Typical Life of a Physician

[MagentaKarma]

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I've shadowed different types of physicians (internal specialist, pediatrician, medical specialist, surgeon) and volunteered countless hours in the hospital. I've also started to receive interviews and a few acceptances to medical schools. Despite this, I still wonder if I fully understand the life of a physician and whether the hours are suitable for me. As someone who is possibly looking at family practice/pathology/being a pediatrician, what sorts of hours can I expect? I realize that residency will involve 60-80+hours a week and I'm sure I would be willing to handle that for about three years. Will the rest of my life look like that? I question whether I could handle that many hours even if I love the profession. Similarly, are the working hours different for physicians in other countries? I know certain European countries have average working hours of around 30 per week. Is there certain specialties I should consider if I want to work around 40 hours a week?

 

[Goro]

Do a search for what the wise @mimelim and @Law2Doc have posted on this subject. They are very eloquent and thorough about it.

 

[Law2Doc]

...Is there certain specialties I should consider if I want to work around 40 hours a week?

In the US working 40 hours a week isn't usually an option. To professionals that's practically part time. Average is in the high 50s to 60s for most specialties post residency, more for surgical fields, and often when you are more junior in your career you will be expected to surpass that as you "pay your dues", and take the lions share of the call, etc. People get ill 24/7 including holidays and weekends, hospitals are always open, so it's really not designed to be a 9-5 job.

In Europe they certainly work shorter hours, not just in medicine but law and most other careers, although I'm not sure why that's relevant to you. The focus and work/life balance expectations are just very different. As a result patients wait longer for care, have less recourse, and doctors earn a lot less.

Know going in that medicine is a very demanding career and requires a lot of trade offs not expected in most other career choices. If you can't picture working more than 40 hours a week, frankly you want to find a nonprofessional 9/5 job, not to join an intense high powered profession. For medicine you need to be "all in". Yes there are cushier gigs here and there but just because someone "knows a guy" who works very little doesn't mean those jobs are out there for grabs. You need to expect to be offered the average hours and going rates, not gamble that you can be the outlier.

 

[MagentaKarma]

I understand that people get ill all the time but what about clinics where physicians only see patients from 9-5pm and close the doors at 5? Is it not the case that physicians in clinics work less? I do not think that I am interested in working in a hospital. From what I have seen of all the family physicians, most only work during those hours and even then divide the time among other doctors? Also, I ask about Europe because I am interested in moving eventually. I'm not as interested in the pay as I am in the maintaining a good quality lifestyle while still being able to do what I believe I will enjoy.

 

[gyngyn]

I understand that people get ill all the time but what about clinics where physicians only see patients from 9-5pm and close the doors at 5? Is it not the case that physicians in clinics work less? I do not think that I am interested in working in a hospital. From what I have seen of all the family physicians, most only work during those hours and even then divide the time among other doctors? Also, I ask about Europe because I am interested in moving eventually. I'm not as interested in the pay as I am in the maintaining a good quality lifestyle while still being able to do what I believe I will enjoy.

I have never worked in a clinic where patients are sent away at 5 because we weren't able to see them on time.
The docs I know that do only outpatient medicine work at least as many hours as those of us who don't.
There are places where you can work a limited number of hours (depending on specialty). The jobs at Kaiser are becoming more competitive every year.

 

[WedgeDawg]

Moving to pre-allo

 

[MD2BE92]

It sounds like you are looking to practice a family medicine practice, in a large region, with many partners. Even then, 9-5 is not guaranteed.
Long story short, you're in the wrong field if you are essentially already asking "how can I get away with the bare minimum 40 hr weeks"

 

[cloudmurder1]

I'll be honest, your inquiry about 40 hr work weeks in this field made me chuckle. Expect 60 hr work weeks at least in U.S. medicine.

 

[Giovanotto]

Retracted.

 

[allantois]

Medicine is a career that's neither for great geographic mobility nor 40 hour work weeks.

 

[6FFF]

Psychiatry, can't believe no one has said it yet

 

[sylviaplathMD]

I currently work in an immunology clinic that operates 8-5 but patients are usually out of here around 4 and the doctors follow not much later. Of the three doctors I work with, only one sees patients in the hospital. So they work roughly 40 hrs a week... but I also know that they're bored out of their minds half the time due to the monotony of their specialty ( their words, not mine) so there's that....

 

[bc65]

There are many specialties in medicine that will allow you to work a regular and reasonable schedule, and many specialties that will not, but on the other hand, there are few well-paying jobs outside of medicine that will give you a 9-5 schedule.

