What's wrong with this calculation?

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Z

ZPakEffect

Full Member
10+ Year Member
Joined
Jan 3, 2013
Messages
412
Reaction score
622
Members do not see this ad.
I am a current ED scribe who will be attending medical school next year. EM is currently one of the top specialties on my list. I love working up patients with vague abd pain or CP. I even rather enjoy the crazy psych patients. I am not quite as fond of the social work aspects but that's what LCSW's are for.

Anyway, I will finish residency with approximately 400K in debt, so compensation is a real concern for me. I plan on working my ass off the first few years out of residency to pay off the debt and I am interested in how physically or logistically possible it is to make 500K+ per year in EM. I am not worried so much about the mental or psychological aspects of working a lot of hours as my other top specialty under consideration is neurosurgery.

TLDR: Let's say $250/hr for 10 hours; 20 shifts per month; 240 shifts per year x $2500 per shift = $600,000. What's wrong with this calculation? Is is unreasonable to expect at least $250/hr with malpractice included?

More info: I currently live in Texas, will attend medical school in Texas, and will practice in Texas. The group whose physicians I scribe for allow their docs to work a maximum of 20 shifts per month. I currently work this EXACT schedule as a scribe and feel as if I could work another 5 shifts a month without any ill effect.
 
Last edited:
ZPakEffect said:
TLDR: Let's say $250/hr for 10 hours; 20 shifts per month; 240 shifts per year x $2500 per shift = $600,000. What's wrong with this calculation? Is is unreasonable to expect at least $250/hr with malpractice included?
Click to expand...

Working 200 hours a month as a scribe != working 200 hours a month as an ED doc. This is not a sustainable amount of work. If you want to burn out early, hate life and quit your job... this is good way to do it.
 
Gwent said:
Working 200 hours a month as a scribe != working 200 hours a month as an ED doc. This is not a sustainable amount of work. If you want to burn out early, hate life and quit your job... this is good way to do it.
Click to expand...

Well, I will make sure to tell the half a dozen docs I scribe for who work 20 shifts per month that they hate their lives and that they should quit their job. In fact, they all love their jobs and think that it is the best job they have ever found.
 
ZPakEffect said:
I am a current ED scribe who will be attending medical school next year. EM is currently one of the top specialties on my list. I love working up patients with vague abd pain or CP. I even rather enjoy the crazy psych patients. I am not quite as fond of the social work aspects but that's what LCSW's are for.

Anyway, I will finish residency with approximately 400K in debt, so compensation is a real concern for me. I plan on working my ass off the first few years out of residency to pay off the debt and I am interested in how physically or logistically possible it is to make 500K+ per year in EM. I am not worried so much about the mental or psychological aspects of working a lot of hours as my other top specialty under consideration is neurosurgery.

TLDR: Let's say $250/hr for 10 hours; 20 shifts per month; 240 shifts per year x $2500 per shift = $600,000. What's wrong with this calculation? Is is unreasonable to expect at least $250/hr with malpractice included?

More info: I currently live in Texas, will attend medical school in Texas, and will practice in Texas. The group whose physicians I scribe for allow their docs to work a maximum of 20 shifts per month. I currently work this EXACT schedule as a scribe and feel as if I could work another 5 shifts a month without any ill effect.
Click to expand...
Most people in EM don't work 20 shifts a month, 15 used to be high when I looked at EM. I don't even work 200 days a year in anesthesia. The stress of that level of work is real. You may physically be able to scribe for the same shift, but you don't get the emotional baggage or the affect of the responsibility for caring for all of those patients.
 
RustedFox said:
I seriously doubt the report of many docs at one site working 200 hours per month with no burnout.

I worked 164 during December. I was toasted. Toasted. Done.
Click to expand...

I have noticed on this board that my experiences have been found to be incredible by some posters. Nevertheless, they are true. The group I scribe for covers 20+ hospitals; my own scribe team covers three different hospitals. I have personally worked with roughly 40 different doctors. So only a minority of the docs work the maximum 20 shifts allowed. But they all love their jobs.
 
IlDestriero said:
Most people in EM don't work 20 shifts a month, 15 used to be high when I looked at EM. I don't even work 200 days a year in anesthesia. The stress of that level of work is real. You may physically be able to scribe for the same shift, but you don't get the emotional baggage or the affect of the responsibility for caring for all of those patients.
Click to expand...

