Vacation days in E

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Ron Swanson

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Hi all,

I am not EM but was wondering if you would be able to enlighten me on how vacation days work within your specialty. I am a psychiatrist who has reached out to a stand alone emergency psychiatry facility about a potential fulltime job. They note that it is shift work (12 hours; 12-14 shifts a month), but noted that they didn't offer vacation days as you could just stack your shifts to take time off. This seems a bit odd to me as you are still working close to the normal 160 hours in a 28 day cycle. Is it common to not give vacation days?

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None of my jobs ever offered vacation. You will really only see it in very big organizations (who have a lot of coverage) and sometimes it’s unpaid if SDG. For a single facility like you are describing I would say it is very unlikely due to coverage concerns.
 
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Hi all,

I am not EM but was wondering if you would be able to enlighten me on how vacation days work within your specialty. I am a psychiatrist who has reached out to a stand alone emergency psychiatry facility about a potential fulltime job. They note that it is shift work (12 hours; 12-14 shifts a month), but noted that they didn't offer vacation days as you could just stack your shifts to take time off. This seems a bit odd to me as you are still working close to the normal 160 hours in a 28 day cycle. Is it common to not give vacation days?
160hrs/28 days is not normal.

You get 0 vacation time in the traditional sense. You either move your shifts around so that you have time off, or you work fewer shifts one month and get paid less as a result.

It's not an ideal situation, but it's generally doable as most em docs work around 130hr/mo. That means if you take 1 full week off in a 28 day month, you need to work 43 hrs/wk for the other 3 weeks.

That doesn't sound too bad until you realize that 1 hr in the ED ~= 1.5hrs in terms of stress/actual doing of things in a different job per the birdstrike conversion factor (which is fairly accurate if you work in a remotely busy shop).
 
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Hi all,

I am not EM but was wondering if you would be able to enlighten me on how vacation days work within your specialty. I am a psychiatrist who has reached out to a stand alone emergency psychiatry facility about a potential fulltime job. They note that it is shift work (12 hours; 12-14 shifts a month), but noted that they didn't offer vacation days as you could just stack your shifts to take time off. This seems a bit odd to me as you are still working close to the normal 160 hours in a 28 day cycle. Is it common to not give vacation days?

Never had paid time off. I'm still obligated to do my shifts. That's basically the standard in emergency medicine except for some very rare positions.

If you do 14 days a month, if you take a week off, you're still doing those 14 days on regardless.
 
Agree with above. IF I arrange vacation time, and *if* it can be accommodated by the scheduler, then I either work a large block of shifts before or after, or I just make less money. With VERY rare exceptions, we don’t get paid vacation time. Although 160hrs/28 days is also not the norm.
 
No PTO in EM but I usually have a week off every month. Just finished a 3 day stretch and have the next 6 days off after having 7 days off to start the month. Still have to work full time (120) hours though.
 
It's all a shell game for salaried positions so whether you get vacation or not is a matter of perspective. From what I've seen, typically management is looking at these salaried positions as 40 hour a week jobs (2080 hours/year). Then they subtract some vacation time (~4 weeks or 160 hours, so now we're down to 1,920 hours/year). Then they budget a portion (~10 hours) of the 40 hours a week to be administrative time (now we're down to ~1440 clinical hours/year or 120 clinical hours/month).

On the employee side, we all just think of it as working 120 hours/month for $(salary/1440) per hour with no true vacation or administrative time because 1) that's the end result and 2) it'a how the substantial independent contractor portion of our workforce is paid and makes it easier to compare jobs. But administration needs to fit us into a box that is used to dealing mostly with outpatient clinics and other 9-5 jobs.
 
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It's all a shell game for salaried positions so whether you get vacation or not is a matter of perspective. From what I've seen, typically management is looking at these salaried positions as 40 hour a week jobs (2080 hours/year). Then they subtract some vacation time (~4 weeks or 160 hours, so now we're down to 1,920 hours/year). Then they budget a portion (~10 hours) of the 40 hours a week to be administrative time (now we're down to ~1440 clinical hours/year or 120 clinical hours/month).

