Options for no nights, holidays or weekends

[han14tra]

What options do emergency physicians have for gigs that are no nights, holidays or weekends? And 8-10 shifts per month? Does it exist? I'm thinking maybe a locums or part-time gig? Or telehealth? Maybe a medical consultant?

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[thegenius]

What options do emergency physicians have for gigs that are no nights, holidays or weekends? And 8-10 shifts per month? Does it exist? I'm thinking maybe a locums or part-time gig? Or telehealth? Maybe a medical consultant?

LOL

 

[thegenius]

LMAO (I'm shaking my head)

Maybe locums because they are desirous of work. But if you expect to join a regular old CMG or SDG, I suspect you will never get this. Everybody would love to just work M-F during the morning and afternoon. Why should you get to opt out of the least desirous shifts and expect others to work them?

Just go do Urgent Care

 

[MechEDoc]

Maybe if you offered to work super cheap? There will be a point on the supply vs demand curve for that type of job, but it probably won't be a very good paycheck.

 

[larpleston]

You can do this with locums if they’re desperate enough.

 

[RustedFox]

Sooo...... you don't wanna do EM.
That's fine. Lots of us don't wanna do EM anymore. Me too.

 

[AlmostAnMD]

I wanna laugh

But

Poor guy

Good luck. Hope you find it

 

[valianteffort]

Wound care , hyperbaric treatments, concierge medicine, wellness clinic, EMS director (some of them), urgent care are some ideas...

 

[miacomet]

A second residency if you aren't too old. Death.

 

[The Knife & Gun Club]

Some medical director gigs will have setups where you’re not working clinically for many if any nights/weekends. You’re still on call for hospital nonsense 24/7 though.

 

[Arcan57]

Buy a group then you can set your own hours. Don't know why everyone doesn't do this.

 

[JacobMcCandles]

What options do emergency physicians have for gigs that are no nights, holidays or weekends? And 8-10 shifts per month? Does it exist? I'm thinking maybe a locums or part-time gig? Or telehealth? Maybe a medical consultant?

If you're in medical school and this is your question, EM isn't going to be for you.

 

[RustedFox]

If you're in medical school and this is your question, EM isn't going to be for you.

I recognize the username. She's asked how to tailor EM to several of her needs in the past; from mommytracking to anxiety management and now to this.

 

[Janders]

If you’ll work for $120/hr I can hire you for weekday shifts in an ED.

 

[han14tra]

Thanks everyone!

 

[skougess]

Thanks everyone!

I just saw which posts you liked and which you ignored. Are you aware the posts you thought were encouraging were actually subtly and not-so-subtly discouraging?

If you just wanted to hear your own hopes, you could have just shouted into a tape recorder…

Edit: On the upside, if this person is GOING INTO the field hating nights and weekends, they probably won’t even finish an EM residency before they realize the mistake and transfer out.

 

[BoardingDoc]

I just saw which posts you liked and which you ignored. Are you aware the posts you thought were encouraging were actually subtly and not-so-subtly discouraging?

If you just wanted to hear your own hopes, you could have just shouted into a tape recorder…

Edit: On the upside, if this person is GOING INTO the field hating nights and weekends, they probably won’t even finish an EM residency before they realize the mistake and transfer out.

OP is an attending.

 

[Birdstrike]

Pain Medicine fellowship.

 

[GassYous]

Pain Medicine fellowship.

Do you still think that it's a viable path for new attendings? It seems that a significant portion of people who have pursued pain fellowship are ending up in general anesthesia jobs lately.

 

[doctoroxygen]

Do you still think that it's a viable path for new attendings? It seems that a significant portion of people who have pursued pain fellowship are ending up in general anesthesia jobs lately.

This is more of a feature of the incredibly hot general anesthesia job market than the pain job market, which is fairly robust but nothing like the current OR anesthesia market.

 

[Birdstrike]

Do you still think that it's a viable path for new attendings? It seems that a significant portion of people who have pursued pain fellowship are ending up in general anesthesia jobs lately.

To answer that, it depends on your definition of “viable.”

For me, anesthesia isn’t a viable option since I’m not anesthesia trained (I’m EM + ACGME Pain fellowship trained).

EM is also not a viable option for me since working nights, weekends and holidays, while suffering the abuse of EM work isn’t what I want to do.

Of the people you know that left Pain Medicine for General anesthesia, what were their reasons?

Pain wasn’t “viable”?

Or those simply preferred general anesthesia for ____reasons?

 

[sloh]

Good thread on pain from the perspective of anesthesiologists

Another pain fellow chiming in to say the same. It's rough and saturated right now in pain unless you are willing to go pretty rural.

Can make more than anesthesia but, imo, the days become quite difficult with you needing to see a lot of patients and do a lot of procedures to make that money.

