What is a derm life actually like?

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Splenda88 said:
I agree. Only one PGY3 in my program (IM) shares what her contract is like. She makes the same case you make.
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All of our seniors share the numbers that they are offered along with rough estimate of time, partnership track, etc. They are very open about it and always willing to help people out. It doesn't make sense to hide the numbers. Usually the people being lowballed big time are told to keep the numbers on the DL, for obvious reasons.
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Psai said:
All of our seniors share the numbers that they are offered along with rough estimate of time, partnership track, etc. They are very open about it and always willing to help people out. It doesn't make sense to hide the numbers. Usually the people being lowballed big time are told to keep the numbers on the DL, for obvious reasons.
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It's good that your seniors are more open about it. I just don't understand the secrecy when the chances of one your co-resident working with you are very slim. I was told there is a facebook page where physicians openly share their salary.
 
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Matthew9Thirtyfive said:
I used to think that if they paid me enough, I’d do any menial task required. My wife is that way. She is an RN and never complained about having to clean a patient’s room or make their bed if housekeeping was busy because she was getting paid very well to change a bed.

Personally, I hate doing a bunch of boring stuff. I know being a physician has boring things in it no matter what specialty it is, but I just couldn’t do it all day lol.

Note: I’m not saying derm is boring. I’m just saying if I found it boring, I couldn’t do it.
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Wowz... Haven't been here in a minute and now you're Moderator and verified expert. Nice job Matty!
 
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From what I understand, it’s lots of short visits, lots of creams and steroids, and lots of money. But honestly it’s not something you do because it’s what you “love”, you do it for the great lifestyle. A Mohs surgeon, for example, usually makes over twice the reported derm salary. Do you think most wake up every morning yearning to remove moles all day, or the ridiculous (some over 1 million) sums of money they generate?
 
CidHighwind said:
From what I understand, it’s lots of short visits, lots of creams and steroids, and lots of money. But honestly it’s not something you do because it’s what you “love”, you do it for the great lifestyle. A Mohs surgeon, for example, usually makes over twice the reported derm salary. Do you think most wake up every morning yearning to remove moles all day, or the ridiculous (some over 1 million) sums of money they generate?
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You understand nothing. For starters they do not make as much money as you think.
Mohs is not for moles. I do not know where you got this idea.
The ability to use the unique sectioning/pathology to limit tissue removal and clear the tumor are interesting.
They also do very cool reconstructions (flaps, grafts, etc)
Mohs does not have a great lifestyle at all. It is however one of the more interesting things I've seen attending do across all fields

Prior to starting derm residency even I thought gen derm lifestyle is great. Now, I do not think it is all that great, particularly the large numbers of patients to churn through.
 
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PhillyMed777 said:
You understand nothing. For starters they do not make as much money as you think.
Mohs is not for moles. I do not know where you got this idea.
The ability to use the unique sectioning/pathology to limit tissue removal and clear the tumor are interesting.
They also do very cool reconstructions (flaps, grafts, etc)
Mohs does not have a great lifestyle at all. It is however one of the more interesting things I've seen attending do across all fields

Prior to starting derm residency even I thought gen derm lifestyle is great. Now, I do not think it is all that great, particularly the large numbers of patients to churn through.
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I mean, obviously I was exaggerating with moles, but you knew that so whatever. Also 700k-1 million is a figure that’s been quoted to me for those that have a well-ran practice/not in saturated markets. Also I don’t see how going through a lot of patients makes it a bad lifestyle. Doesn’t the PCP have to churn through patients quickly, or the ED physician that also has to make sure that they don’t miss anything life-threatening in a patient, or the surgeon at a surgical-center going through cases,or the radiologist churning through reads, or the pathologist churning through slides, etc. Main difference is derm gets paid a lot more thus can work less.
 
CidHighwind said:
I mean, obviously I was exaggerating with moles, but you knew that so whatever. Also 700k-1 million is a figure that’s been quoted to me for those that have a well-ran practice/not in saturated markets. Also I don’t see how going through a lot of patients makes it a bad lifestyle. Doesn’t the PCP have to churn through patients quickly, or the ED physician that also has to make sure that they don’t miss anything life-threatening in a patient, or the surgeon at a surgical-center going through cases,or the radiologist churning through reads, or the pathologist churning through slides, etc. Main difference is derm gets paid a lot more thus can work less.
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You are basing this off random stories, internet numbers, and generalizations. Work a week in the field. See every single patient and Bill everything yourself. And get back to me.

Also do expand upon what your definition of a well run mohs practice is? I'm sure we would all like to learn about your in depth knowledge on this.
 