If you go into primary care and work for one large large group that I'm familiar with, it's entirely possible to work 8:30 - 5:30, and never take call. If you're efficient with your charting and emails, you can be out by 5. If you're very slow, you might be there until 6, or you might choose to do your charting and emails from home. Even the surgical specialties can have somewhat similar hours when they are not on call, although they will have call schedules that are unpredictable and will disrupt their evenings and weekends periodically, and frankly, their entire lives. After I stopped taking call it took me an entire year before I was able to get used to the fact that I could go to sleep every single night secure in the knowledge that no one will wake me up at night, and that on weekends I could go anywhere and do anything without fear of interruption.

To make a realistic comparison, you need to compare the hours in medicine to a similar career in business, law, or finance. I'm a surgeon, and my wife is an executive in a large corporation. Her hours are worse than mine, and at times, more unpredictable. She has to travel, sometimes with little notice. She has phone meetings at all hours of the night, and dinner meetings that take up her evenings. Attorneys and investment bankers sometimes work through the night, especially early in their careers. Accountants are run ragged during tax season and when quarterly reports are due. Lately, due to "just in time" scheduling,even hourly workers are forced to work unpredictable schedules.

 

[Winged Scapula]

I currently work in an immunology clinic that operates 8-5 but patients are usually out of here around 4 and the doctors follow not much later. Of the three doctors I work with, only one sees patients in the hospital. So they work roughly 40 hrs a week... but I also know that they're bored out of their minds half the time due to the monotony of their specialty ( their words, not mine) so there's that....

I have to ask if you are aware of how much work goes on behind the scenes?

Now Allergy/Immuno is known as a low hours field but even your physicians have paperwork, insurance documentation, meetings and after hours phone calls from patients. While your physicians may be shielded from the latter especially, the OP should realize that just because the "doors close" at 5 (LOL) doesn't mean patients don't call and need to speak with you.

 

[bc65]

I have to ask if you are aware of how much work goes on behind the scenes?

Now Allergy/Immuno is known as a low hours field but even your physicians have paperwork, insurance documentation, meetings and after hours phone calls from patients. While your physicians may be shielded from the latter especially, the OP should realize that just because the "doors close" at 5 (LOL) doesn't mean patients don't call and need to speak with you.

That's why, when you shadow physicians, you should be there the whole day, and not just when they are seeing patients or doing surgery. If you just watch a surgeon in the OR, you aren't getting much out of the experience. You should be there when she's on the phone arguing with the OR about trying to get a case on the schedule, or stand around for 3 hours at night waiting to do your emergency case, or going to yet another useless meeting at 7am.

 

[Pagan FutureDoc]

Even IF you were in some clinic where they closed at 5. Your last patient likely wouldn't be seen till 6 or 6:30 at least. And that's just seeing patients.

 

[sylviaplathMD]

I have to ask if you are aware of how much work goes on behind the scenes?

Now Allergy/Immuno is known as a low hours field but even your physicians have paperwork, insurance documentation, meetings and after hours phone calls from patients. While your physicians may be shielded from the latter especially, the OP should realize that just because the "doors close" at 5 (LOL) doesn't mean patients don't call and need to speak with you.

I AM the behind the scenes, haha! I've been an allied health care worker for a few years now. Don't get me wrong, these doctors are kept busy while they are at work but they also have awesome nurses who do a substantial amount of documentation, letter writing, paperwork, etc, for the doctors and then just bring it to them for their signature. But alas, you're right I don't follow them home at night and see what happens there.

I was merely pointing out the more "relaxed" lifestyle of these physicians ( clinic-based, in a semi-rural setting) vs the more hectic lifestyle of the physicians I've worked with in the hospital setting.

Either way, no matter the specialty, I hope the OP realizes that being a physician is more than just job and will require more hours, sweat, dedication and persistence than any other career.

Can't wait!

 

[MagentaKarma]

I have to ask if you are aware of how much work goes on behind the scenes?

Now Allergy/Immuno is known as a low hours field but even your physicians have paperwork, insurance documentation, meetings and after hours phone calls from patients. While your physicians may be shielded from the latter especially, the OP should realize that just because the "doors close" at 5 (LOL) doesn't mean patients don't call and need to speak with you.

I understand that there's behind the scenes work. I ask because every personal HMO (I've had about 7) I know of is unreachable after 5pm and on weekends, and stops taking appointments after four. I know from personal medical needs that when I called my doctor on the weekends, she had an automatic reply to go see an emergency clinic or hospital or to wait until the office was open on Monday. I don't mind the paperwork and documentation. I understand that's necessary. I feel like that's something I can do in between patients if I am efficient.

 

[MagentaKarma]

That's why, when you shadow physicians, you should be there the whole day, and not just when they are seeing patients or doing surgery. If you just watch a surgeon in the OR, you aren't getting much out of the experience. You should be there when she's on the phone arguing with the OR about trying to get a case on the schedule, or stand around for 3 hours at night waiting to do your emergency case, or going to yet another useless meeting at 7am.