I find that even a difficult anesthesia day I am less tired than my typical pain days.

I did pain before switching back to anesthesia, I now regret it. Practiced 100% pain practice after training. Opioids were an issue. Other docs prescribing habits impact your patient referral and practice. Financial incentive may make you see patients you don’t want to be seeing, may be pushed to prescribe for referrals and volume. May have a crappy neurosurgeon as the “surgical referral” and be stuck with some postop pain issues and such. You may not have enough control over your schedule to make your lifestyle what you want. Sure there is no in house call but 4 weeks PTO or less seems to be the norm for pain. Pain job may not have all these issues, but mine certainly did. Left me wondering, what is actually redeeming about this job? Certainly not getting yelled at about opioids by new consults or having to discharge my colleagues patients for bad utox. Days were also busier, like 25+ patients per day, not unmanageable but definitely busier than anesthesia. Looking back I now think why was I killing myself.

Anesthesia is an easier lifestyle, easier job, higher paying potentially, but trade off is you’ll take some call. But you’ll probably have more vacation.

 

[namethatsmell]

Good thread on pain from the perspective of anesthesiologists

Yup, this is a golden age for anesthesia. In even competitive markets, going rate seems to be 450-650k or possibly significantly more…and there’s such a demand for gas docs, places are also *tending* to treat them more humanly.

Pain job market isn’t amazing right now but not horrendous either if you don’t have to be locked into a single metro. IMHO if I had to work at a place like the 2nd doc you quoted or leave medicine, I’d leave medicine. But fortunately my pain job is nothing like that. I virtually never prescribe opioids. These jobs are more challenging to find and/or get off the ground, but highly worth pursuing.

 

[The Knife & Gun Club]

It’s tough to compare EM or pain to anesthesia right now because the general anesthesia market is on rocket fuel but almost certainly not sustainable. Among the anesthesia/crit colleagues I work with almost all are either transitioning back to general anesthesia or doing a mix (like Gas + per diem ICU) because it’s just financially ludicrous not to be working in general anesthesia right now.

Starting salaries at some places an hour out from our metro area are $600,000+ per year, with generous Vacation and benefits. With some call but no circadian flipping EM style. There’s very few jobs in medicine that can compete with that.

But that also comes with that a good proportion of anesthesia docs I work with will openly say they don’t think general anesthesia is really a job that should be done by a physician and that CRNAs are the way of the future. I think you’d have a hard time finding an EM doc that thinks EM could be done by an NP.

The overall view of anesthesiology as a career for a med student right now is cloudy. On one hand the current docs are making money hand over fist. On the other hand they’re actively in the process of losing the speciality to mid levels and being left up a creek without a paddle.

 

[miacomet]

It’s tough to compare EM or pain to anesthesia right now because the general anesthesia market is on rocket fuel but almost certainly not sustainable. Among the anesthesia/crit colleagues I work with almost all are either transitioning back to general anesthesia or doing a mix (like Gas + per diem ICU) because it’s just financially ludicrous not to be working in general anesthesia right now.

Starting salaries at some places an hour out from our metro area are $600,000+ per year, with generous Vacation and benefits. With some call but no circadian flipping EM style. There’s very few jobs in medicine that can compete with that.

But that also comes with that a good proportion of anesthesia docs I work with will openly say they don’t think general anesthesia is really a job that should be done by a physician and that CRNAs are the way of the future. I think you’d have a hard time finding an EM doc that thinks EM could be done by an NP.

The overall view of anesthesiology as a career for a med student right now is cloudy. On one hand the current docs are making money hand over fist. On the other hand they’re actively in the process of losing the speciality to mid levels and being left up a creek without a paddle.

Why haven't CRNAs taken over already? They have been around for decades, longer than any other kind of midlevel.

Patients are older and sicker and higher risk. It seems unlikely that CRNAs will encroach more than they have. A bigger question is, why haven't they done so yet? I'm curious.

As to EM, what EM docs think is largely irrelevant. The question is whether health systems think the job can be done by an NP, and outside of Kaiser and the VA, the answer generally seems to be "yes."

I graduated medical school not long after the end of the biggest anesthesiologist surplus where the field was considered dead, and I agree the current market is a bubble, but there's a lot of daylight between "rocket fuel" and "cloudy." And anesthesia has plenty of fellowships compared to EM. Given the choice, I'd pick gas any day.

 

[PB2464]

Very easy to do what you asked with locums.

 

[The Knife & Gun Club]

Why haven't CRNAs taken over already? They have been around for decades, longer than any other kind of midlevel.

Patients are older and sicker and higher risk. It seems unlikely that CRNAs will encroach more than they have. A bigger question is, why haven't they done so yet? I'm curious.