We have one the few ED's in the country with staggered acuity, where new oncoming docs pick up all the high-acuity patients, then proceed downward in acuity as their shift progresses and each successive oncoming doc pushes the ones ahead of him down. At the end of the shift, we're all just mopping up quickies. The guy who is next to leave is the one who does ALL the procedures (or supervises the students/residents/fellows who are doing them). So the first 3-4 hours is VERY stressful, but the second half of the shift is pretty easy.
 
True or False: 50 hours a week as an attending EP is not tougher than 100 hours per week as a neurosurgery resident?

Because, should I go for EM, for the first 4 years out of residency, I will be looking to work just as hard as a resident in order to pay off my massive loan. If EM PGY-1's can work 18-20 12-hour shifts, or NSGY PGY-2's can work 100-hour weeks, or NSGY attendings can work 65-hour weeks, then I sure as hell can work 50-hour weeks as an EM attending.
 
ZPakEffect said:
True or False: 50 hours a week as an attending EP is not tougher than 100 hours per week as a neurosurgery resident?

Because, should I go for EM, for the first 4 years out of residency, I will be looking to work just as hard as a resident in order to pay off my massive loan. If EM PGY-1's can work 18-20 12-hour shifts, or NSGY PGY-2's can work 100-hour weeks, or NSGY attendings can work 65-hour weeks, then I sure as hell can work 50-hour weeks as an EM attending.
Click to expand...

This logic, again on here.

Listen amigo; it just doesn't work that way - especially "right out of residency". You're just ASKING to be sent to peer review or placed on probation.
 
Furthermore, I made the exact same cognitive error when I was starting residency.

Anyone else?

And your true/false question just doesn't work. You're comparing oranges to baseball stadiums.
 
ZPakEffect said:
True or False: 50 hours a week as an attending EP is not tougher than 100 hours per week as a neurosurgery resident?

Because, should I go for EM, for the first 4 years out of residency, I will be looking to work just as hard as a resident in order to pay off my massive loan. If EM PGY-1's can work 18-20 12-hour shifts, or NSGY PGY-2's can work 100-hour weeks, or NSGY attendings can work 65-hour weeks, then I sure as hell can work 50-hour weeks as an EM attending.
Click to expand...
So go ahead and find a job that lets you work that many shifts. One of the problems you might have is transitioning from day to night to swing shifts and back again. If you can make that work and pull 20+ shifts a month more power to you. There are no doubt plenty of groups set up for maximum work, minimal down time, and maximum income. If that's what you want you can probably find it. But you might not like it after a while. That's why some groups are 95th+ percentile income. It's not rocket science how they get the big bucks, but that's not the lifestyle most aspire to.
 
RustedFox said:
This logic, again on here.

Listen amigo; it just doesn't work that way - especially "right out of residency". You're just ASKING to be sent to peer review or placed on probation.
Click to expand...

Look, from my perspective, the most persuasive evidence I have of what is feasible or realistic are the real life physicians I work with every day. One of the docs that I work with who does 20 shifts per month tells me that the ONLY reason he doesn't work MORE shifts is because of the group 20-shift maximum rule. This guy is one of the most energetic, upbeat, enthusiastic EP's I work with. Hell, he even leads all his patients and family members in prayer after each H&P.

Excuse me if my ideas of what it's really like to be an EP are gathered from what I see every single day.
 
Zpak, you're being so incredibly naive , it's sad. I'm not sure if you're trolling or what. Each successive step up the chain (ie med student, resident, attending) comes more responsibility and emotional stress. This stress is real and adds to quick burn out. All EM attending have done 80+ hour weeks as a resident and med student. We know what long hours are. There is a reason why most don't work 20 shifts a month. Its not sustainable, compared to your scribe job? Its not even close. Triple the amount of stress, and work. You think that you understand now, but you will once you have finished your 7+ years of training you still have left. You will realize that work doesn't end when you go home when you're a medical student, resident nor attending. Good luck

Sent from my VS986 using Tapatalk
 
ZPakEffect said:
True or False: 50 hours a week as an attending EP is not tougher than 100 hours per week as a neurosurgery resident?

Because, should I go for EM, for the first 4 years out of residency, I will be looking to work just as hard as a resident in order to pay off my massive loan. If EM PGY-1's can work 18-20 12-hour shifts, or NSGY PGY-2's can work 100-hour weeks, or NSGY attendings can work 65-hour weeks, then I sure as hell can work 50-hour weeks as an EM attending.
Click to expand...

