances in order. Our field is going through an unpleasant transition, but like Dave Ramsey says we still have big shovels which can be leveraged to live life, and practice medicine on our own terms."

And your point is?

 

[BLADEMDA]

Had long discussion with the mba/md who’s been around the block. They do cost analysis for many hospitals.

The bottom line is if you are a good doctor. You are gonna to stil have a job. Even if they cut cost and let you go. You will find another job easy if you are a competent doctor.

It’s the incompetent doctors who ride out for years and years. Than they get let go. They will be screwed.

So as anesthesiologists. Keep up your skills. Even if you are 99% supervising. Nothing wrong with starting a case on ur own or doing ur own intubations once in a while. Don’t get lazy. But I’ve seen some MD go 5 years without intubations. It’s crazy. Than they turn 60 and haven’t done their own cases and get let go. They screwed.

By age 60 they should have a decent nest egg. For those just starting out this is a valuable lesson to try to stay married to one spouse and save up a F U account. By age 60 you should have the option of fulltime vs part-time employment. If this isn't the case something went terribly wrong (e.g., 2 ex-wives receiving alimony).

 

[gasdoc77]

By age 60 they should have a decent nest egg. For those just starting out this is a valuable lesson to try to stay married to one spouse and save up a F U account. By age 60 you should have the option of fulltime vs part-time employment. If this isn't the case something went terribly wrong (e.g., 2 ex-wives receiving alimony).

What anesthesia practice setting do you think will change the least over the next 30 years Blade? From all the stories I keep reading and hearing about firsthand from friends, I am glad I stayed in academics.

 

[aneftp]

What anesthesia practice setting do you think will change the least over the next 30 years Blade? From all the stories I keep reading and hearing about firsthand from friends, I am glad I stayed in academics.

Academics is always a safe position (assuming it’s not one of slave driving academic jobs where you don’t get non clinical days and working just as many hours as those in private sector world (46-52 hours is the true average work hours).

It’s the spending that gets out of control in the private sector. You can easily earn 100k more a year over academic. And sometimes up to 300k more a year.

So do the simple math. Spread of 20 years. Someone in private practice should have 1 million-3 million more saved than private sector. But many spent it.

 

[pgg]

I'm still a resident

Ah, missed that. If you were one of our residents then you'd be prohibited from ALL off duty remunerative employment, and possibly some kinds of volunteer work too. We can do that because we're the military and we get to boss people around, but in a broad general sense I think residents shouldn't be working side jobs.

No matter how strong a resident is, extra working time ought to be going toward becoming a better anesthesiologist. I recognize that finances can be tough during residency, for a whole lot of self inflicted and non self inflicted reasons, and some residents have a hard choice to make there. If your side gig objective is investing or early retirement though, I think your priorities are a little out of whack.

In house moonlighting is a special case because there's experience to be gained.

 

[shepardsun]

No matter how strong a resident is, extra working time ought to be going toward becoming a better anesthesiologist.

I respect your opinion, and am thankful for your service (am also considering joining the reserves at some point down the line). However to me that argument could be extended toward any activity that isn't reading Miller obsessively or volunteering to place pre-op IVs until you never miss one, Bruce Lee style.

What is the difference between working time and things like family or leisure time? I don't have kids and would actually find a couple of hospitalist shifts relaxing in a way. I'm nowhere close to violating ACGME hours, and there is plenty of time that could be spent moonlighting and keep me under the 80 hour/week over 4 cap.

Sorry, I know I'm straw manning you for all of the things I keep in my head but want to say to my program 😛

 

[pgg]

I see your point, and ultimately there are a lot of individual factors and judgment involved, but time spent with family or watching TV or is needed mental health time.

It's a rare person that gets that kind of relaxing / recharge time from work.

80 hours total may be under the work hour limits but 80 hours is still a brutal week, and potentially soul crushing if it's a routine.

 

[dannyboy1]

I respect your opinion, and am thankful for your service (am also considering joining the reserves at some point down the line). However to me that argument could be extended toward any activity that isn't reading Miller obsessively or volunteering to place pre-op IVs until you never miss one, Bruce Lee style.

What is the difference between working time and things like family or leisure time? I don't have kids and would actually find a couple of hospitalist shifts relaxing in a way. I'm nowhere close to violating ACGME hours, and there is plenty of time that could be spent moonlighting and keep me under the 80 hour/week over 4 cap.

Sorry, I know I'm straw manning you for all of the things I keep in my head but want to say to my program 😛

Agree. We are all adults. Your program director does not get to tell you how much time to spend with your family, when to go to sleep, how much Netflix to watch ect. They also should not have a say if you choose to find employment outside of work. There are (supposedly) objective and measurable criteria which are used to evaluate a resident's progress. So long as he is meeting these milestones what he does in his free time should be none of anyone's business.

