This job's bad for you

[tkim]

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When talking about ways to have control over your life, less stress,etc. I haven't heard anyone mention alternate income streams in this discussion. Finding a way to generate an income stream separate from just logging more hours is huge and gives you the early financial freedom to cut your hours as you see fit. If you're used to making 300k and you can find a way to generate 100k in an alternate income stream, you can cut your clinical work load by a 1/3 and still have the same income (or keep working at your regular pace and start really adding to your savings, debt reduction, etc). This is a huge sense of control to me at least. That was one of the driving motivations for me and my partners in starting a side business in urgent care.

Our group started two standalone urgent cares and offers a stake as part of partnership. Makes me a little nervous investing in something that hasn't turned a profit yet. If you're making 100K/year on a side urgent care kudos.

 

[EctopicFetus]

A few things.. as someone who is crippled by student debt as I owe over 300k. My struggle is there.. the current struggle with finances I could live without.

Regarding alternate income, I totally agree. I have been looking at other options but I just cant find something that will work.

Our group looked at Urgent Cares the market is saturated. I looked at med spa, vein clinic etc... market full.. Looking at real estate investment property and that looks like the only possibility. There are risks and real fears there.

I think that might be my move.. Im gonna wait a little as I think the market dips again. Too many factors out there look like they will hurt the economy.

 

[EvoDevo]

When talking about ways to have control over your life, less stress,etc. I haven't heard anyone mention alternate income streams in this discussion. Finding a way to generate an income stream separate from just logging more hours is huge and gives you the early financial freedom to cut your hours as you see fit. If you're used to making 300k and you can find a way to generate 100k in an alternate income stream, you can cut your clinical work load by a 1/3 and still have the same income (or keep working at your regular pace and start really adding to your savings, debt reduction, etc). This is a huge sense of control to me at least. That was one of the driving motivations for me and my partners in starting a side business in urgent care.

I like this idea and it's part of our family's Master Plan

 

[discharged]

I propose ED's across America each hire bouncers to filter out the people with real emergencies.. 🙂

 

[deleted6669]

I propose ED's across America each hire bouncers to filter out the people with real emergencies.. 🙂

all 5% of them according to acep.....

 

[BJJVP]

Birdstrike,

I agree with much of what you post and truly hope you are not done with SDN. While in private practice, it's easy to become isolated and forget that other EM physicians go through what you go through, and feel what you feel, and see what you see. I read this forum as a way to remind myself that I'm not alone. My wife and friends will never understand why I feel the way I do about the ED.

Even if you were the "most negative" person on here (I don't think you are), your insight and perspective on this forum are necessary. Too many premeds and med students get caught up in listening to those who just want to give the positive aspects of a medical field without telling the entire truth or painting a realistic picture. Your post regarding ways to avoid being trapped with an unfair group/hospital made a big impression on me and has stuck in my mind as very important advice.

Thanks.

P.S. If you really are done with SDN, will you now tell us what field you switched to? J/K.

 

[8654Marine]

If you're gonna smell the roses, you have to watch the thorns.

It's all a matter of perspective.

The biggest cynics are optimists at heart cause we really give a rat's ass when things go wrong. And really hate it when it happens time and time again.

Birdstrike gives balance.

If you ain't bitchin', you ain't trying.

 

[Cerberus]

I should've included this in the original post:
Casino Shifts

The Panama Schedule: Two week blocks of all the same shift with week 1 = On M,T,W, Th. Off F, Sat, Sun. week 2 = off M, T, W, Th. On F, Sat, Sun. Everyone works 2 weeks/year of all nights - either together or separate.

I'll agree that these schedules exist if you're willing to take the jobs that offer them - that's where I got the idea. However, Birdstrike makes other points. PG scores being a terrible measure of emeregency care, but our still being beholden to it is one example. Administration's refusal to recognize that when people complain that we're taking too long to get to their ingrown toenail at 3am, the complainer ought to be informed of the definition of emergency is another. But most of all, his point is that there's no one more to blame for this than we.

That's an interesting schedule. I imagine it would be harder to do without having a very large number of physicians in the staffing pool (depending on how much coverage is provided on night shifts).

I didn't have any disagreement with any of his arguments aside from the complaints about scheduling without providing an alternative (and perhaps I am biased because I am doing the schedule, and it's probably the most thankless, miserable job in the universe).

 

[Apollyon]

I am doing the schedule, and it's probably the most thankless, miserable job in the universe.

Ding ding ding! We have a winnnnnnner!!

(The only thing worse is something that is physically gnarly, like a sewage ditch.)

 

[Groove]

Bird, keep posting. Not everyone hates you and as others said, it's good to see the negative perspective to balance the positives. Your experiences and perspectives are valuable... to med students with stars in their eyes, residents, attendings, and anyone else who reads this forum. You're going to get the most responses from those that disagree with you and the least from those that agree, or even worse.. the lurkers who are despondent and feel the same way that you do but just don't want to respond.

As for myself, even though I disagree with many of your points about EM, I still agree with many and it's a useful perspective to help balance my own and plan for my future as someone about to graduate and might just be in your shoes some day.