This type of attitude seems prevalent amongst lots of pre-meds and even med students. I think there may be a diminished idea of what it is we actually do as EM physicians. When I was a med student I thought the same thing to a certain extent, but even during my trauma and nsrgry months I was just a tourist for ~30 days. You can do just about anything for a month, but this isn't the same as working a career for years in a specialty as the 'one in charge'. After doing a bunch of surgery rotations, I thought EM was a really nice change of pace...at first.

As a senior resident I work about 160-180 hours directly in the pit, and if you add on didactics, conferences, meetings, studying, board/inservice review, time spent on papers/case studies/M&M's, moonlighting, its easily over 230 hrs a month. Many of my co-residents are feeling very burnt, and have signed at slow paced well balanced community gigs, and not for the big $$ gigs. A couple guys ahead of me graduated and moved to west texas and attempted what you describe, the 40-50 hrs a week breakneck pace, 2.5+ pph (not including midlevel staffing) jobs and are making 500k+. They lasted less than a year before they completely burnt out. One quit altogether and is working in informatics for an EHR company. The other one cut his hours to half time, switched shops to a low acuity place, and is trying to get his marriage back on track.

It's just really really difficult to do. The schedule switches from days to nights, the jet lag/DOMAs, the pressure of administration and metrics, difficult patients and hardened ancillary staff, political battles with specialists, threat of litigation, nights awake being self-critical thinking about patients with bad outcomes or ones you missed things on and bounced back, or discharged when you should have worked them up more. I can work about 3-4 shifts in a row, then I start to really feel the strain. If you work as hard as you described, you start making mistakes, and then everyone pays for it. I think you have a duty to patients and yourself to be as close to 100% gas in the tank each and every shift. The work we do is important, even if the business aspect of medicine can sometimes make that feel diminished.

There is a reason most jobs consider 120-132 hrs 'full time'.

You cannot keep a breakneck pace like that for very long and expect to come out medium-rare.
 
Thanks for all of your input. I think I have now finally realized why every doctor I scribe for loves their job so much. It's eye-opening when you realize that you just lucked into something that most people don't believe exist.
 
ZPakEffect said:
Thanks for all of your input. I think I have now finally realized why every doctor I scribe for loves their job so much. It's eye-opening when you realize that you just lucked into something that most people don't believe exist.
Click to expand...

Based on your reaction to the answers you received, I'm wondering why you took the time to ask here? It sounds like based on your scribing experience, you decided you knew the answer ahead of time.

Can you make $500k/yr in EM? Absolutely. You may even be able to do it without burning yourself out and working 240 hrs/mo. That being said, it's probably not a great idea to pick a specialty where only 1% of the jobs in your field will meet your expectations and satisfy you. Kind of sets you up with a 99% chance of getting disappointed and bitter.

If you actually like your children/spouse/friends and have interests outside of medicine, 240 hrs will put a strain on those other aspects of your life.
 
If you are a texas resident, how do you figure you will be 400k in debt? state schools in texas are just about the cheapest around. What city are you in?
 
Hercules said:
Based on your reaction to the answers you received, I'm wondering why you took the time to ask here? It sounds like based on your scribing experience, you decided you knew the answer ahead of time.

Can you make $500k/yr in EM? Absolutely. You may even be able to do it without burning yourself out and working 240 hrs/mo. That being said, it's probably not a great idea to pick a specialty where only 1% of the jobs in your field will meet your expectations and satisfy you. Kind of sets you up with a 99% chance of getting disappointed and bitter.

If you actually like your children/spouse/friends and have interests outside of medicine, 240 hrs will put a strain on those other aspects of your life.
Click to expand...

The reason I asked the question is because I thought maybe there were actual logistical, physical, or legal constraints of which I was not aware that would make my calculation misinformed. I am very grateful that you all have informed me that one is only limited by how hard one is willing to work.
 
throckmortonDO said:
If you are a texas resident, how do you figure you will be 400k in debt? state schools in texas are just about the cheapest around. What city are you in?
Click to expand...

I have a JD from a very expensive private East Coast law school that I never used. So law school debt + medical school debt + a decade's worth of interest.
 