 

[IMGASMD]

Agree. We are all adults. Your program director does not get to tell you how much time to spend with your family, when to go to sleep, how much Netflix to watch ect. They also should not have a say if you choose to find employment outside of work. There are (supposedly) objective and measurable criteria which are used to evaluate a resident's progress. So long as he is meeting these milestones what he does in his free time should be none of anyone's business.

@shepardsun, if you truly finished Peds residency, “I” would not consider you moonlighting. My thought process is that let’s say I am an electrician before my residency career (torture/low wage work/abuse or whatever you want to call it). I am really strapped for cash while in residency, do I need my PDs blessing if I go out and wire someone’s house?

I am sure I will get some blow back from this crowd..... but that’s one way I can rationalize it. What’s that saying again? “ask forgiveness rather than permission.” Obviously don’t mess up at your current residency, because if you get caught, certainly ground for disciplinary actions. I think there is a thread somewhere someone got caught moonlight, (I assume while doing first residency), was fired because the program director’s wife happened to go to that ED while he’s taking an shift......

Risk/benefit analysis. Good luck!

 

[pgg]

I totally agree, as a libertarian from the non crackpot wing of the party, I firmly and enthusiastically believe in individual choice, responsibility, and freedom in all things. And the dirty little secret of freedom is you're on your own, you screw it up, it's on you.

However. On this topic, I think a lot of moonlighters underestimate the academic risk.

By all means do what you think is best, where "best" is some value of graduating with excellence while avoiding time in the PD's office giving explanations. 🙂

I'll just close by saying I was a mediocre med student with a non-medical side job, and I was an excellent resident who didn't have a non-medical side job. There are confounders in my personal story, sure, but in retrospect the incremental bump in lifestyle and savings side work got me as a student wasn't worth the distraction and angst over subsequent applications for higher learning that were less than they could have been ...

Residency is short. Stay focused and grind it out, but let your time off be time off. JMHO, YMMV, etc. 🙂

 

[shepardsun]

@shepardsun, if you truly finished Peds residency, “I” would not consider you moonlighting. !

Board certified, baby 🙂

I appreciate everyone's perspective and comments and apologize for the slight derailment of the thread. I understand where most people are coming from, even my PD, and I'm very respectful of my primary responsibility to learn anesthesia. Entertained no thoughts whatsoever about moonlighting when I was a CA-1 on the steepest learning curve of my life AND studying for peds boards.

Most of the problem stems from the fact that I'm feeling attending level loans on a resident salary, but that's another story. That's why I was hoping for a magical non-clinical side hustle tip from this thread!

 

[Planktonmd]

My job is totally secure. Why, it's so secure, that if I quit, they'd come looking for me to bring me back. That's how much they appreciate me.

LOL

Well, yeah, there's all that. 🙂

I am 8,456 miles from home right now ...

And you have internet access! that's just amazing!

 

[IMGASMD]

Board certified, baby 🙂

I appreciate everyone's perspective and comments and apologize for the slight derailment of the thread. I understand where most people are coming from, even my PD, and I'm very respectful of my primary responsibility to learn anesthesia. Entertained no thoughts whatsoever about moonlighting when I was a CA-1 on the steepest learning curve of my life AND studying for peds boards.

Most of the problem stems from the fact that I'm feeling attending level loans on a resident salary, but that's another story. That's why I was hoping for a magical non-clinical side hustle tip from this thread!

I then definitely won’t consider you moonlighting. You’re using your own skill set. I don’t think there is any side hustle that can guarantee $100+/hr. I had a friend who day trade on the side in med school. Usually start with 600, maybe a few times cracked a grand by end of the day. Or count cards, learning a new skill that’s not medically related. 😉

 

[pgg]

LOL

And you have internet access! that's just amazing!

Even war zones have pretty good wifi these days. 14 years ago when I was camping with Marines on the border of Pakistan we mail ordered a satellite modem and dish and hooked ourselves up. $4,000/month for a dedicated 1 mbps downlink and 256 kbps uplink. It's gotten a lot easier and cheaper.

This trip, I'm not in a war zone, though. A $6 prepaid sim card for my phone got me two months of unlimited 4G data good enough to stream HD movies. A VPN and Fubo subscription got me all the World Cup games in English. While that $3/month bill just underscores how unbelievably badly AT&T etc are screwing us in the states, it also demonstrates just how civilized the uncivilized 3rd world has become. In some ways.

 

[Twiggidy]

And yes, there are bad jobs out there. Jobs where you’re a cog, working a lot. But you’ll still make a boatload and are guaranteed to find something if you’re flexible.

This isn’t true in other professional fields, especially as one ages.

