Normal Vacation Amounts for Pain

[foxtrot]

I have been job hunting and got an offer with descent pay but with 3 weeks of vacation. This seems like a very low amount but everyone in the group takes this amount of time off. Obviously, I don't want to be the outlier. Is 3 weeks the norm for most pain groups? I worry that I might burn out seeing 20-30 pain patients a day with less vacation than residency. Any input would be appreciated.

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[lobelsteve]

I have been job hunting and got an offer with descent pay but with 3 weeks of vacation. This seems like a very low amount but everyone in the group takes this amount of time off. Obviously, I don't want to be the outlier. Is 3 weeks the norm for most pain groups? I worry that I might burn out seeing 20-30 pain patients a day with less vacation than residency. Any input would be appreciated.

I get unlimited vacation. I take 1 week per year outside of speaking and conferences. 13 yrs of training after HS just seems pointless if I cannot use it everyday. I just don't like relaxing.

 

[ghost dog]

I have been job hunting and got an offer with descent pay but with 3 weeks of vacation. This seems like a very low amount but everyone in the group takes this amount of time off. Obviously, I don't want to be the outlier. Is 3 weeks the norm for most pain groups? I worry that I might burn out seeing 20-30 pain patients a day with less vacation than residency. Any input would be appreciated.

I take about 4 weeks / year. 1 week at a time.

 

[bedrock]

I have been job hunting and got an offer with descent pay but with 3 weeks of vacation. This seems like a very low amount but everyone in the group takes this amount of time off. Obviously, I don't want to be the outlier. Is 3 weeks the norm for most pain groups? I worry that I might burn out seeing 20-30 pain patients a day with less vacation than residency. Any input would be appreciated.

I take 3 weeks a year. 2 separate one-week vacations and the other week spread around in 3-day weekends.

 

[lonelobo]

I take 7-8 weeks a year....life is too short to work all the time

of course I am self employed, for employed position would ask for minimum of 4 weeks

 

[specepic]

I also get 3 weeks which also seemed low to me but they also have 2 weeks of CME. How much CME are they offering? IF you really need more time off you will have to give on something else, like salary, ultimately they have to pay the bills...

 

[SSdoc33]

i think for a lot of us, it comes come to the $$$. sure, we can take more vacation, but that means that less money / bonus on the other end. its tough to rationalize a week off of work when it may cost you 10K. that being said, i would guess that around 3 weeks off/year is not all that unusual

 

[101N]

i think for a lot of us, it comes come to the $$$.

1+

 

[lonelobo]

i think for a lot of us, it comes come to the $$$. sure, we can take more vacation, but that means that less money / bonus on the other end. its tough to rationalize a week off of work when it may cost you 10K. that being said, i would guess that around 3 weeks off/year is not all that unusual

Ya but what good is all that money ... when your your wheeling around in your Rascal looking for your dentures

I am amazed at my relatively young friends who don't take vacation or time off when they are young and healthly and can enjoy it

 

[SSdoc33]

Ya but what good is all that money ... when your your wheeling around in your Rascal looking for your dentures

I am amazed at my relatively young friends who don't take vacation or time off when they are young and healthly and can enjoy it

preaching to the choir. i gotta let (make) myself take more time off. im sure a lot of us are in that boat.

 

[foxtrot]

You get money for CME but no extra time off. Not that I am a slacker, but I just can't take less vacation than what I had in residency. Life is too short to work your *&^ into the ground. I have been out of training a couple of years so this would definitely be a big drop in vacation time from my current gig. Thanks for the responses.

 

[specepic]

You get money for CME but no extra time off. Not that I am a slacker, but I just can't take less vacation than what I had in residency. Life is too short to work your *&^ into the ground. I have been out of training a couple of years so this would definitely be a big drop in vacation time from my current gig. Thanks for the responses.

ok, if the 3 weeks includes both vacation and CME that is no good. If you are otherwise in love with the job and they won't budge, then just take unpaid time or lower the salary and have it be paid time off. I was going to b*tch about my 3 weeks vacation until I realized the 2 weeks CME (with a juicy travel stipend) was also vacation of sorts, with them paying the travel, meals, etc...😛 I go somewhere for a conference, my wife joins me and shops, etc.

 

[Jcm800]

You get money for CME but no extra time off. Not that I am a slacker, but I just can't take less vacation than what I had in residency. Life is too short to work your *&^ into the ground. I have been out of training a couple of years so this would definitely be a big drop in vacation time from my current gig. Thanks for the responses.

i think the way we work and the BS we put up with, gotta do at least 4-5 weeks (this can include CME) especially if no weekends.

when i started this practice i took 2 weeks, but a day here and there also, and then 3 weeks, now im taking 5-6 weeks, because **** it! i gotta have some fun too. my kids get everyhing, my wife gets everything, the government gets 40%... dammit i am gonna play some golf!