As to EM, what EM docs think is largely irrelevant. The question is whether health systems think the job can be done by an NP, and outside of Kaiser and the VA, the answer generally seems to be "yes."

I graduated medical school not long after the end of the biggest anesthesiologist surplus where the field was considered dead, and I agree the current market is a bubble, but there's a lot of daylight between "rocket fuel" and "cloudy." And anesthesia has plenty of fellowships compared to EM. Given the choice, I'd pick gas any day.

Yea between gas and EM I’d pick gas too for that exact reason (fellowship and tamer hours) but I think both would be risky moves.

Really I’d advise most med students to do IM + fellowship or surgical something where the future seems less in flux.

I’m super grateful for my EM training because I truly believe it’s one of the most valuable skill sets to have both in medicine and in life but career wise the long term outlook is non-reassuring.

 

[miacomet]

Yea between gas and EM I’d pick gas too for that exact reason (fellowship and tamer hours) but I think both would be risky moves.

Really I’d advise most med students to do IM + fellowship or surgical something where the future seems less in flux.

I’m super grateful for my EM training because I truly believe it’s one of the most valuable skill sets to have both in medicine and in life but career wise the long term outlook is non-reassuring.

On this we agree completely.
As to the academic EM docs who do nothing all day and encourage their students to pursue EM, I have a few choice words. NO ONE should be encouraging anyone to pursue EM unless they have years of experience working in the community. Academic EM is the biggest scam.

 

[GatorCHOMPions]

On this we agree completely.
As to the academic EM docs who do nothing all day and encourage their students to pursue EM, I have a few choice words. NO ONE should be encouraging anyone to pursue EM unless they have years of experience working in the community. Academic EM is the biggest scam.

Not going to lie, if it weren't Pain one of my potential paths was to continue slurping up the academic EM ladder. It's the only viable long term career path in many major metros. Some of those guys have sweet gigs. I would never be the one to actively encourage EM, though.

 

[miacomet]

Not going to lie, if it weren't Pain one of my potential paths was to continue slurping up the academic EM ladder. It's the only viable long term career path in many major metros. Some of those guys have sweet gigs. I would never be the one to actively encourage EM, though.

Emphasis on guys. These sweet paths are much less open to women. Because someone has to actually see the patients.

 

[Mount Asclepius]

Robert McNamara MD - The dangers of private equity in the ED

Discusses some of the history of PE in EM, as well as AAEM’s fight in taking EM back.

Comments at 16:00-16:35 minute mark highlight how some of academic EM has let the specialty down.

 

[CoolDoc1729]

Emphasis on guys. These sweet paths are much less open to women. Because someone has to actually see the patients.

Curious why you think these paths are less open to women ?

 

[TexasMed22]

Yea between gas and EM I’d pick gas too for that exact reason (fellowship and tamer hours) but I think both would be risky moves.

Really I’d advise most med students to do IM + fellowship or surgical something where the future seems less in flux.

I’m super grateful for my EM training because I truly believe it’s one of the most valuable skill sets to have both in medicine and in life but career wise the long term outlook is non-reassuring.

Agree with this sentiment, specifically IM + fellowship (cards, onc, GI) seems like the most "hedged" of any med student career path, given the ability to jump ship to PCP, hospitalist, or a different 2/3 year fellowship if there would be major changes in reimbursement (cataract reimbursement , etc) or the job market (rad onc, etc). Plus decreasing reimbursement for procedures/surgeries and neutral/increasing reimbursement for clinic seems to be a brighter (or less dark) future.

Curious to hear others opinion on this

 

[JacobMcCandles]

Agree with this sentiment, specifically IM + fellowship (cards, onc, GI) seems like the most "hedged" of any med student career path, given the ability to jump ship to PCP, hospitalist, or a different 2/3 year fellowship if there would be major changes in reimbursement (cataract reimbursement , etc) or the job market (rad onc, etc). Plus decreasing reimbursement for procedures/surgeries and neutral/increasing reimbursement for clinic seems to be a brighter (or less dark) future.

Curious to hear others opinion on this

My opinion is that anyone who does an IM subspecialty immediately forgets their IM training the day of fellowship graduation.

 

[Arcan57]

My opinion is that anyone who does an IM subspecialty immediately forgets their IM training the day of fellowship graduation.

You’ve clearly never seen the newly minted nephrologist that’s waiting for their dialysis practice to take off. Hungriest hospitalists you’ve ever seen.

 

[Apollyon]

My opinion is that anyone who does an IM subspecialty immediately forgets their IM training the day of fellowship graduation.

What's been said? The absolute worst part of cards is the 3 years of IM?

 

[gutonc]

My opinion is that anyone who does an IM subspecialty immediately forgets their IM training the day of fellowship graduation.

I can't believe how wrong you are here. It's actually the FIRST day of fellowship.