Work-Life Balance

[Feeter]

How is everyone managing to keep a healthy work life balance? I work in a hospital system doing a lot of limb salvage call. Busy OR, call, clinic combined with staffing shortages has been challenging last year or so. I've pretty much had to decrease my productivity by reducing number of clinic patients I see but in a wRVU system that means your pay is lower. Two friends that switched from this job to private practice because of hectic work conditions. I do have other job offers with higher salary and higher wRVU conversion factor but I think it will be the same challenges as my current job as they are hospital employed jobs. Not sure if the grass is greener.

Would like to start a discussion on this thread to see how everyone else is managing a healthy balance between work and life.

I have been taking some lavish vacations with family to avoid work stress and turn my phone off on weekends when I am not on call but then I get punished with ton of messages when I get back to work.

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[wakaflocka88]

Sorry to hear but these type of jobs - especially Kaiser in NorCal - come with these obligations. I have friends at Kaiser and other systems that take an absurd amount of call since it’s so damn busy. Residents and fellows want this volume coming out new but they soon realize what you mention above. Have you tried taking less call and/or other community providers also share call? Maybe try taking more call on weekdays to offload weekends? Possible for a 4 day work week instead of 5? Take an admin day off every other week? I’m glad you’re taking time off with your family as that is a big priority, your health and well being comes first. To me, taking call is the most draining and if you can mitigate this part to some degree I feel
It’ll make your work week more manageable.

 

[air bud]

I do a terrible job of separation of work/life. It's taking it's toll on my relationships. And I don't see how private practice makes things easier. The bills still need to get paid even if you take time off. And mine is probably more mental energy than physical energy actually. And that is more of a me problem, not being able to truly get away mentally.

 

[DYK343]

Most doctors, especially surgical, struggle with mental health and work life balance. Could you imagine being a general surgeon at a busy hospital? It would be awful.

It helps to have a partner that doesnt work or works from home that can run the daily errrands, take the dog to the vet, take the kids to school, etc.

I take frequent vacations on weekends. I have a spot we keep returning to. Its not expensive and 100% worth it for a brain drain. Phone goes off and doesnt get turned back on until Sunday when I get back home. No social media. No texts. No emails. Nothing. Thats the best I've found for mental health recovery. Makes Monday much better. Tuesday its usually back to holy hell again though lol.

Clip board nurses gave me my ethyl chloride back! I fought that battle and won.

 

[Feli]

I have not worked one weekend (on-call or in the office) since I left hospital employ - unless I count studying for boards or working on templates at the library back when I first started. It is nice to not have to worry about not fully enjoying a party or not being able to go too far from the hospital in a weekend. That's for sure.

I still have some long days of charting late or being up early doing surgery, but it's manageable. It will only get better as I improve my templates and staff cohesiveness. I now do inpatient consults infrequently or round on one of mine who gets admitted, but it's now a roughly monthly and no longer a weekly or daily thing that I'm on the hospital floor.

...That's the nice thing about podiatry: you can make it into whatever you want it to be...

PP owner/solo or hospital employ = usually best $$$, bad hours, on-call in one form or another, hospital admin can torpedo you
VA/IHS = $$$ fair with the benefits, hours are fair, call is zero to avg depending on facility, huge admin inefficiency typically
PP associate = low to fair $$$ (maybe good $ in some MSG or ortho), good hours, call is you get what you allow
Nsg homes or similar = low $$$ but best hours, job quality ultra-low by most ppl's standards, very hard on your posture

Personally, I find that the more $ that I make, the more hours I'm working. It's very possible that all of the above setups make roughly the same per hour. The key is finding a good system and admins that support you - regardless of whether that's PP or hospital.

For me, I find that I tend to make more dumb "I'm working too much so I'm gonna reward myself" buys if I'm doing 70hr/wk... luxury stuff, expensive meals/dates, not looking for deals, etc. If I'm doing 40-50hr/wk, that's usually less $$$, but I tend to hit the gym more, which means I sleep better. That means I make smarter budgets and make relaxed investments and debt payments... still have some "mad money" fun but generally think purchases through more clearly. I probably don't need to spend as much dating since I look and feel better, haha. It does create a bit of a 'less is more' thing for my money situation. Just my own exp through a few PP, a MSG, and a hosp job.