Do we have perfect job security and never have to worry? Of course not. But find me a lawyer, banker, broker, etc that wouldn’t kill for the security we do have.

There is always work out there for an anesthesiologist, you just may need to be willing to live in the stix (or driving 2hrs to the stix)

 

[Twiggidy]

And by the way, I would love some passive income so I don't have to be "married" to my job. "Shyte" does happen and it would be nice that if that "shyte" does hit the fan that I wouldn't have to worry about making ends meet. I dont have much a support system to teach me to take certain risks so it's a bunch of small steps and learning on my own. Soon I'll make that big move though, because I dont want to need to take call when I'm 70, or even 60, if I'm lucky 50.

 

[deleted171991]

Agree. We are all adults. Your program director does not get to tell you how much time to spend with your family, when to go to sleep, how much Netflix to watch ect. They also should not have a say if you choose to find employment outside of work. There are (supposedly) objective and measurable criteria which are used to evaluate a resident's progress. So long as he is meeting these milestones what he does in his free time should be none of anyone's business.

A lot of attending contracts contain a clause about not being allowed to work in other places without the consent of the employer. I have seen it both in academia and PP. I am not saying it's right.

I assume this is important for employers because one cannot overwork an employee who's been already overworked elsewhere. 🙂

 

[Twiggidy]

I see your point, and ultimately there are a lot of individual factors and judgment involved, but time spent with family or watching TV or is needed mental health time.

It's a rare person that gets that kind of relaxing / recharge time from work.

80 hours total may be under the work hour limits but 80 hours is still a brutal week, and potentially soul crushing if it's a routine.

Not to mention that the theory behind residency is that when you're not working you're supposed to be studying. We all know the root behind why it's called "residency". I agree that in-house field specific moon-lighting should be done if allowed.

 

[Twiggidy]

Board certified, baby 🙂

I appreciate everyone's perspective and comments and apologize for the slight derailment of the thread. I understand where most people are coming from, even my PD, and I'm very respectful of my primary responsibility to learn anesthesia. Entertained no thoughts whatsoever about moonlighting when I was a CA-1 on the steepest learning curve of my life AND studying for peds boards.

Most of the problem stems from the fact that I'm feeling attending level loans on a resident salary, but that's another story. That's why I was hoping for a magical non-clinical side hustle tip from this thread!

Uber/Lyft driver.....and i'm actually being serious. It can be quite anonymous unless you pick up someone from your dept

 

[resiroth]

You guys are confusing "job" security with "income and lifestyle" security.

Can our incomes and work hours change on the whim of a boardroom meeting? Sure. But this is also true for just about any other career out there.

Will we as physicians ever face a sky high unemployment rate in the event of a recession? Unlikely. We will always have a job, with some form of income, to put food on the table and a roof over our heads. Count your blessings on that one.

Exactly. While reimbursement may decline, I think a lot of people (including myself on occasion) forget how crazy 2008 was. Or the dot com bust. In a recession a lot of stuff is scaled back, but generally not healthcare spending. You might make less, but you'll have a job. In 2008 unemployment was at 10%. Kind of crazy.

I also agree most of the advice about saving early is key. Want some passive income? You could spend a bunch of time trying to make a blog or something...or just invest money into the stock market (broadly). After all, dividends are about as passive (and reliable) as you can get. I'm less pessimistic compared to others here (partially because my lifestyle is sub 30k, so I am not in the same position as some docs going from 500 to 400 or 350) but I think preparing for the worst is always reasonable. Live frugally at the start, and slowly increase your lifestyle. It's a lot easier to "cut back" in response to a pay cut if cutting back means the same lifestyle (say living on 100-150k) with 20% less money going into the fidelity account after all.

 

[Shimmy8]

I AirBNB my house out regularly, looking to buy another so I can move and rent my current house full time.

I pick up all kinds of extra time within my group, and have been approached about IV fluid businesses and maybe a ketamine clinic.

But my real dream is to open a doggy daycare in my young professional neighborhood.

Never be afraid to hustle.

 

[anbuitachi]

I AirBNB my house out regularly, looking to buy another so I can move and rent my current house full time.

I pick up all kinds of extra time within my group, and have been approached about IV fluid businesses and maybe a ketamine clinic.

But my real dream is to open a doggy daycare in my young professional neighborhood.

Never be afraid to hustle.

Is airbnb worth it? Here a 1 bedroom rent is about 2-3000 per month for rent on average. Unless you are filling up your airBNB everyday, it's hard or you wont make much more with airbnb vs renting especially factoring in the cost and effort of cleaning/organization the place every time the person leaves. Hotels here are about 200s per night so chances are your airbnb price will be lower

 

[Shimmy8]

I live in a unique destination city that has a serious hotel shortage at the moment. It’s very worth it to me.