 

[Tenesma]

when you are starting a practice, taking frequent time off for vacations, is not conducive to buidling that practice.... availability is what helps cement referral patterns.

i'd rather a new hire take 2-3 weeks of vacation and then 3-5 personal days per month (for long weekends) - instead of 5-6 weeks vacation for the first year or so... after the 1st year, I don't care how many weeks of vacation - with the understanding that it is eat what you treat...

so most of us on this board (on average) do not take much vacation - because
a) we are either solo
b) nuts or
c) we can't stand the thought of losing 4-5k/day in collections and still paying your overhead/staff, and being stuck with 5-10k that a vacation will cost - just to have your oldest son develop abdominal pain buying you an ER visit in Cozumel, followed by airline losing your baggage (yup, the one w/ the baby food, diapers for the youngest child), followed by an airport delay that makes you miss your connecting flight, so now you are stuck in a crap town, in a cheap hotel, with 2 screaming kids for one miserable night, only to find out that the air-conditioner is broken in your room (the only room left in that cheap airport hotel), etc....

 

[Mister Mxyzptlk]

YTD I've taken off about 6 weeks. I'm doing my retirement in 1 week increments before I get too old or too dead. Got 4 more trips planned through the end of the year.

 

[mille125]

YTD I've taken off about 6 weeks. I'm doing my retirement in 1 week increments before I get too old or too dead. Got 4 more trips planned through the end of the year.

I am similar to most here. I take off all major holidays and then another 10-12 business days which comes out to about 4 weeks. The anesthesia mentality is 12-16-20+ weeks off. You still could do that in private practice pain but you will not build your practice (as Tenesma said) and your pocketbook will suffer. In the real world bills and expenses continue to accrue and someone has to pay them.

I do advocate taking some vacation especially when dealing with our patient population. Otherwise burnout will definitely creep in. The longest stretch that I have gone is 6.5 months and that was too long. My office staff told me that they considered paying for me to take a vacation and that I was grumpy.

 

[mille125]

when you are starting a practice, taking frequent time off for vacations, is not conducive to buidling that practice.... availability is what helps cement referral patterns.

i'd rather a new hire take 2-3 weeks of vacation and then 3-5 personal days per month (for long weekends) - instead of 5-6 weeks vacation for the first year or so... after the 1st year, I don't care how many weeks of vacation - with the understanding that it is eat what you treat...

so most of us on this board (on average) do not take much vacation - because
a) we are either solo
b) nuts or
c) we can't stand the thought of losing 4-5k/day in collections and still paying your overhead/staff, and being stuck with 5-10k that a vacation will cost - just to have your oldest son develop abdominal pain buying you an ER visit in Cozumel, followed by airline losing your baggage (yup, the one w/ the baby food, diapers for the youngest child), followed by an airport delay that makes you miss your connecting flight, so now you are stuck in a crap town, in a cheap hotel, with 2 screaming kids for one miserable night, only to find out that the air-conditioner is broken in your room (the only room left in that cheap airport hotel), etc....

I thought that you were flying around in your own private plane by now.......

 

[mille125]

I have been job hunting and got an offer with descent pay but with 3 weeks of vacation. This seems like a very low amount but everyone in the group takes this amount of time off. Obviously, I don't want to be the outlier. Is 3 weeks the norm for most pain groups? I worry that I might burn out seeing 20-30 pain patients a day with less vacation than residency. Any input would be appreciated.

Another question is how many days per week do you guys work? Do you take a whole day or half day off per week? If so do you give this to the employed physician as well? It is a lot easier to have only two or three weeks of vacation if you are only working a four day week.

 

[lobelsteve]

M-F 7:15 to 4:30

No weekends
No call

I pay the price for vacations by being 12 extra patients per day 2-3 days before and after. If my vacation isn't special, it just isn't worth it. 4 years in at the current job. I'll leave when I retire. I'd rather take a long weekend every other month and 1 week per year plus CME then several weeks off per year. Maybe when I'm old and mxtpik crusty I can enjoy more time off, but there is work to do and I love my job and patients.

 

[foxtrot]

This group works M-F 8-5 and covers pain call at several hospitals. Although from what I am told, the call consults are pretty light. The ER's know not to call you to come in. Sometimes, a couple of the docs work an occasional Saturday. I guess if you truly love what you do, vacation does not matter. I personally know that if I were to see pain patients everyday where I live and only take 3 weeks off, I may kill someone, or myself. I guess I don't truly love what I do. That sucks.