 

[dtrack22]

Hospital employed. I have 3 days of clinic with a schedule that only allows for more than 25 patients if I give the front desk permission to over book. I have one surgical day and generally don’t schedule more than 3 elective cases on any given day which means I tell patients regularly that they can’t have surgery for 4-5 weeks even though I could squeeze them in a few weeks sooner if I wanted to. I am rural and therefore don’t always have someone in house with a foot infection but can always hand them off to Gen Surg or Ortho if I’m leaving town. I did around 5,800-5,900 wRVU my first year with the above scheduling limits and it wasn’t as full as it is now for the first 5-6 months. A little above median MGMA production, with median $/wRVU compensation ($54). So not counting quality bonuses or benefits, gross pay of around $320k. If my current production levels continue into next year, I should do something closer to 7,000 wRVU in year 2. So more like $380k yearly gross pay with 75-80 clinic encounters per week, 4 surgical cases per week, inconsistent inpatient work and a month of vacation. I’m sure the people who regularly complain about being busy, not getting vacation, always being on call, having some obligation to treat every patient who comes through the ED/inpatient floor, etc. make more money than I do. But I’ll happily continue to purposefully limit my work load in exchange for compensation that realistically caps out at $400k…at least until negotiating a higher $/wRVU compensation figure.

The OP, just like everyone else in medicine, needs to learn to say “no.” Especially when you are like the OP and have other jobs available. What are they gonna do, fire you? Ok, go work elsewhere.

 

[Feeter]

Thanks everyone for the discussion here. Seems to me that everyone is in a similar situation as me or at least have gone through it to know what I am talking about. I am still early in my career to make changes such as different job with more support or adequate pay according to MGMA data so I feel that I may take a different job.

It seems family support and vacations are the main ways people are managing work related stress.

Anyone tried one of those "coaches"? I've seen some in podiatry advertise themselves as life coaches but seems like that is a gimmick.

Appreciate everyone's input.

 

[wakaflocka88]

Hospital employed. I have 3 days of clinic with a schedule that only allows for more than 25 patients if I give the front desk permission to over book. I have one surgical day and generally don’t schedule more than 3 elective cases on any given day which means I tell patients regularly that they can’t have surgery for 4-5 weeks even though I could squeeze them in a few weeks sooner if I wanted to. I am rural and therefore don’t always have someone in house with a foot infection but can always hand them off to Gen Surg or Ortho if I’m leaving town. I did around 5,800-5,900 wRVU my first year with the above scheduling limits and it wasn’t as full as it is now for the first 5-6 months. A little above median MGMA production, with median $/wRVU compensation ($54). So not counting quality bonuses or benefits, gross pay of around $320k. If my current production levels continue into next year, I should do something closer to 7,000 wRVU in year 2. So more like $380k yearly gross pay with 75-80 clinic encounters per week, 4 surgical cases per week, inconsistent inpatient work and a month of vacation. I’m sure the people who regularly complain about being busy, not getting vacation, always being on call, having some obligation to treat every patient who comes through the ED/inpatient floor, etc. make more money than I do. But I’ll happily continue to purposefully limit my work load in exchange for compensation that realistically caps out at $400k…at least until negotiating a higher $/wRVU compensation figure.

The OP, just like everyone else in medicine, needs to learn to say “no.” Especially when you are like the OP and have other jobs available. What are they gonna do, fire you? Ok, go work elsewhere.

Great stuff, i do exactly the same thing by purposely limiting my availability especially for clinic and OR cases. I’m happily grossing about $400k currently and I intend to keep it at this pace or less in the future. Plus all the extra benefits, 401k, bonuses require minimal extra work

 

[wakaflocka88]

Thanks everyone for the discussion here. Seems to me that everyone is in a similar situation as me or at least have gone through it to know what I am talking about. I am still early in my career to make changes such as different job with more support or adequate pay according to MGMA data so I feel that I may take a different job.

It seems family support and vacations are the main ways people are managing work related stress.

Anyone tried one of those "coaches"? I've seen some in podiatry advertise themselves as life coaches but seems like that is a gimmick.

Appreciate everyone's input.

I’d say these coaches are more scam than good. Maybe a book from the library will provide more useful info. It all comes down to how much you value your personal time, period. As Dtrack said, he purposely sets up his schedule and I do so too to maximize my family time. Others have different goals - I have friends with families that want to take call 24/7 because they love being abused by the ED (just kidding) and others that want to make $800k. Good for them. You have to figure out what’s best for you because you only live once. It’s easy to work more but once you let it snowball it will be very hard to scale back as quickly as you like.

 

[icebreaker32]

I have not worked one weekend (on-call or in the office) since I left hospital employ - unless I count studying for boards or working on templates at the library back when I first started. It is nice to not have to worry about not fully enjoying a party or not being able to go too far from the hospital in a weekend. That's for sure.

I still have some long days of charting late or being up early doing surgery, but it's manageable. It will only get better as I improve my templates and staff cohesiveness. I now do inpatient consults infrequently or round on one of mine who gets admitted, but it's now a roughly monthly and no longer a weekly or daily thing that I'm on the hospital floor.