On the employee side, we all just think of it as working 120 hours/month for $(salary/1440) per hour with no true vacation or administrative time because 1) that's the end result and 2) it'a how the substantial independent contractor portion of our workforce is paid and makes it easier to compare jobs. But administration needs to fit us into a box that is used to dealing mostly with outpatient clinics and other 9-5 jobs.
That was the most clear explanation that I ever seen on explaining the hours for the 40 hour work week for an ER physician, an how they come up with all that. I appreciate that thank you lol!!!
 
I find EM is the most flexible job to take vacations. Before Kids, we took 5-7 vacations a year without difficulties.

Scheduled for 14 shifts a month. If I wanted to take a week off, I would do 14 shifts in 21 dys or take 3 end of month dys and 4 beginning of month days.

Take a longer vacation, give up 4 shifts and work 10 dys. I took 3 wks off on an overseas vacation and did it over 2 months and gave up some shifts.

Now I work 6 dys a month and can vacations are a breeze.
 
Thanks all this is very helpful! Any more experiences is also helpful
 
One shop I’m interviewing at offers the ability to take a month off a year (because there’s high/ low seasonality to the shift coverage, I guess). Seems pretty unique? This is separate from random stretches of days off you work out anyway in other months.
 
One shop I’m interviewing at offers the ability to take a month off a year (because there’s high/ low seasonality to the shift coverage, I guess). Seems pretty unique? This is separate from random stretches of days off you work out anyway in other months.

Would totally work at my one older shop.
Effing SNOWBIRDS ruin everything here from Thanksgiving to Easter.

Old schedule (from current shop):

7a-4p. (9h)
12p-10p. (10h)
8p-7a (11h)

2 PLP shifts are in there as well.

Everyone was happy with that. The volume dwindled overnight. Then came the snowbirds.

7a-7p.
11a-11p.
7p-7a.

2 PLP shifts again.

Boom. All shifts immediately 12 hours, and the overnight guy gets crushed all night. Your 120 hours immediately become 140 something. Nobody asked us about it.

Snowbirds. Fat. Smokey. Vasculopathic. Metabolic/endocrine train wrecks.

Noo Yawk.
Bahhstahn.
Mitchigan.
 
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Here... They... Come...

Hurrdurrdurrdurrrrr.
"Insulin should be free. It's a right. I have a disease."

B!tch, your only disease is fear of green vegetables.


discrimination%20against%20obese%20people%20at%20work.jpg
 
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Here... They... Come...

Hurrdurrdurrdurrrrr.
"Insulin should be free. It's a right. I have a disease."

B!tch, your only disease is fear of green vegetables.


discrimination%20against%20obese%20people%20at%20work.jpg

Hmmm... This is a strange way to direct one's ire, away from the powerful (insurance companies) and towards the socioeconomically low.
I mean, can't we all agree that insulin is extremely high priced in the US, about 8x the price as that in other developed countries, with a strange scam of a scheme going on between the patient, hospital, pharmaceutical companies, insurance companies, and the government.

But, yeah, if they just ate their green veggies.
 
Hmmm... This is a strange way to direct one's ire, away from the powerful (insurance companies) and towards the socioeconomically low.
I mean, can't we all agree that insulin is extremely high priced in the US, about 8x the price as that in other developed countries, with a strange scam of a scheme going on between the patient, hospital, pharmaceutical companies, insurance companies, and the government.

But, yeah, if they just ate their green veggies.

Ah, I missed your replies. Again; you've missed the point, and argued a tangential one.

The point that you've missed: DM-2 is staggeringly common in our staggeringly obese society. Why is our society staggeringly obese, and thus displays a staggeringly high rate of DM-2? Because Americans by and large (see what I did there) don't have any incentive to avoid this disease state. I mean, why stop living a sedentary lifestyle and consuming 5000 calories a day when you can simply get on all the medicines (sic) when you inevitably become a metabolic trainwreck?

Before anyone points a self-righteous finger at me for being edgy here.... if you can get mad at the COPD patient that continues to smoke, or the CABG patient who won't take his meds and not feel bad about yourself... then you can also get mad at the fatass who cries "I need free medicines" but also won't eat a salad and hit the running trails. Is it a "mean thing to say"? Sure. But you know what - that's life, baby. Truths are often uncomfortable.

