Occupational medicine

[cyanide12345678]

So…i think i have a job opportunity in occupational medicine.

What’s the job stability like? It seems like a field ripe for NP take over. I had a recruitment event with concentra - haven’t talked about income or anything yet but google search says that occupational med docs are clearing 290k-300k? Is that true?

Kind of genuinely tempted to work PRN for them 4 monthly shifts and get my foot in the door.

Anyone here have any information about occupational medicine? I’m assuming the life is significantly better with 50 percent of the day being DOT physicals with workman’s comp related injuries in between.

Seems like a great way to get out of emergency medicine, without fellowship, into the normal 8-5 - no nights/weekends/holidays life.

But a part of me keeps thinking - i could work 8-9 shifts a month in the ER and make the same money as a full time 20 days a month occupational med guy/gal.

Thoughts?

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[Porfirio]

Why not just try the 8-9 shift a month life first?

If that does not work then go Occ Med.

 

[Apollyon]

Isn't Occ Med it's own residency?

 

[xffan624]

Isn't Occ Med it's own residency?

Concentra is an urgent care chain that specializes mostly in Occ Med from my understanding, but does take other non-Occ Med patients. I don't think they require Occ Med fellowship for hire. Some Occ Med jobs might.

 

[cyanide12345678]

Concentra is an urgent care chain that specializes mostly in Occ Med from my understanding, but does take other non-Occ Med patients. I don't think they require Occ Med fellowship for hire. Some Occ Med jobs might.

They dont. And they literally do 86 percent of all DOT physicals. All their sites are urgent care sites as well, but that accounts for 5-10 percent of their visits. No fellowship required. They basically train you in a week. Sat down and had dinner with 4 of their docs, 3 were FM and 1 was EM. The EM doc couldn’t stop gloating how she was so much happier despite the pay cut. She was literally on the board of one of my system’s hospital and was very very high in admin and did 25 yrs of clinical EM.

But yeah…no fellowship needed at all and they are the biggest fish in the occupational med space with contracts with all the big guys - amazon, fedex, walmart, usps etc. they’re in 44 states.

I was surprised.

 

[cyanide12345678]

Why not just try the 8-9 shift a month life first?

If that does not work then go Occ Med.

Already kind of trying it since im down to 10 shifts per month.

 

[BreadXray]

I’m boarded in Occ Med and can try answering some of these questions.

So…i think i have a job opportunity in occupational medicine.

What’s the job stability like? It seems like a field ripe for NP take over.

I’d say as stable as primary care. Similar to primary care, there are a lot of NPs/PAs, but there’s always a need for physicians and I don’t see that changing in our working lifetimes. If anything, there are some bureaucratic/legal aspects that might protect Occ Med negligibly more from a “full takeover”.

I had a recruitment event with concentra - haven’t talked about income or anything yet but google search says that occupational med docs are clearing 290k-300k? Is that true?

Some are, including total compensation. I expect the typical full-time salary to be closer to $230-270k/yr. Depending on location and need, I’d expect Concentra to offer you $130-$160/hr for PRN work.

Kind of genuinely tempted to work PRN for them 4 monthly shifts and get my foot in the door.

Do it. Get your DOT certification, do their training modules, and start getting familiar with the workers comp and occupational health system. There’s no real downside to adding this to your CV. Concentra is not the cushiest Occ Med job, but it’s a very solid introduction to the field.

Anyone here have any information about occupational medicine?

If you’re business minded, get your MRO certification and you can have a nice non-clinical side gig.

If you really like Occ Med and want to climb up directorship ladders in the healthcare or corporate setting, look into getting boarded. There are ways to do it without becoming a full-time resident.

Once you’re experienced, if you’re very business minded and good at networking, find a place where you can get some experience doing IMEs (independent physical examinations), get your own insurance/lawyer referral base, and you can make a decent amount per exam ($2-3k per 1-2 hr exam and case review).

There’s a lot more to Occ Med than the bread and butter Concentra-type clinics. If you end up liking the field, consider attending AOHC (our annual society meeting) at some point to network and see what else is out there and what others are doing.

I’m assuming the life is significantly better with 50 percent of the day being DOT physicals with workman’s comp related injuries in between.