 

[PMR 4 MSK]

M-Th 8-noon, 1-4 pm
Fridays off, except recently I worked a few half fridays (8-noon) to make up for some of my 10 day vacation.
No call.
No inpts.
Theoretically I get 4 weeks vacation per year, but I don't get PTO, so no one really counts.
I typically take 2 week-long vacations per year, plus an extra one b/w Xmas and NY.
I also try to hit 2 CME events per year, but most are on long weekends.

 

[W222]

M-Th 8-noon, 1-4 pm
Fridays off, except recently I worked a few half fridays (8-noon) to make up for some of my 10 day vacation.
No call.
No inpts.
Theoretically I get 4 weeks vacation per year, but I don't get PTO, so no one really counts.
I typically take 2 week-long vacations per year, plus an extra one b/w Xmas and NY.
I also try to hit 2 CME events per year, but most are on long weekends.

Are you looking for a partner?

 

[foxtrot]

Are you looking for a partner?

Me first!!!

 

[Aether2000]

While I can take as much vacation as I want in my private practice, I won't. Typically I have taken off a total of about 4 weeks per year at conferences, board meetings, and R&R. My board meeting days are over (thank god) and now I am taking more R&R than before. Work 5 days a week....42 hours a week.

 

[Tenesma]

1) No private plane: way too expensive - and I am afraid of flying... however, there are a few companies that actually sell "dead head" seats on private jets when they are repositioning them and you can actually get pretty decent prices as long as you are willing to be flexible AND live near rich folk who use a lot of those private jets

2) I love time away to regroup - but I loathe dealing w/ the office issues
- Patients freak out and typically 4-6 patients will have cauda equina symptoms (but no pathology) friday afternoon at 3pm just before you leave
- When you return there is a stack 7 inches tall of radiology reports, lab work, patient calls/issues, etc that make your first 1-3 days back from vacation true night-mares...

it is interesting how the newbies want more vacation time, and then as they transition into private practice, they realize that private practice vacation ain't like residency/fellowship vacation...

 

[mille125]

1) No private plane: way too expensive - and I am afraid of flying... however, there are a few companies that actually sell "dead head" seats on private jets when they are repositioning them and you can actually get pretty decent prices as long as you are willing to be flexible AND live near rich folk who use a lot of those private jets

2) I love time away to regroup - but I loathe dealing w/ the office issues
- Patients freak out and typically 4-6 patients will have cauda equina symptoms (but no pathology) friday afternoon at 3pm just before you leave
- When you return there is a stack 7 inches tall of radiology reports, lab work, patient calls/issues, etc that make your first 1-3 days back from vacation true night-mares...

it is interesting how the newbies want more vacation time, and then as they transition into private practice, they realize that private practice vacation ain't like residency/fellowship vacation...

I work 8:30-12 and 1-4:30 M, T, W, F. I only work in the morning on Thursday. 4.5 days per week seems to be the norm in my area and who am I to upset the norm.

No call
No weekends
Inpatient consults for spine only on my schedule.

I take off all holidays (about 10 days) and then probably another 10-12 business days usually arranged around long weekends but sometimes a whole week. As Tenesma said the whole weeks are tough because patient calls add up and paperwork piles up. I find myself checking messages on my EMR twice during a week off to lighten the load.

I also like what I do but do find that I need some vacation time to recharge.

 

[PMR 4 MSK]

it is interesting how the newbies want more vacation time, and then as they transition into private practice, they realize that private practice vacation ain't like residency/fellowship vacation...

In residency, when you go on vacation, other people take care of your problems for you.

In private practice, they get as many of the problems in as possible before you leave, and the rest wait for your return. Then they ambush you.

 

[jj337]

I have been out of fellowship one year and thought I would take more vacation than I actually did (dreamed of taking 8 to 9 weeks but took only 2.5 with a few days here and there - plus every other Wed off). The main driving force for not taking the time was trying to build up my practice, pay off debt, and save money. Going through undergrad, medical school, residency, and fellowship made me tight. Additionally, when it comes out of my wallet, I am a little more cautious...

I hope to take off more in the next year or two but it has been tough to justify when I owe gazzilions in student loan debt. I hardly ever agree with lonelobo (mostly because he sits across the room from me and I like to give him crap 😀) but I need to take more time in the next year or two. Maybe his reference to young guys not taking enough time off was meant for me.