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PhillyMed777 said:
You are basing this off random stories and internet numbers. Work a week in the field. Bill everything yourself. And get back to me.
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I can see how churning through many patients can be taxing. But the lifestyle is still there, reasonably long residency, little to no call as an attending. Lets not act like dermatologists have a lifestyle/compensation that is worse or equivalent to surgical sub-specialists or even IM.
The data doesnt lie, on average Dermatologists work less than most other specialities hours wise and also on average get compensated more.
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PhillyMed777 said:
You are basing this off random stories, internet numbers, and generalizations. Work a week in the field. Bill everything yourself. And get back to me. What I am saying will then become clear
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I’ve shadowed dermatologists and Mohs surgeons, I know what they do, and some let me know how much they make. Does that mean that they make that right out of the gate? Of course not, but it’s disingenuous to pretend that they’re not doing well for themselves either. Also the idea of derm making money JUST because the practices are ran like “well-oiled machines” is kind of silly. One would hope that whatever practice in whatever specialty you choose would be efficient and well-ran.

libertyyne said:
I can see how churning through many patients can be taxing. But the lifestyle is still there, reasonably long residency, little to no call as an attending. Lets not act like dermatologists have a lifestyle/compensation that is worse or equivalent to surgical sub-specialists or even IM.
The data doesnt lie, on average Dermatologists work less than most other specialities hours wise and also on average get compensated more.
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But you see, people get sensitive if you point out that they have it better than others on here for some reason, so they have to bend the truth about certain things to feel better about themselves. I personally never got it, since who doesn’t want a nice lifestyle, good money, and minimal stress. Do you think it’s just coincidence that the specialties/fellowships that pay the most are the most competitive?
 
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PhillyMed777 said:
i wish i could transpose my frustration with every day of residency to your mind for just a moment so you can experience what is happening right now. I feel trapped, and in fact want to leave this field (and the rest of medicine). I have no other viable options at this time, and any move needs to be done carefully with my loans. Anyways, with the degree of disagreement with my experience on this site, it's clearly not the place to post so I will gladly leave
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No one is asking you to leave, And disagreement is hardly a cause. No one is questioning that residency sucks in the grand scheme of things. Perhaps you could share more of your frustrations, you might be surprised that people would be willing to hear out your frustrations in good faith. However the data does indicate that being a derm attending is not a terrible lifestyle or compensation relative to the rest of medicine.
 
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PhillyMed777 said:
i wish i could transpose my frustration with every day of residency to your mind for just a moment so you can experience what is happening right now. I feel trapped, and in fact want to leave this field (and the rest of medicine). I have no other viable options at this time, and any move needs to be done carefully with my loans. Anyways, with the degree of disagreement with my experience on this site, it's clearly not the place to post so I will gladly leave
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Where are you in your training? Both physically and chronologically? You weren’t recently displaced were you?

If you don’t feel like answering, that’s fine. And you don’t owe anyone else any explanations, so don’t feel obligated to bend over backwards trying to explain it to them. One of the best things about our field is being an expert in something that other specialities literally know next to nothing about. It’s also part of why they are so confused about what we do and how we do it, but that’s how it goes.

I will say that in general my lifestyle is superior to most of my medical school colleagues who did other specialties. Absolutely no apologies for that. I lucked out that Derm happened to be super interesting to me and being a niche expert is super rewarding. Of course it won’t be for everyone, but the repetitive notion of “Ugh derm is is booooring” is more often than not steeped in ignorance and jealousy.
 
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so i'm a dermatologist at a somewhat large private practice. i work on average 4.5 days per week. on a typical day if i'm not doing excisions i'll see about 40 of my own patients, plus 5-10 patients staffing PA visits and other things. I do about 75% general derm, 25% excising various things, and just a little bit of laser tx. days are usually busy to hectic; I almost always do paperwork over lunch, and maybe about an hour or so after seeing patients at the end of the day. typical day is 7:30-5:30, so I probably work about 45 hours per week, sometimes a little more when on call. I do consults at the hospital when on call, which average 1 or 2 a day. There's a low volume of after-hours calls from patients, but it does come up and is mostly surgical complications. I very occasionally have to come into the office in the middle of the night to stop someone who is bleeding.
work is somewhat stressful while i'm there, but 45 hours per week isn't terrible and I like what I do.
 
you look at skin for the worried well and prescribe triamcinolone or clabetasol. if it's anything more complicated, you refer it to the academic derm department. also, biopsy anything on someone with good insurance.

no one respects you and the work you do is mostly meaningless other than to make anxious house wives feel better about themselves.
 
aafisahar said:
you look at skin for the worried well and prescribe triamcinolone or clabetasol. if it's anything more complicated, you refer it to the academic derm department. also, biopsy anything on someone with good insurance.

no one respects you and the work you do is mostly meaningless other than to make anxious house wives feel better about themselves.
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It took you two paragraphs to say “I’m jealous.”
 
libertyyne said:
I can see how churning through many patients can be taxing. But the lifestyle is still there, reasonably long residency, little to no call as an attending. Lets not act like dermatologists have a lifestyle/compensation that is worse or equivalent to surgical sub-specialists or even IM.
The data doesnt lie, on average Dermatologists work less than most other specialities hours wise and also on average get compensated more.
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Semi-off topic, but it surprises me a little that urology (generally considered a more chill surgical specialty) works more than ortho (generally considered one of the most intense specialties). Also med-onc and gen surg working more than neurosurg?