I did shadow physicians for the whole time. I couldn't follow them home and see the extent to how much of "work" continues at home once they leave the clinic or hospital.

 

[bc65]

I did shadow physicians for the whole time. I couldn't follow them home and see the extent to how much of "work" continues at home once they leave the clinic or hospital.

I wasn't directing that post at you. It was meant for all those who shadow, but I can see that my intentions weren't entirely clear.

 

[charmiedermie]

In the US working 40 hours a week isn't usually an option. To professionals that's practically part time. Average is in the high 50s to 60s for most specialties post residency, more for surgical fields, and often when you are more junior in your career you will be expected to surpass that as you "pay your dues", and take the lions share of the call, etc. People get ill 24/7 including holidays and weekends, hospitals are always open, so it's really not designed to be a 9-5 job.

In Europe they certainly work shorter hours, not just in medicine but law and most other careers, although I'm not sure why that's relevant to you. The focus and work/life balance expectations are just very different. As a result patients wait longer for care, have less recourse, and doctors earn a lot less.

Know going in that medicine is a very demanding career and requires a lot of trade offs not expected in most other career choices. If you can't picture working more than 40 hours a week, frankly you want to find a nonprofessional 9/5 job, not to join an intense high powered profession. For medicine you need to be "all in". Yes there are cushier gigs here and there but just because someone "knows a guy" who works very little doesn't mean those jobs are out there for grabs. You need to expect to be offered the average hours and going rates, not gamble that you can be the outlier.

I wish more people responded like you and listened. On another note, there was another thread I saw where the person had a mental issue - i.e. depression, and was asking whether it was still a good idea to go to med school, and you were the only one to not cheerlead them into going.

 

[Law2Doc]

... I couldn't follow them home and see the extent to how much of "work" continues at home once they leave the clinic or hospital.

That was Winged Scapulas point. There are tons of doctors who SEEM to stroll into their jobs at 8 and leave at 5. But maybe you don't see the 2 hours of seeing patients they might do each morning even before they get to "work" and/or the 3 hours of phone calls they have with patients each night.

One example I like to point to was an attending I rotated with during med school who we all thought seemed to be living the dream with a very cushy 40 hour a week job... Until I rotated to another hospital and learned he basically had a second 40 hour a week schedule working over there as well. So bear in mind that shadowing might only show you half the picture and even coworkers and trainees might not know what happens behind the scenes, after hours or at other facilities.

 

[Lost in Translation]

I wish more people responded like you and listened. On another note, there was another thread I saw where the person had a mental issue - i.e. depression, and was asking whether it was still a good idea to go to med school, and you were the only one to not cheerlead them into going.

@Law2Doc is one of the very few posters on here I respect and listen to without question. He tells it like it is and doesn't sugarcoat anything. He isn't going to tell an OP what they want to hear–he tells them what they need to hear.

 

[rocklobstr]

Work in emergency medicine with a scribe. I know a good amount of EM physicians who work 3-5 days a week in the ED and leave at the end of their shift with no charting to do.

 

[Lost in Translation]

There are many specialties in medicine that will allow you to work a regular and reasonable schedule, and many specialties that will not, but on the other hand, there are few well-paying jobs outside of medicine that will give you a 9-5 schedule.

If you go into primary care and work for one large large group that I'm familiar with, it's entirely possible to work 8:30 - 5:30, and never take call. If you're efficient with your charting and emails, you can be out by 5. If you're very slow, you might be there until 6, or you might choose to do your charting and emails from home. Even the surgical specialties can have somewhat similar hours when they are not on call, although they will have call schedules that are unpredictable and will disrupt their evenings and weekends periodically, and frankly, their entire lives. After I stopped taking call it took me an entire year before I was able to get used to the fact that I could go to sleep every single night secure in the knowledge that no one will wake me up at night, and that on weekends I could go anywhere and do anything without fear of interruption.

To make a realistic comparison, you need to compare the hours in medicine to a similar career in business, law, or finance. I'm a surgeon, and my wife is an executive in a large corporation. Her hours are worse than mine, and at times, more unpredictable. She has to travel, sometimes with little notice. She has phone meetings at all hours of the night, and dinner meetings that take up her evenings. Attorneys and investment bankers sometimes work through the night, especially early in their careers. Accountants are run ragged during tax season and when quarterly reports are due. Lately, due to "just in time" scheduling,even hourly workers are forced to work unpredictable schedules.

You're living the life that I want to have. Yes, I want to be a surgeon that's on call all the time. Yes, I want a wife whose schedule is more erratic than mine. Yes, I'm strange.