 

[painMD24]

1) No private plane: way too expensive - and I am afraid of flying... however, there are a few companies that actually sell "dead head" seats on private jets when they are repositioning them and you can actually get pretty decent prices as long as you are willing to be flexible AND live near rich folk who use a lot of those private jets

2) I love time away to regroup - but I loathe dealing w/ the office issues
- Patients freak out and typically 4-6 patients will have cauda equina symptoms (but no pathology) friday afternoon at 3pm just before you leave
- When you return there is a stack 7 inches tall of radiology reports, lab work, patient calls/issues, etc that make your first 1-3 days back from vacation true night-mares...

it is interesting how the newbies want more vacation time, and then as they transition into private practice, they realize that private practice vacation ain't like residency/fellowship vacation...

Know this all too well. Took a two week vacation in June and had never done that before. It took me a full week working until 9pm every night to get caught up by Sat at noon. Worth it? Well, the vacation was awesome, but paid quite a high price for it when I got back.

 

[Finally M3]

I was seeing 30 patients a day 3 days before, and 1 week after my 4-day vacation (Thurs, Fri, Sat, Sun) last week.

This year has been getting progressively busier, so I'm afraid to see how long it will take me to 'catch up' after my 9 day vacation this fall.

I have 4 weeks of vacation a year. I use em all. Can't be buried with all the shekels you earn so may as well enjoy life before the monsters (kids) come

 

[Mister Mxyzptlk]

Start in the OR at 7:30 and do a few cases til about 8:30-9:00. Then office. Lunch 11:00-12:00, last patient at 3 pm. I do about 3/4 of my cases in the office mixed in with the office visits.

Friday off.

However, I'm in a different demographic than most of you. I'm cruising and not empire-building.

 

[mille125]

Start in the OR at 7:30 and do a few cases til about 8:30-9:00. Then office. Lunch 11:00-12:00, last patient at 3 pm. I do about 3/4 of my cases in the office mixed in with the office visits.

Friday off.

However, I'm in a different demographic than most of you. I'm cruising and not empire-building.

gotta love mxyzptlk....the king of one liners....we are not worthy..

 

[powermd]

16 weeks vacation, numerous holidays, last Friday of the month is a half day, 3 other summer Fridays are off for the whole practice. We have an unusual setup- 3 docs doing the work of two FTEs. Thus the practice is ALWAYS humming along at full speed. With the addition of the third physician (me), it was projected our revenues would rise about 15% just due to improved efficiency (clinic always fully staffed). This is turning out to be about 30% and we have been having record months. Thus we really don't take that much of a financial hit for all the vacation. We're non-narcotic, recs only for appropriate meds, so encounters tend to be pretty quick- and everyone who sees us - NP or FU - expects an injection. Folks who are doing well are trained to cancel/postpone appointments. Can make extra money doing kyphos during vacation weeks, if desired. Can't imagine a setup much better than this. I took this job with a goal of enjoying the remainder of my youth, so far it seems to be working!

 

[mille125]

16 weeks vacation, numerous holidays, last Friday of the month is a half day, 3 other summer Fridays are off for the whole practice. We have an unusual setup- 3 docs doing the work of two FTEs. Thus the practice is ALWAYS humming along at full speed. With the addition of the third physician (me), it was projected our revenues would rise about 15% just due to improved efficiency (clinic always fully staffed). This is turning out to be about 30% and we have been having record months. Thus we really don't take that much of a financial hit for all the vacation. We're non-narcotic, recs only for appropriate meds, so encounters tend to be pretty quick- and everyone who sees us - NP or FU - expects an injection. Folks who are doing well are trained to cancel/postpone appointments. Can make extra money doing kyphos during vacation weeks, if desired. Can't imagine a setup much better than this. I took this job with a goal of enjoying the remainder of my youth, so far it seems to be working!

good to hear that folks are doing well because we all deserve it....it is so much easier when you like what you are doing

 

[powermd]

good to hear that folks are doing well because we all deserve it....it is so much easier when you like what you are doing

I find that being non-narcotic is key to enjoying what I do. The percentage of happy, satisfied patients has gone WAY up with my new practice. 'Miracle' cases where the patient loses it with affection for you happen occasionally too.. I truly love what I do.

 

[foxtrot]

I find that being non-narcotic is key to enjoying what I do. The percentage of happy, satisfied patients has gone WAY up with my new practice. 'Miracle' cases where the patient loses it with affection for you happen occasionally too.. I truly love what I do.

Good for you. I wish I could find a practice like that in a place where I want to live. I just can't figure out where I want to live.

 

[powermd]

Good for you. I wish I could find a practice like that in a place where I want to live. I just can't figure out where I want to live.