Seems like a great way to get out of emergency medicine, without fellowship, into the normal 8-5 - no nights/weekends/holidays life.

Yeah, I’d say those are accurate statements.

Edit: I just remembered I made a comment last year on this forum with a bit more detail: EM Fellowships- Occ Med and Sports

 

[Bombastus]

So…i think i have a job opportunity in occupational medicine.

What’s the job stability like? It seems like a field ripe for NP take over. I had a recruitment event with concentra - haven’t talked about income or anything yet but google search says that occupational med docs are clearing 290k-300k? Is that true?

Kind of genuinely tempted to work PRN for them 4 monthly shifts and get my foot in the door.

Anyone here have any information about occupational medicine? I’m assuming the life is significantly better with 50 percent of the day being DOT physicals with workman’s comp related injuries in between.

Seems like a great way to get out of emergency medicine, without fellowship, into the normal 8-5 - no nights/weekends/holidays life.

But a part of me keeps thinking - i could work 8-9 shifts a month in the ER and make the same money as a full time 20 days a month occupational med guy/gal.

Thoughts?

For two years I worked in an urgent care that did about 15% occ med/work comp/DOT physicals. Work comp SUCKS! So many of the patients were employees who simply didn't want to do their job or felt entitled to permanent disability. It was an endless cycle of throwing resources at them that would never have any effect. But that wasn't as bad as the patients with truly painful and debilitating injuries that needed nonemergent surgery. Cumulatively, it would take hours of my time spread over days and weeks trying to get those increasingly frustrated patients the surgery they desperately needed. And then there were the DOT physicals. Performing the physicals was the easy part. The hard part was following the Byzantine treatment pathways. The really hard part was telling the employees that they were prohibited from working as a result of failing to achieve arbitrary health metrics. Imagine the worst patient interaction you've ever had in the ER. Trust me, it pales in comparison to telling a burly truck driver and sole bread winner for his family that you are cutting off his livelihood due to a disqualifying medical condition that he can neither see nor feel.
After 20+ years in the ER I fully appreciate the need to find an alternative practice environment. For me, occ med would not be an option, particularly given the paltry $120/hr. Concentra pays (in California).

 

[namethatsmell]

But a part of me keeps thinking - i could work 8-9 shifts a month in the ER and make the same money as a full time 20 days a month occupational med guy/gal.

Thoughts?

Your overall thought process seems sound and want to add some context here for how the idea of “20d/mo” may feel.

Basically, if you are blessed to have the constitution to be able to frequently change sleep schedules easily and be normally functional on random chunks of sleep, then moving from 9 shifts a month to 20 working days a month may suck too much to contemplate. That math may not pencil out unless you really detest those 9 shifts or you're really drawn to the 20d/month opportunity.

But if you experience even quasi-DOMAs the day after later swing shifts where you don't actually fall asleep until 2-4a (in addition to full-on DOMAs after overnights), then working the "20" weekday-only bankers hours days may actually be a decent trade.

And when you look at "20 days per month jobs" you have to factor in real PTO (something that most EM gigs don't offer). There also may be options to add in some telework over time and/or start earlier/work later at some of these seemingly "fixed" 9-5 style jobs so that you don't have to work 5d/wk but still be full-time. I was able to do this after working at my current job for awhile. So now, when factoring in my PTO and weekends/holidays I only work ~16d/mo. If you factor in my telework, I'm only going into the office ~14d/mo. And 100% of these hours are non-holiday weekdays between 7a-5p.

Hopefully these ramblings provide some further food for thought.

 

[DeadCactus]

Your overall thought process seems sound and want to add some context here for how the idea of “20d/mo” may feel.

Basically, if you are blessed to have the constitution to be able to frequently change sleep schedules easily and be normally functional on random chunks of sleep, then moving from 9 shifts a month to 20 working days a month may suck too much to contemplate. That math may not pencil out unless you really detest those 9 shifts or you're really drawn to the 20d/month opportunity.

But if you experience even quasi-DOMAs the day after later swing shifts where you don't actually fall asleep until 2-4a (in addition to full-on DOMAs after overnights), then working the "20" weekday-only bankers hours days may actually be a decent trade.

