Valley Emergency Physician docs plan walk out for tomorrow

[VA Hopeful Dr]

My response will be brief and hopefully I can add more tomorrow. I think it’s a bit of an oversimplification. I truly enjoy what I do. I work on average under 100 clinical hours a month. I’ve been in the 1100-1150 range for about the past 5 years. Yes nights (not many) yes weekends (my share) but I’m not there that much and I enjoy my co workers, the work itself and the pay. If my pay dumped I would work even less.

Em docs almost by rule and anesthesia have a ton of non clinical interests and the time to explore those interests.

While we may talk a lot about money I believe I saw pcps work about 55 hours a week for that money. Curious your take on that.

That's fair, and I suspect like most generalizations there will be significant numbers of people it doesn't exactly apply to. It's also possible that SDN doesn't reflect all of EM that accurately. I guess from my end I just see more money discussions here and in the anesthesiology areas often together with the idea of saving early and aggressively so either FIRE is an option or at least a significant break from working if works gets bad. Which given the high stress of the fields combined with CMG involvement is a very real concern. You even say that your hours are lower than most and if you didn't like the work you could work less, which is great but the ability to do that as you've talked about before took saving and getting non-medicine income streams.

If a PCP is working 55 hours a week they are doing it completely wrong, or own the business and that extra time is used for that and not patient work that requires.

I get to work at 8am, have a 90 minute lunch, rarely leave after 4:30, and take Wednesday afternoon off. Generally take 6 weeks off per year. My partners all work the same number of hours (36-ish) just in slightly different ways. Hospital employed and all but the new guy were in the 400k range this past year. We all work pretty hard while at work to manage that as you'd expect but not so hard that we don't enjoy the work.

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[The kitchen sink]

No, it’s tuition free for everyone. Prospective students can also prematch into postgrad specialty training at NYU and be done with med school in 3years to save even more money on fees and living expenses. Hopefully all medical schools, or all top tier schools with adequate funding, will go this route.

Affordability & Financial Aid for MD Students | NYU Langone Health

NYU Grossman School of Medicine Office of Financial Aid helps students find resources to cover medical school expenses beyond tuition.

med.nyu.edu

Direct Progression to an NYU Grossman School of Medicine Residency | NYU Langone Health

At NYU Grossman School of Medicine, our three-year MD degree program offers conditional acceptance to a residency in one of 20 specialties.

med.nyu.edu

With the amount of inflation nowadays, this is badly needed

 

[The kitchen sink]

That's fair, and I suspect like most generalizations there will be significant numbers of people it doesn't exactly apply to. It's also possible that SDN doesn't reflect all of EM that accurately. I guess from my end I just see more money discussions here and in the anesthesiology areas often together with the idea of saving early and aggressively so either FIRE is an option or at least a significant break from working if works gets bad. Which given the high stress of the fields combined with CMG involvement is a very real concern. You even say that your hours are lower than most and if you didn't like the work you could work less, which is great but the ability to do that as you've talked about before took saving and getting non-medicine income streams.

If a PCP is working 55 hours a week they are doing it completely wrong, or own the business and that extra time is used for that and not patient work that requires.

I get to work at 8am, have a 90 minute lunch, rarely leave after 4:30, and take Wednesday afternoon off. Generally take 6 weeks off per year. My partners all work the same number of hours (36-ish) just in slightly different ways. Hospital employed and all but the new guy were in the 400k range this past year. We all work pretty hard while at work to manage that as you'd expect but not so hard that we don't enjoy the work.

Nice.

Do you practice in VA? Straight outpatient? Are you on wRVUs? Just curious of your practice model.

Also, did you see that proposed bill in VA that wants to increase the require of licensure from 12 to 36 months for MD/DO and reduce oversight for NPs. Proposed by a delegate who is an NP. Crazy times, my friends.

 

[WilcoWorld]

Unless I'm missing something, methinks you guys actually agree...

And I agree with you. Money isn't everything. My main gig pays less than several other options I've had, but it's exactly what I need. Generally low stress and mostly grateful patients. No clipboard nurses. Zero bs metrics to deal with. No pph or production goals. Reasonable workload with enough time to give good care to complex patients. Solid resources. Patient volumes rising? Group's answer isn't to flog folks into seeing more patients...it's to hire more docs. Bankers hours only and no nights/weekends/holidays. Tons of paid time off and actual work-life balance. To me, all of these things are much more valuable than nabbing every last dollar.

I still make decent coin but have almost none of the moral-injury type issues that have arisen at many prior jobs.

Simply chasing $$$ in medicine is a recipe for disaster.

I think we agree as well.

 

[VA Hopeful Dr]

Nice.

Do you practice in VA? Straight outpatient? Are you on wRVUs? Just curious of your practice model.

Also, did you see that proposed bill in VA that wants to increase the require of licensure from 12 to 36 months for MD/DO and reduce oversight for NPs. Proposed by a delegate who is an NP. Crazy times, my friends.

I'm in SC, outpatient only, hospital employed, wRVUs with quality bonuses.

VA is a mess for doctors. Few years back they passed a bill that an NP with 5 years of supervised practice could then practice independently.

 

[EctopicFetus]

That's fair, and I suspect like most generalizations there will be significant numbers of people it doesn't exactly apply to. It's also possible that SDN doesn't reflect all of EM that accurately. I guess from my end I just see more money discussions here and in the anesthesiology areas often together with the idea of saving early and aggressively so either FIRE is an option or at least a significant break from working if works gets bad. Which given the high stress of the fields combined with CMG involvement is a very real concern. You even say that your hours are lower than most and if you didn't like the work you could work less, which is great but the ability to do that as you've talked about before took saving and getting non-medicine income streams.

If a PCP is working 55 hours a week they are doing it completely wrong, or own the business and that extra time is used for that and not patient work that requires.

I get to work at 8am, have a 90 minute lunch, rarely leave after 4:30, and take Wednesday afternoon off. Generally take 6 weeks off per year. My partners all work the same number of hours (36-ish) just in slightly different ways. Hospital employed and all but the new guy were in the 400k range this past year. We all work pretty hard while at work to manage that as you'd expect but not so hard that we don't enjoy the work.

Thats fair. Plenty of ways to skin the cat. While we each have our own realities I think the salary surveys do help in gauging where specialties are as compared to others. I know a number of orthopods making $1m+. I know of 4 different EM docs who each earned $1M in a year doing just clinical medicine. I am not one of those. I think perhaps what you see from EM and anesthesia is folks seeing the pressure of CMGs, expectant lower pay etc. Its a make hay while the sun is shining approach. I can work less but while I work minimally now at my old job I averaged 160 hours a month. I did that for the first 5 or so years of my career. No doubt investments, diversification and other things helped smooth the financial path for me. I made a lot those first 5 years, the job was fairly easy and my schedule fit my families needs at the time. Now I happily give away shifts, have non clinical income and non medical income which is fairly passive. All those things have given me freedom. I dont want to work in a "real" ED for a CMG. Ill sit in some low volume spot and collect low pay while streaming netflix (I have done this in the past), but Im not about to see 2pph of high acuity stuff while some HCA noctor or nurse berates my care and get under $250/hr for that. Hard pass.

The sacrifice of earlier on and a lot of lucky breaks provided me freedom for the final 2/3 of my career. FWIW I can from a poor family, I myself am an immigrant. I had 400k+ in student loans so this isnt like I came from a family of docs. my dad drove a taxi until I was in like 6th grade and my mom worked retails and sold cheap clothing at a flea market when i was growing up. She got her real job when I was around 4th grade.