Well, you'd better be sure you want to practice medicine in general regardless of salary. By the time you will be an attending (8-9 years from now assuming you are going this fall) things in medicine may not be the same as they are now, especially with some of the new reimbursement changes happening to EM recently. They sure aren't the same as they were about 8 years ago when I was just starting that's for sure.
 
throckmortonDO said:
Well, you'd better be sure you want to practice medicine in general regardless of salary. By the time you will be an attending (8-9 years from now assuming you are going this fall) things in medicine may not be the same as they are now, especially with some of the new reimbursement changes happening to EM recently. They sure aren't the same as they were about 8 years ago when I was just starting that's for sure.
Click to expand...

Hell, I scribe for 10 bucks an hour and I am far happier than I was doing anything related to law. And charting is my least favorite part of the job.
 
ZPakEffect said:
The reason I asked the question is because I thought maybe there were actual logistical, physical, or legal constraints of which I was not aware that would make my calculation misinformed. I am very grateful that you all have informed me that one is only limited by how hard one is willing to work.
Click to expand...

Wow just wow. You are going to get your ass handed to you in the wards with this attitude. Best of luck. As for your last comment about 10/hr. Get rdy to keep making that during residency, and paying during medical school.

Sent from my VS986 using Tapatalk
 
Does this guy have a spectrum disorder?

To answer your question, yes, you can make a ton of money if you work a lot. You can make a mil if you wanted to, but as everyone has advised, you better be ready for some misery.
You can easily moonlight elsewhere, etc. If you're a machine and you can work like that and put your family, friends, dog and social life on hold then more power to you.

Everyone just gave you some reasonable advice as far as burn out and realistic expectations of working hours like that, but you already have the answer.
 
Hook_EM said:
Does this guy have a spectrum disorder?

To answer your question, yes, you can make a ton of money if you work a lot. You can make a mil if you wanted to, but as everyone has advised, you better be ready for some misery.
You can easily moonlight elsewhere, etc. If you're a machine and you can work like that and put your family, friends, dog and social life on hold then more power to you.

Everyone just gave you some reasonable advice as far as burn out and realistic expectations of working hours like that, but you already have the answer.
Click to expand...

Before about 4 hours ago, the only thing I knew about EM was from what I observed while scribing for the physicians of a single group, and from the conversations I had with those same physicians. I am only now realizing that the environment in which this group practices is an outlier in EM. Almost all of the doctors I scribe for work at least 16 shifts per month. The average is 18, and working 20 shifts per month is only 75th percentile for the doctors in the group. They are all, without exception, extremely happy with their jobs and all are wonderful people to work with. There is not a single malignant, unhappy doctor in the group. I feel lucky that I have had the opportunity to build great relationships with the group and might have an edge when it comes to joining the group after residency because I sure as hell don't want to work anywhere else in the EM world.

From the hostile reactions I received, I might as well have claimed to have had afternoon tea with Bigfoot and Mrs. Sasquatch up in the Cascades.
 
Sounds like you're working in DFW in EMcare staffed ERs based on your description of the reducing acuity model and the fact that you're in Texas. Based on the fact that these docs are supervising students and residents, you are either at BUMC, Presby, Parkland, or JPS. I've interacted or worked with physicians in all of these locations and what you are describing is not the norm and it really is not all roses at any of these locations like you describe.
 
Zebra Hunter said:
Sounds like you're working in DFW in EMcare staffed ERs based on your description of the reducing acuity model and the fact that you're in Texas. Based on the fact that these docs are supervising students and residents, you are either at BUMC, Presby, Parkland, or JPS. I've interacted or worked with physicians in all of these locations and what you are describing is not the norm at these locations and it really is not all roses at any of these locations like you describe.
Click to expand...

Nope, none of those. Some of the doctors I have worked with have worked at some of those places and they are much happier where they are at now. For one thing, this group pays their physicians a good deal more than EMCare.

One of the docs that pulls 20 shifts per month at our hospital says that he worked at 10 different EDs before this one and that this one is his dream job.
 
Last edited:
OK, I will lay the truth for you.

I have been doing this for 15 yrs. I have done locums at a bunch of places and most are more difficult and less desireable city than my main job. Thus I take a pay cut.

MOST docs work 15 shift (8-10) a month. Say you do the top end, 150 hr x 250/hr (I would say most IC jobs would pay atleast this) puts you at 450k. You can find jobs at 275/hr and put you over 500k.

