Rubberband

2+ Year Member
Sep 19, 2015
3
0
Status
Medical Student (Accepted)
Hi guys, Im a medical student who finished 3rd year and Im taking some time off for research. I'm really interested in plastics, and really like the reconstructive and even some of the cometic work they do as well. The lifestyle/work hours from what Ive seen isnt significantly better or worse than other subspecialties and generally doesn't worry me. What I did hear during my third year is that plastics is one of the most stressful and litigious of the surgical subspecialties. Additionally, running a private practice is by far a pleasant experience with constant turf battles and politics involved.

So I'm not so much asking "Am I going to have to work long hours?" or "Am I going to make a good living?". I know I'll most likely work long hours and that I'll be compensated reasonably; what I am thinking is more the mental toll the practice takes on the plastic surgeons mentally. Is there significant burnout because of that? Honestly this isn't the kind of question Im comfortable asking any of the plastics I know (I don't feel comfortable enough yet). I was hoping I could get some insight here. Thanks for your help guys!
 

witzelsucht

7+ Year Member
Jun 20, 2012
475
711
Status
Resident [Any Field]
you can always go into academics and teach and sew firefighters faces back on for a meager $300k/yr if making 1.5m/yr doing boobies gets too stressful for your delicate personality
 
Oct 15, 2012
3
6
Status
Attending Physician
Plastic Surgery is not easy, at all. Academic institutions do not give a realistic view as they have pediatric hospitals, cancer centers and more that feed huge numbers of patients. Academic plastic surgeons are one of the few specialties that make more in academics than the average private practice.
Competition in plastic surgery is brutal. There are too many plastic surgeons, and then the increasing numbers of non plastic surgeons doing what we do. Add to that we dont own a territory and anything profitable gets taken over by another field from abdominal wall reconstruction now done by general surgeons, to hand by hand only orthopedics, to skin cancers by dermatologists.
Then you have to build a practice, market, run staff, and most of the time it is solo practice because egotistical plastic surgeons all think they are king of the hill.

If you have a spouse that is a radiologist and can support you, it is not bad, you can drop all the non profitable work and have a decent lifestyle. But if you are the major breadwinner it is a constant struggle. Females do much better , just like in OBGYN.

Add to that 7 years of residency. Economic downturns hit us hard too.

True, the ones that get the Beverly Hills practices make $$, but that is like playing college basketball and assuming you will make the Lakers for certain. Only the top 100 make those type of numbers. The average anesthesiologist, makes more with less training, hours, stress, than the average private practice plastic surgeon.

The only reason the field has survived has been the increase in cosmetic procedures from 1990 to 2005. Reconstructive procedures hardly pay enough to cover overhead, since we have to sign HMO and PPO contracts.

Hours in residency are long. In practice they are still long, but not as much as cardiology. The mental toll is significant, from competition, patients, lawsuits, and more.
I have never been bored, but if I could waive a magic wand and do it over, anesthesia would be my choice. I would have worked half the hours in my lifetime, and made more. Add the time value of money and I would have made much more by investing the extra years of income.

I believe we are training far too many plastic surgeons. Hospitals are not hiring. They dont need us, they contract out for a few breast reconstructions and skin cancer goes to derms, and the hand to ortho, unless it is the ER in the middle of the night and it is us.
 
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bc65

5+ Year Member
Oct 16, 2013
824
1,420
Status
Attending Physician
Plastic Surgery is not easy, at all. Academic institutions do not give a realistic view as they have pediatric hospitals, cancer centers and more that feed huge numbers of patients. Academic plastic surgeons are one of the few specialties that make more in academics than the average private practice.
Competition in plastic surgery is brutal. There are too many plastic surgeons, and then the increasing numbers of non plastic surgeons doing what we do. Add to that we dont own a territory and anything profitable gets taken over by another field from abdominal wall reconstruction now done by general surgeons, to hand by hand only orthopedics, to skin cancers by dermatologists.
Then you have to build a practice, market, run staff, and most of the time it is solo practice because egotistical plastic surgeons all think they are king of the hill.

If you have a spouse that is a radiologist and can support you, it is not bad, you can drop all the non profitable work and have a decent lifestyle. But if you are the major breadwinner it is a constant struggle. Females do much better , just like in OBGYN.

Add to that 7 years of residency. Economic downturns hit us hard too.

True, the ones that get the Beverly Hills practices make $$, but that is like playing college basketball and assuming you will make the Lakers for certain. Only the top 100 make those type of numbers. The average anesthesiologist, makes more with less training, hours, stress, than the average private practice plastic surgeon.

The only reason the field has survived has been the increase in cosmetic procedures from 1990 to 2005. Reconstructive procedures hardly pay enough to cover overhead, since we have to sign HMO and PPO contracts.

Hours in residency are long. In practice they are still long, but not as much as cardiology. The mental toll is significant, from competition, patients, lawsuits, and more.
I have never been bored, but if I could waive a magic wand and do it over, anesthesia would be my choice. I would have worked half the hours in my lifetime, and made more. Add the time value of money and I would have made much more by investing the extra years of income.

I believe we are training far too many plastic surgeons. Hospitals are not hiring. They dont need us, they contract out for a few breast reconstructions and skin cancer goes to derms, and the hand to ortho, unless it is the ER in the middle of the night and it is us.
This.

The truth is that you can have a fairly decent lifestyle, but it is fairly stressful. There's a medscape survey that looked at physician satisfaction and asked if physicians would choose medicine again, and if they would choose the same specialty. Plastic surgery was in the middle, if I remember correctly. There are plenty of other specialties I would choose if I did medicine again. For me, it would be Mohs dermatology, or ortho.
 
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Rubberband

2+ Year Member
Sep 19, 2015
3
0
Status
Medical Student (Accepted)
Thanks for the thoughtful replies guys. I think similar to others pursuing more competitive specialties, there is a bit of information overload when you realize the amount of options you have when it comes to choosing a specialty. Part of what I like about plastics is definitely the wide spectrum of practice that I've seen; the flipside is that they rarely "own" any specific procedure, like you guys mentioned. I'm working myself to the bone to make sure I can get in a decent academic center, because I seem to gravitate more to that side. On the flipside, if I end up doing more private practice stuff...will I end up wishing I had gone to a smaller center where I got more OR experience?