Also, in regards to the original post before we got off on a tangent, to everyone who read that, he's actually right, as most of us know. The caveat is that this is common among just about all shift workers as the disruption of the circadian rhythm and associated detrimental health effects are well known. The problem is that this is not specific for EM, or even medicine. It's something we have in common with every shift worker out there and shift work is very common in many more industries than medicine. I know physicians like to think that medicine is the most high stress job that is out there, but you'd be wrong. So, shift work and it's effects on your health should be something that everyone knows about before going into the field, but let's face it... medicine and most "high stress" fields are not the best careers to look for health longevity and internal tranquility. Shift work and the associated health effects are certainly no reason to write off EM. You can mitigate much of it by having a good cardiovascular regimen and deciding not to see the $$$ in 17-18 shifts a month and kill your joy and health in your pursuit of money. The loans will get paid off, the house will get paid off, and you'll be able to earn and invest in retirement, just don't go buy a 1.5 million home and a porsche when you're 300K in debt like I am...

Anyway, keep posting. If anything, it keeps things lively in here.

 

[ljpm8224]

Too many premeds and med students get caught up in listening to those who just want to give the positive aspects of a medical field without telling the entire truth or painting a realistic picture. Your post regarding ways to avoid being trapped with an unfair group/hospital made a big impression on me and has stuck in my mind as very important advice.

^^ well, and also that people naturally filter and morph what you're saying into what they wanna hear. "Oh, sweet, that's going to be so awesome I can't wait to spend all my days off playing golf."

I thought it would be like that when I started only doing evening strike car- sweet, yeah tons of offtime! Without ever accounting for that- oh yeah, huh... I need to actually *sleep* sometimes. 😳

Anyways this thread is really interesting, thanks for putting it up.

 

[Jack is Back]

I don't dislike EM. I love EM. I absolutely love the core of EM so much it kills me that certain things are the way they are. If I thought EM was crap I wouldn't waste my time here on this forum. If I didn't have eternal respect for EM docs and nurses, who I know for a fact are the hardest working people in Medicine, I wouldn't waste my time on this forum. 10% of EM is the absolute best and purest part of all of medicine that I love. It still kills me sometimes that the other BS grew so toxic that I just owed it to myself and family to walk away.

As far as being "negative", part of that is my personality. But I struggle and work to make lemonade out of the lemons. (And by the way for Apollyon, who I know reads everyone of my posts, I'm happily married with 2 awesome kids). Almost every post has a conclusion that points to a positive solution or something that should and can be changed (okay, a few are just rants). You criticise my OP in this thread as "negative"? I quoted a news story, not my own, and thanked those who work in the ED for all the hard work they do! What the hell is negative about that?

I don't currently work full time in "the pit". I still am a doc, though, and I still see patients in the ED from time to time, but now as a consultant. I'm still EM boarded and always will be. I could work shifts in the ED on a moments notice if I chose to, and maybe I will.

If you don't like my posts, add me to your ignore list. Private message some moderators so I get banned. See if I give a sh--. It would save me a lot of time spent writing. I should charge for the wisdom I put on this screen for free.

I've thought about leaving this forum for good many times, wondering why I waste my time, and anytime I do, I get some epic "spot on!" response, or "thanks for that post" or a private message telling me they "love reading your posts" and that they helped someone make a major decision in their life. I've never once told anyone not to go into EM, on a public post or by private message. You think I want to roll into an ED on a stretcher bleeding to find out the whole damn profession is on strike?

Hell no.

I agree with RustedFox (and by the way you can speak for me because you get it). EM and all of medicine are DYING, abso-frickin-lately dying, because of the namby pamby docs of our past, present and future have rolled over and sold us out to the politicians, the socialists, the lawyers and MBAs. That's got to change (positive).

Rustedfox gets it.

Trumpetdoc gets it.

GeneralVeers gets it.

DocB gets it.

LaGringa gets it.

Others get it.

But nobody is willing to stand up and fight for EM, or medicine in general. I can't even get half of you to agree that things need to change on an anonymous forum.??

Wilcoworld gets it.

JBar gets it. I agree we should see emergencies 24 hours per day. But why should we (you) provide triple coverage to see 2wk vag-itch, and med refill within 5 minutes at 3 am? OBgyn doesn't see non-emergent vag-itch at 2 am. Derm doesn't see non-emergent "itchy" at 4 am on a holiday. Why don't they? Cause it's too damn hard! I'm not saying we shouldn't, but could we cut coverage a little bit for God's sake and let the door to doctor times rise a touch and ease off on the staff a little bit, when we have medical documentation showing shift work is as unhealthy as smoking a pack of cigarettes per day?


A long lost friend of mine who I trained with years ago called me out of the blue the other day and said he wants out of EM. Wants out of EM. He asked me to give him advice. He was the absolute star of my residency, was a year ahead of me, and was my attending! Was and still is the nicest, well liked and one of the most positive guys I have known. Period. He's a great ER doc, only 40 and he's done. Now I'm writing him letters of recommendation in his efforts to get out of the ED. WTF?

If you wanna hide your head in the sand. Go ahead. Ignore list me. You wouldn't be the first. Ban me from SDN? It's only a matter of time, I'm sure.

I wrote a very personal post about the downsides of EM which I've sourced many times, which lists just as many pro's of the field (positive). I made another detailed post about some disturbing trends in EM, with the dangers of shift work and ten crucial things to do to protect yourself (positive).


But to answer your question, why do I care? Why do I waste my time? I don't know. I just don't know. But I think you may be right. I'm wasting my time. I should not waste anymore time posting on this forum. It's time to cut bait and move on.

You convinced me. I'm done with SDN.

Wow. Everytime I hear you talk about EM it makes me want to cross it off my list of possibilities.

With that said, I hope you keep posting because you speak your mind and tell it straight. Rather the truth than false optimism. Reality is always the best Rx.