I would say this is a hefty work load.

I have locummed at some places where docs do 20-22 twelve hr shifts for YEARS. Some been doing this pace 10+ years so its possible. This would kill me but some can do it. These guys were getting rates at 325+/hr. Do the math. At the low end, they are pulling over 900K. I know some that made well over 1 mil.
 
emergentmd said:
OK, I will lay the truth for you.

I have been doing this for 15 yrs. I have done locums at a bunch of places and most are more difficult and less desireable city than my main job. Thus I take a pay cut.

MOST docs work 15 shift (8-10) a month. Say you do the top end, 150 hr x 250/hr (I would say most IC jobs would pay atleast this) puts you at 450k. You can find jobs at 275/hr and put you over 500k.

I would say this is a hefty work load.

I have locummed at some places where docs do 20-22 twelve hr shifts for YEARS. Some been doing this pace 10+ years so its possible. This would kill me but some can do it. These guys were getting rates at 325+/hr. Do the math. At the low end, they are pulling over 900K. I know some that made well over 1 mil.
Click to expand...

Thanks for for the info, emd!

Are these $325/hr places tiny, low-volume, low-acuity ED's in the middle of Nowhere, West/East Texas? Because a 12-hour shift isn't that bad if you only see 10 patients in those 12 hours. Now, if you have to see 40 patients in those 12 hours, then that's a whole nuther story.
 
Last edited:
ZPakEffect said:
The group whose physicians I scribe for allow their docs to work a maximum of 20 shifts per month. I currently work this EXACT schedule as a scribe and feel as if I could work another 5 shifts a month without any ill effect.
Click to expand...

You're comparing apples to oranges. It's a bit different documenting what someone else does and actually being the one who is doing it.

Emergency medicine is mentally, physically, and emotionally exhausting. I cannot emphasize this enough.

I work 10-hour shifts. I probably get to sit down for less than an hour of that shift. I work at a very high acuity level II trauma/comprehensive stroke center, so my mind is constantly trying to think things through (often times hard cases). Telling a patient or family member that someone has died, has cancer, has a terminal illness, etc. can be devastating, and yet we have to do it routinely. Going through differential diagnoses, treatment options, etc. can wear your brain function down quickly. Most of us have to eat quickly and use the restroom quickly, and some times I work so hard I don't eat because I never had an opportunity to.

At the end of my 10-hour shift I am pretty much useless. I get home and my wife knows to not even ask me what I want to eat, what I want to watch on TV, etc. because she knows I pretty much don't care because I don't want to think anything through.

Repeating that 14-15 shifts/month is bad enough. Doing it 20 times/month is brutal and setting yourself up for burnout very quickly. I know because I've been there. I worked 18-20 shifts/month for nearly 3 years, and I almost quit emergency medicine.

I'm a very tough individual and can handle stress with the best of them, but overtaxed is overtaxed. You will overtax your physical, mental, and emotional well being and something will break if you fail to recognize it soon enough. Luckily I was able to recognize it before something stupid or harmful happened.
 
southerndoc said:
You're comparing apples to oranges. It's a bit different documenting what someone else does and actually being the one who is doing it.

Emergency medicine is mentally, physically, and emotionally exhausting. I cannot emphasize this enough.

I work 10-hour shifts. I probably get to sit down for less than an hour of that shift. I work at a very high acuity level II trauma/comprehensive stroke center, so my mind is constantly trying to think things through (often times hard cases). Telling a patient or family member that someone has died, has cancer, has a terminal illness, etc. can be devastating, and yet we have to do it routinely. Going through differential diagnoses, treatment options, etc. can wear your brain function down quickly. Most of us have to eat quickly and use the restroom quickly, and some times I work so hard I don't eat because I never had an opportunity to.

At the end of my 10-hour shift I am pretty much useless. I get home and my wife knows to not even ask me what I want to eat, what I want to watch on TV, etc. because she knows I pretty much don't care because I don't want to think anything through.

Repeating that 14-15 shifts/month is bad enough. Doing it 20 times/month is brutal and setting yourself up for burnout very quickly. I know because I've been there. I worked 18-20 shifts/month for nearly 3 years, and I almost quit emergency medicine.

I'm a very tough individual and can handle stress with the best of them, but overtaxed is overtaxed. You will overtax your physical, mental, and emotional well being and something will break if you fail to recognize it soon enough. Luckily I was able to recognize it before something stupid or harmful happened.
Click to expand...