After reading the success stories of some of our colleagues in the anesthesia forum, I decided to start looking at locations slightly "off the grid". I'm not living in my first, second, third, or fourth choice location, but all things considered, it's perfectly adequate! I've had no trouble adapting to a simpler life, and there's a lot of beauty in the countryside. There's a good airport available here too, which helps. Cost of living is also pretty low, we're looking at no more than $500K for a very nice house.

 

[Jcm800]

After reading the success stories of some of our colleagues in the anesthesia forum, I decided to start looking at locations slightly "off the grid". I'm not living in my first, second, third, or fourth choice location, but all things considered, it's perfectly adequate! I've had no trouble adapting to a simpler life, and there's a lot of beauty in the countryside. There's a good airport available here too, which helps. Cost of living is also pretty low, we're looking at no more than $500K for a very nice house.

that is the way to do it in the final days of pain medicine being financially worth it...

i went to 4.25 days a week...i work a half of a wednesay every other week, the other half is administrative, and the other half of the other day is for fun...
so basically i take one morning off every other week...this has been a miracle for my sanity!
at least for the summer. i work more in the winter, no question...
for being relatively young, 6 years in practice, i am so jaded that i only am trying to work hard enough to make what i made last year. since i am getting more efficient, and have found some other revenue sources, that means actually working a little less. ill take it!

 

[PinchandBurn]

I have been job hunting and got an offer with descent pay but with 3 weeks of vacation. This seems like a very low amount but everyone in the group takes this amount of time off. Obviously, I don't want to be the outlier. Is 3 weeks the norm for most pain groups? I worry that I might burn out seeing 20-30 pain patients a day with less vacation than residency. Any input would be appreciated.

3 weeks is nothing.

Ask for 4 weeks. That's what I've seen to be average.

 

[Tenesma]

foxtrot: 20-30 patients/day is going to burn you out?

welcome to private practice - you ain't gonna survive long on 20 patients/day, especially as reimbursements continue to plummet.

I find that vacations do NOT help with burn out - instead they tend to be more stressful just prior to leaving and just after returning.

I find that burn out is relieved with regular "personal days" interspersed randomly during the month --- wednesdays are my favorites..

if i were looking for a job - i'd ask for 2 weeks of vacation and 24 personal days a year...

 

[lonelobo]

"if i were looking for a job - i'd ask for 2 weeks of vacation and 24 personal days a year... "

How is that any different from 7 weeks of vacation?
Never seen a contract that says anything about not taking vacation one day at a time

 

[Tenesma]

i agree lonelobo --- but when people talk about vacation they typically are thinking 1-week blocks...

 

[foxtrot]

foxtrot: 20-30 patients/day is going to burn you out?

welcome to private practice - you ain't gonna survive long on 20 patients/day, especially as reimbursements continue to plummet.

I find that vacations do NOT help with burn out - instead they tend to be more stressful just prior to leaving and just after returning.

I find that burn out is relieved with regular "personal days" interspersed randomly during the month --- wednesdays are my favorites..

if i were looking for a job - i'd ask for 2 weeks of vacation and 24 personal days a year...

No contract I have seen gives "personal days." And I am not about to ask for that because I will get laughed out of the office. My question was not about the number of patients I see a day. It was about the amount of vacation time a group was offering. As you can see on this forum, some people take more than 3 weeks and some take less. My main goal was to ask others opinions regarding vacation in an all pain practice. Obviously, I don't want to be an outlier and ask for more vacation if others in the group are not taking more than this. And for your info, I have been out in private practice for several years but I have been doing a mix of anesthesia and pain.

 

[PMR 4 MSK]

The more that the money in a group is pooled and divded evenly, the more people will bitch about everyone else taking time off. I've seen groups where the doctors' time off are counted by the hour, and that factored into pay checks.

A buddy from med school watched his group implode over differences in vacation and pay. It sounded like the older guys felt like the time they had put into building the group should earn them more vacation, yet still be given an equal share of the earnings.

Thats why I like Eat-What-You-Kill. The more you work, the more you earn.

 

[101N]

Thats why I like Eat-What-You-Kill. The more you work, the more you earn.

1+. Our government could learn something here.

 

[painchas]

There is no answer here. What feels right and what are you willing to accept. The responses will be all over the map. In anesthesia 12 weeks per year but many nights away and working post call. If you ask for alot of VK right out of training in a new practice what will you want in the years to come? Employers want to see a strong work ethic for the most part. Increased vacation accrual down the road once you have proven yourself and generated revenue for the employer who has built the practice and needs overflow help will be better perceived but you need to communicate your desires to determine the fit which must be right for all to succeed.
Regards,