 

[charmiedermie]

@Law2Doc is one of the very few posters on here I respect and listen to without question. He tells it like it is and doesn't sugarcoat anything. He isn't going to tell an OP what they want to hear–he tells them what they need to hear.

I was just surprised because everyone else on the thread was like don't worry about it, there are so many people in med school with mental problems, you should still go to med school, and it wasn't Pre-Allos saying this either. And in my mind, I was like you've got to be kidding. I think OP has a real high chance of being disappointed as @Law2Doc mentioned.

 

[bc65]

Work in emergency medicine with a scribe. I know a good amount of EM physicians who work 3-5 days a week in the ED and leave at the end of their shift with no charting to do.

In my experience, an ER shift is busier and more unrelenting than most other specialties. While it's true that once the shift is over, it's over, ER docs will often spend 30 minutes or more catching up on their charting and signing out.

I understand that there's behind the scenes work. I ask because every personal HMO (I've had about 7) I know of is unreachable after 5pm and on weekends, and stops taking appointments after four. I know from personal medical needs that when I called my doctor on the weekends, she had an automatic reply to go see an emergency clinic or hospital or to wait until the office was open on Monday. I don't mind the paperwork and documentation. I understand that's necessary. I feel like that's something I can do in between patients if I am efficient.

My receptionist leaves at 5, and my nurse leaves at 5:30. After that, the phone goes to voice mail. However, I might still be in my office returning calls and emails, and charting, then going to the hospital to see consults and round on my inpatients. If I'm not on call, I can go home. If I am on call, I may have to see someone in the ER during the evening or night. Even if I'm not on call, I might have an urgent case waiting to go in the OR. If I'm lucky, it will go at 6 or 7. If there's an emergency or other cases ahead of me, I might be there until midnight. Weekends, if I'm on call, I might be in the ER. All that time, while I'm working, your phone call will go to voicemail.

I don't mind the paperwork and documentation. I understand that's necessary. I feel like that's something I can do in between patients if I am efficient

Please don't make the mistake of assuming that all the other doctors are inefficient, but somehow, you will be the efficient one who will do all the charting between patients. If that's your expectation, you'll end up very unhappy and disappointed. Sure, sometimes you can do your charting in between patients and go home at 6. Mostly what happens is that in between patients, instead of charting, you'll be seeing other patients. i.e. you will have urgent consults, urgent returns from patients with problems who need to be seen immediately, urgent consults in the hospital that need to be seen NOW. So, by the time you finish your scheduled patients and all the work-ins, you've worked through lunch and 40 minutes into the afternoon schedule, and haven't had time to write a single note, and of course missed lunch, and probably haven't had time to go to the bathroom. "Efficiency" can't fix that.

 

[rocklobstr]

In my experience, an ER shift is busier and more unrelenting than most other specialties. While it's true that once the shift is over, it's over, ER docs will often spend 30 minutes or more catching up on their charting and signing out.

That has mostly been my experience as well (from an observational standpoint as a scribe). It depends doc to doc though. Some docs will take their charts home and work for hours on them, and other docs sign them as we finish them and never touch them again. Its definitely a trade off between the timing of the shifts (overnights, weekends, etc.) and very fast paced/difficult days with overall more time off.

I'm only a scribe though, so I could be completely wrong about all of this. It's just what I've observed/talked to some of the physicians about.

 

[Winged Scapula]

Please don't make the mistake of assuming that all the other doctors are inefficient, but somehow, you will be the efficient one who will do all the charting between patients. If that's your expectation, you'll end up very unhappy and disappointed. Sure, sometimes you can do your charting in between patients and go home at 6. Mostly what happens is that in between patients, instead of charting, you'll be seeing other patients. i.e. you will have urgent consults, urgent returns from patients with problems who need to be seen immediately, urgent consults in the hospital that need to be seen NOW. So, by the time you finish your scheduled patients and all the work-ins, you've worked through lunch and 40 minutes into the afternoon schedule, and haven't had time to write a single note, and of course missed lunch, and probably haven't had time to go to the bathroom. "Efficiency" can't fix that.

Let's make it even simpler and assume he has no urgent consults or work ins, but rather the everyday occurrence:

you will likely not get your charting done "between patients" because you'll be seeing other patients (as noted above) as some patients will be late, some will show up on time but take more than the 10 minutes allotted because a) they didn't do their paperwork on the portal like they were asked or b) didn't bring their list of meds with them or c) can't read English or d) they think you are their PCP and they should ask you questions which are unrelated to their visit with you/your speciality or they got lost or they don't have their co-pay or you need a referral which they don't have or they have 10 different issues which you weren't prepared for etc.