As somebody really interested in plastics though, sure hope these numbers are accurate!
 
FindersFee5 said:
Semi-off topic, but it surprises me a little that urology (generally considered a more chill surgical specialty) works more than ortho (generally considered one of the most intense specialties). Also med-onc and gen surg working more than neurosurg?

As somebody really interested in plastics though, sure hope these numbers are accurate!
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The paper made a mistake with the neurosurgery hours. The are closer to the top. The 458 was accidentally inputed as -458 for their lower bound.
 
FindersFee5 said:
more than ortho (generally considered one of the most intense specialties).
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Meh.

Here’s what I know about derm:

1. It’s a lot more to it than popping pimples and prescribing triamcinilone. It’s an interesting field if that’s what tickles your fancy.

2. It’s a good lifestyle and you make decent money.

3. I have no interest in dermatology and i do t care what their hours or take home are.
 
I always felt like derm is overreated compared to psychiatry. You want to work 4 days a week with no call and see 15 patients a day? You could make 200K easily. If you want to work 4 days and see 30 patients a day and no call, you could make 300K plus. Want to move to some place rural, you can pull in 400K.

There's also telepsych which for some people has become a full-time gig. I have a stay-at-home mom friend who does this. She "sees" patients 4 hours a day from her home office. She schedules them from 10 am - 2 pm when her kids are in school and never has to leave the house. I never asked how much she makes, but when I was researching telepsych jobs, the going rate was around $170/hour and you can work as much or as little as you like. So in my friends case, if that's what she's getting paid, she works 20 hours a week and makes around $160K. Make it 40 hours a week and you can double that amount (if that's what she's getting paid).

There's also locums work. Fill in for 2 - 3 weeks on an inpatient psych unit and you can make 20K. I had a friend who did nothing but locums work for a few years after residency. Got to see the country, traveling from coast to coast, doing 2 weeks of work here and there, taking 6 weeks off, doing 2 more weeks, taking another 6 weeks off.

There's also consult work and expert witness work where you bill by the hour (ranges from 300/hr to 500/hr depending on your training and level of expertise) to be a consultant. And if that's not your thing, you can choose to do side hustles because you'll have a lot of time if you choose a job with less hours/patients.
 
Mass Effect said:
I always felt like derm is overreated compared to psychiatry. You want to work 4 days a week with no call and see 15 patients a day? You could make 200K easily. If you want to work 4 days and see 30 patients a day and no call, you could make 300K plus. Want to move to some place rural, you can pull in 400K.

There's also telepsych which for some people has become a full-time gig. I have a stay-at-home mom friend who does this. She "sees" patients 4 hours a day from her home office. She schedules them from 10 am - 2 pm when her kids are in school and never has to leave the house. I never asked how much she makes, but when I was researching telepsych jobs, the going rate was around $170/hour and you can work as much or as little as you like. So in my friends case, if that's what she's getting paid, she works 20 hours a week and makes around $160K. Make it 40 hours a week and you can double that amount (if that's what she's getting paid).

There's also locums work. Fill in for 2 - 3 weeks on an inpatient psych unit and you can make 20K. I had a friend who did nothing but locums work for a few years after residency. Got to see the country, traveling from coast to coast, doing 2 weeks of work here and there, taking 6 weeks off, doing 2 more weeks, taking another 6 weeks off.

There's also consult work and expert witness work where you bill by the hour (ranges from 300/hr to 500/hr depending on your training and level of expertise) to be a consultant. And if that's not your thing, you can choose to do side hustles because you'll have a lot of time if you choose a job with less hours/patients.
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Over rated is the wrong term. Don’t get me wrong, I think psych is a great field, but let’s not confuse psych and derm.
 
LoGo said:
Over rated is the wrong term. Don’t get me wrong, I think psych is a great field, but let’s not confuse psych and derm.
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LOL. No, it's not the wrong term. My opinion is that derm is over-rated. To tell me over-rated is the wrong term is to tell me my opinion is wrong.
 
Mass Effect said:
LOL. No, it's not the wrong term. My opinion is that derm is over-rated. To tell me over-rated is the wrong term is to tell me my opinion is wrong.
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Yup. Everyone is entitled to an opinion, but it so happens that some opinions are wrong. When you go about comparing hrs per week to dollar income and ability to bill for extras, I’m sorry but derm is most certainly not over rated compared to psych.
 
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