Do you work at a place that has the decreasing-acuity model? Because it seems to be a major component of why the physicians I work with are so happy. They only have to deal with high-acuity patients for the first half of the shift. The second half of the shift is all back pain, pregnant vag bleeds, sore throats, procedures, and signing charts. Also, the scribes on my team do ALL the manual labor. We handle all of the paperwork. Some of the doctors only touch a single of piece of paper if they have to pull out their triplicate pad to write Norco's. We even put in all the orders, do all the discharges and admits. All the doctors have to do (other than the mental work of being a physician of course) is talk to the patient, examine the patient, talk to consultants and hospitalists, and talk to RN's, PCT's, LCSW's, etc. The only time they have to interact with the EMR is to click "Sign" on each set of orders and click "Sign" again on each chart.
 
southerndoc said:
Telling a patient or family member that someone has died, has cancer, has a terminal illness, etc. can be devastating, and yet we have to do it routinely.
Click to expand...

I too work at a Level II trauma center where we average 30 charts per shift and I can count on one hand the number of patients that I have seen die in my 16 months of 20-shifts per month work. With the other hand and a few toes I can count of the number of cancer and terminal illness diagnoses. These things do happen but they're really not all that frequent.
 
ZPakEffect said:
Do you work at a place that has the decreasing-acuity model? Because it seems to be a major component of why the physicians I work with are so happy. They only have to deal with high-acuity patients for the first half of the shift. The second half of the shift is all back pain, pregnant vag bleeds, sore throats, procedures, and signing charts. Also, the scribes on my team do ALL the manual labor. We handle all of the paperwork. Some of the doctors only touch a single of piece of paper if they have to pull out their triplicate pad to write Norco's. We even put in all the orders, do all the discharges and admits. All the doctors have to do (other than the mental work of being a physician of course) is talk to the patient, examine the patient, talk to consultants and hospitalists, and talk to RN's, PCT's, LCSW's, etc. The only time they have to interact with the EMR is to click "Sign" on each set of orders and click "Sign" again on each chart.
Click to expand...
Bro, really? Why are you arguing with physicians who are IN the field?
 
ZPakEffect said:
Bro, do you read posts that you quote? Because nothing in that post can be construed as being argumentative in the slightest.
Click to expand...
You literally aren't taking anything they are saying into consideration. If you know so much about the field from your job, why did you even post?
 
SynapticDoctah said:
You literally aren't taking anything they are saying into consideration. If you know so much about the field from your job, why did you even post?
Click to expand...

I am taking it into consideration. If you read a few posts up, I stated that I fully recognize that the environment I work in is an outlier, BUT I only recognized this after I posted my question and got the kind of replies I got. It's apparent that you're jumping into a conversation where you haven't read the entire thread.
 
ZPakEffect said:
I am taking it into consideration. If you read a few posts up, I stated that I fully recognize that the environment I work in is an outlier, BUT I only recognized this after I posted my question and got the kind of replies I got. It's apparent that you're jumping into a conversation where you haven't read the entire thread.
Click to expand...
Nah, I've read the entire thing and this is the impression I got.

Anyways, continue. 🙂
 
Lol wow this is is hilarious. OP, no matter how it might seem in your head, on this post it really does look like you're not considering the whole story.

You've calculated everything to a T from the debt you'll be in to the money you'll make, to how many hours you have to work to pay off those debts and continue life. And as good and valid as those calculations are, it doesn't seem like you realize that you're dealing with a human life. You really don't know if you can physically mentally and emotionally take on those hours and maintain a Non-zombie/vagabond like state. No one knows!! And I think thats a big part of what the doctor was saying earlier.

You're not even in med school yet lol so its all good.
 
Last edited:
The closer you get to be an attending the less you care about money. Or specifically you realize, 300K or 400K per year is a ton more than you have ever had in your life.

Even as a resident at 60K /yr as a single male I basically buy whatever I want without too much thought. Drive a fairly new car, have a nice apartment, travel a few times a year.

You will be fine paying your loans back if you only make 350 K /yr.
 
Zebra Hunter said:
DFW
Click to expand...

Most likely working for the Compton Broaders group in DFW. They have most of the THR contracts. They are paid well but even so working 20 shifts a month takes these folks away from their families most of the time, especially so if they are flipping back and forth from day to night and night to day. I just graduated from residency 1.5 years ago and I don't want to work more than 15 shifts a month.