Now, seeing as how "living a healthy lifestyle" and not looking like a disgusting, amorphous blob isn't positive motivation enough to change their behaviors, perhaps negative motivation (it will cost you a lot of money to live this way) will work? Nah. Instead, the cattle will start to recite things like: "its my RIGHT to have the medicines; they should be FREE". Nevermind the fact that the whole problem (in the vast majority of cases) could be obviated by a smidgen of personal responsibility. This is a great example of moral hazard; and it is a giant (I did it again) part of what is wrong with America.

Is insulin expensive in this country? Sure. Could it be cheaper? Why not? Is corporate fatcat robbery also ruining America? Absolutely.

But on this issue - it really comes down to "put down the bearclaws and get up and move your ass, America" in a huge percentage of cases. I would love it if endocrinology would chime in here, because I didn't make this stuff up myself. I listened to the endos who were exasperated about this precise issue. I can still hear them: "It wasn't like this in the 80s... NOBODY had DM2. Now, EVERYBODY does."

I'm not asking for the sun, moon, and stars here. I'm just asking Americans to exercise a modicum of responsibility to self and not offload the liability onto the healthcare system. My argument is not directed at the socioeconomically "low". It's directed at fatasses of all income brackets from coast to coast who would rather cry victim and "blame society!" than fix the problem that is well within their control.

Look; you love collectivism. Let me pitch this idea to you: Organize a group that meets weekly and does physically active, constructive, positive things for your community. It need not have any greater structure or organization. Putting my money where my mouth is, I am part of such a group. We have about 12 or so men who meet weekly and basically function as a "league of do-gooders". Group members bring activity ideas to the group, and we go and do the right thing. We don't fight crime or foil bank robberies planned by robot masterminds; we just do good things. Most recently, GroupMember09 said: "Hey men - my neighbors are an elderly couple who can no longer live independently. They need help moving all their stuff into their new living situation, because they're old and frail. They have no family. Professional movers aren't in their budget." On the designated day, 8-10 able-bodied men show up, muscle up, and move grandpa/grandma to their new home. No payment needed. Just doing the right thing. There's a lot of things to do that will improve the community. Find some things and go burn the calories to get them done. Pick up trash along a highway. Build some bike trails. Clean a waterway. Whatever. It's not hard.

Hey, America: want to alleviate disease burden, lower your healthcare expenditures, improve your self-esteem, live longer, feel better, and improve society at large? Get up. Get out. Do it. Walk. Run. Bike. Swim. Clean. Help. Verb.

Stop making excuses. Go do it.

Want a better country? Look like Captain America, and go do heroic things. You probably won't end up needing to adjust your insulin sliding scale and wonder why its so expensive. Have the body of a Greek God, and write your Epic.

Imagine how awesome America would be if this were the norm, instead of "My life is fast food, a desk job, and social media."


EDIT: If enough people say so, I'll continue my rant. I've got more to say. I'll shut up for now, because I'm going to the gym to get that Greek God Bod.
 
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Hmmm... This is a strange way to direct one's ire, away from the powerful (insurance companies) and towards the socioeconomically low.


But only one of those groups is yelling at me for a turkey sandwich while I'm running a code across the hall
 
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where I work each full time partner has to be assigned to 12 x 9 hour shifts each month. Some give up their shifts to the younger docs who want to work more.

The hospitalists are hospital employees (that is kind of redundant and repetitive). They used to earn PDO, but very few used it, so instead they have a similar arrangement - but work 14 shifts a month I believe, and what was going into their PDO bank was built into their contract/benefits.

@DeadCactus explained it pretty well.

I am a W-2 employee who works 7 on 7 off (10 hour shifts)- but paid for 80 hours - the extra 10 hours is coded admin time but I have no admin work - so it essentially my night shift differential (on to top of the regular differential) - That with maxed out PDO of 320 hours - it works out to me working 1500 hours a year - so it all depends on your perspective of how you want to calculate your time/salary to compare apples to apples.
 
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