And when you look at "20 days per month jobs" you have to factor in real PTO (something that most EM gigs don't offer). There also may be options to add in some telework over time and/or start earlier/work later at some of these seemingly "fixed" 9-5 style jobs so that you don't have to work 5d/wk but still be full-time. I was able to do this after working at my current job for awhile. So now, when factoring in my PTO and weekends/holidays I only work ~16d/mo. If you factor in my telework, I'm only going into the office ~14d/mo. And 100% of these hours are non-holiday weekdays between 7a-5p.

Hopefully these ramblings provide some further food for thought.

This post really needs to be reiterated. I think this is something a lot of trainees and even emergency medicine attendings don't always understand; business hour jobs get vacation days, sick days, CME days, administrative days, etc. that drastically reduce the actual number of days worked in a typical month while emergency medicine gets overnights on Christmas Eve and a sleep, deprived useless day off the next day which functionally increases the days lost to work each month.

 

[cyanide12345678]

Talked numbers today

40 hours a week, Monday to Friday, 8 am to 5 pm.

240k, plus 6k medical director stipend, plus some rvu incentives and quality bonuses

Quoted PRN was only $110/hr.

Yeah I’m not taking that big a paycut today, but good to know there’s options to get out of EM.

 

[BoardingDoc]

Talked numbers today

40 hours a week, Monday to Friday, 8 am to 5 pm.

240k, plus 6k medical director stipend, plus some rvu incentives and quality bonuses

Quoted PRN was only $110/hr.

Yeah I’m not taking that big a paycut today, but good to know there’s options to get out of EM.

1 hour for lunch per day it seems? I have to say, I never understood the 1 hr lunch break. I mean, I'll obviously take it if offered, but I'd personally much rather work, say, 830 - 5 and only take a 30 min lunch.

 

[GatorCHOMPions]

1 hour for lunch per day it seems? I have to say, I never understood the 1 hr lunch break. I mean, I'll obviously take it if offered, but I'd personally much rather work, say, 830 - 5 and only take a 30 min lunch.

Same, but it's more the supporting staff that either expects the whole hour or is built into their contract. Only way around it is if you have a lot of staff per MD and they can stagger their lunch breaks, or be the owner and set the rules.

 

[cyanide12345678]

1 hour for lunch per day it seems? I have to say, I never understood the 1 hr lunch break. I mean, I'll obviously take it if offered, but I'd personally much rather work, say, 830 - 5 and only take a 30 min lunch.

Yes. 1 hour daily lunch. 25 PTO days per year of service that accrue.

I told them that ill be interested if they can get in the 300s.

Not the worst offer when you consider time off etc for a low stress occupational med job with no nights, weekends, or holidays. Plus 25 pto days, federal holidays, and 3 cme days. That’s basically 6-7 weeks paid time off as well.

 

[cyanide12345678]

Same, but it's more the supporting staff that either expects the whole hour or is built into their contract. Only way around it is if you have a lot of staff per MD and they can stagger their lunch breaks, or be the owner and set the rules.

My wife takes a 30 minute break at optum. They didn’t have a problem with that as long as her MA didn’t have a problem with that because it is expected that the support staff works the same times

 

[bky3c]

My wife takes a 30 minute break at optum. They didn’t have a problem with that as long as her MA didn’t have a problem with that because it is expected that the support staff works the same times

So the physician's schedule was determined by the MA's preferences? Not to sound overly old-school, but that seems backwards.

 

[HemorrhagicShock]

I told them that ill be interested if they can get in the 300s.

Did they respond to this offer?

 

[cyanide12345678]

So the physician's schedule was determined by the MA's preferences? Not to sound overly old-school, but that seems backwards.

Eh…their office is hurting for MAs. 2 or 3 recently left with some doctors being forced to work without one.

My wife’s MA is excellent, she also preferred a shorter day and a 30 minute lunch, so it wasn’t an issue.

 

[namethatsmell]

This post really needs to be reiterated. I think this is something a lot of trainees and even emergency medicine attendings don't always understand; business hour jobs get vacation days, sick days, CME days, administrative days, etc. that drastically reduce the actual number of days worked in a typical month while emergency medicine gets overnights on Christmas Eve and a sleep, deprived useless day off the next day which functionally increases the days lost to work each month.

Oh yeah I forgot to include time off for CME