As long as the OP acknowledges the fact that once you are married and have children, the equation to happiness is working less and being with your family more often. Working 20 shifts a month puts a serious dent in your family life especially your spouse. If the spouse is not happy, you and your family life will be miserable.
 
traxus said:
Most likely working for the Compton Broaders group in DFW. They have most of the THR contracts. They are paid well but even so working 20 shifts a month takes these folks away from their families most of the time, especially so if they are flipping back and forth from day to night and night to day. I just graduated from residency 1.5 years ago and I don't want to work more than 15 shifts a month.

As long as the OP acknowledges the fact that once you are married and have children, the equation to happiness is working less and being with your family more often. Working 20 shifts a month puts a serious dent in your family life especially your spouse. If the spouse is not happy, you and your family life will be miserable.
Click to expand...

Yeah, the plan is to work my ass off for about 4-5 years out of residency then cut back and spend more time with family. Plus, I am thinking of doing full time nocturnist to avoid the flipping entirely.
 
ZPakEffect said:
I too work at a Level II trauma center where we average 30 charts per shift and I can count on one hand the number of patients that I have seen die in my 16 months of 20-shifts per month work. With the other hand and a few toes I can count of the number of cancer and terminal illness diagnoses. These things do happen but they're really not all that frequent.
Click to expand...

I think you are overestimating documentation. Documentation is a time killer for me, but it's the easiest part of the job. It's like saying a coffee barista is stressed out over making 200 cups of coffee in a 2 hour period, but by having someone else sweep the floors it makes their job so much easier.

If I had a scribe, I could probably see one or two more patients per shift. It does nothing to relieve my mental, physical, or emotional exhaustion.

For you to have worked so long and not seen a ton of cardiac arrests that have died, cancer/terminal illness, etc. means you are probably working in a shop without high acuity.

We work in a care team approach where docs are assigned rooms. I rarely, if ever, see level 4's and 5's because these are sent to fast track where a PA sees it. 75% of my patients are level 5's and another 10-15% are critical care.
 
ZPakEffect said:
Well, I will make sure to tell the half a dozen docs I scribe for who work 20 shifts per month that they hate their lives and that they should quit their job. In fact, they all love their jobs and think that it is the best job they have ever found.
Click to expand...

ZPakEffect said:
Look, from my perspective, the most persuasive evidence I have of what is feasible or realistic are the real life physicians I work with every day. One of the docs that I work with who does 20 shifts per month tells me that the ONLY reason he doesn't work MORE shifts is because of the group 20-shift maximum rule. This guy is one of the most energetic, upbeat, enthusiastic EP's I work with. Hell, he even leads all his patients and family members in prayer after each H&P.

Excuse me if my ideas of what it's really like to be an EP are gathered from what I see every single day.
Click to expand...

ZPakEffect said:
The reason I asked the question is because I thought maybe there were actual logistical, physical, or legal constraints of which I was not aware that would make my calculation misinformed. I am very grateful that you all have informed me that one is only limited by how hard one is willing to work.
Click to expand...

Man, if I got these replies to a thread like this, I would just let the thread die. You guys are saints for putting up with this premed by giving him honest appraisals of how things really are. It's interesting how people who don't know anything and have such little experience can be so confident in their misguided thought processes.
 
Last edited:
Psai said:
Man, if I got these replies to a thread like this, I would just let the thread die. You guys are saints for putting up with this premed by giving him honest appraisals of how things really are. It's interesting how people who don't know anything and have such little experience can be so confident in their misguided thought processes.
Click to expand...
But he is taking into account what the docs are saying lol
 
You must log in or register to reply here.

Similar threads

Brigade4Radiant
Hospitals replacing anesthesia docs with EM?
2 3
Replies
102
Views
7K
Janders
J
P
What's the deal with EM?
Replies
44
Views
8K
emergentmd
E
Elbrus
  • Poll Poll
Are physical therapists working with you in the ED?
Replies
18
Views
2K
old_boy
old_boy
E
  • Locked
M3 applying aways- reconsidering if I fit in this speciality
Replies
48
Views
4K
WhatJobDoIPick
W
N
Can this still be a lifestyle job?
2 3 4 5
Replies
247
Views
23K
WhatJobDoIPick
W
Top