...That's the nice thing about podiatry: you can make it into whatever you want it to be...

PP owner/solo or hospital employ = usually best $$$, bad hours, on-call in one form or another, hospital admin can torpedo you
VA/IHS = $$$ fair with the benefits, hours are fair, call is zero to avg depending on facility, huge admin inefficiency typically
PP associate = low to fair $$$ (maybe good $ in some MSG or ortho), good hours, call is you get what you allow
Nsg homes or similar = low $$$ but best hours, job quality ultra-low by most ppl's standards, very hard on your posture

Personally, I find that the more $ that I make, the more hours I'm working. It's very possible that all of the above setups make roughly the same per hour. The key is finding a good system and admins that support you - regardless of whether that's PP or hospital.

For me, I find that I tend to make more dumb "I'm working too much so I'm gonna reward myself" buys if I'm doing 70hr/wk... luxury stuff, expensive meals/dates, not looking for deals, etc. If I'm doing 40-50hr/wk, that's usually less $$$, but I tend to hit the gym more, which means I sleep better. That means I make smarter budgets and make relaxed investments and debt payments... still have some "mad money" fun but generally think purchases through more clearly. I probably don't need to spend as much dating since I look and feel better, haha. It does create a bit of a 'less is more' thing for my money situation. Just my own exp through a few PP, a MSG, and a hosp job.

I would add PP solo is not only $$$ best, but $$$ fair and $$$ low also. A pretty equal mix of all 3 based on many factors.

https://apma.cms-plus.com/files/2018%20Practice%20Survey%20Results_FINAL.pdf

https://podiatrym.com/pdf/2022/2/Survey222Web.pdf

 

[Feli]

...The OP, just like everyone else in medicine, needs to learn to say “no.” Especially when you are like the OP and have other jobs available. What are they gonna do, fire you? Ok, go work elsewhere.

Yep, this is the bottom line. You get what you allow. ^^^

It's easier in some situations than others, but you can always put your foot down.
I could be taking call at multiple hospitals or doing Saturday clinic if I wanted to. Those are all hard no for me at this point.

The main problem is the frog in boiling water thing... you take a job with fine enough call schedule (or even no call) , then someone leaves, then you absorb most of those patients, then other stuff comes up, then maybe admin changes, blah bla bla etc. You have to stick to your guns, but in some places, that risks your job (esp when new hires or colleagues are quietly just taking the gradually increased call and/or the over-bookings).

I agree that you are fine if you have job options and have savings + investments, though. I'm a big fan of quitting (as opposed to staying in a bad situation indefinitely and hoping it improves)... learn the lesson and move on. Sometimes, you have to put deadlines on a struggling job, relationship, project, etc and stick to it: "if I'm not X by date Y, I'm gone." Quitting lights that fire that'll get you working aggressively on a better job and thinking about what you want and need. Those are some of the best times for personal growth. Coaches might be ok for very passive types or in short term situations (divorce, grief, job loss, etc), but you are serving a life sentence of solitary confinement in your own skin and mind... usually best to figure out how to self-direct and self-soothe sooner rather than later?

Regardless, if you are producing and being reasonable, sometimes you simply don't align with the admins. No big deal. Learn the lesson and move on. The whole idea of a resume with too many job changes being toxic is from a generation or more ago. Now, it's no big deal to say in an interview that you didn't feel you were being utilized properly or weren't being promoted or given increased compensation... so you left. Not a big deal. MBAs, attorneys, laborers job-hop and find where they're happiest and treated best. There is no reason docs shouldn't do the same (now that we're largely hospital or big VC group pod/MSG grunt workers instead on entrepreneurs, as we were a few decades ago).

 

[NatCh]

Clip board nurses gave me my ethyl chloride back! I fought that battle and won.

Victory!

 

[Hungry_Anxiety8703]

I've found after working for a year that inpatient and call is just miserable to me. I hated in residency and I hate it as an attending. I do a ton of it right now and don't plan to do it again if I can help it. Also the work is also just so physically exhausting in the hospital because you can't just walk into a room, talk to the patient and move on to the next. If I have a list of 12 people and half of them have bilateral wounds across both legs that I need to see a significant chunk of my time gets taken up just doing the dressing change. Half the time the nurses are either too busy or too lazy to do the dressing changes that they are told to do. Trying to concentrate in office is also a pain in the ass when your phone is blowing up with texts and calls from people in the hospital. As far as work life balance inpatient seems like the absolute worst way to go.

 

[air bud]

Hospital employed. I have 3 days of clinic with a schedule that only allows for more than 25 patients if I give the front desk permission to over book. I have one surgical day and generally don’t schedule more than 3 elective cases on any given day which means I tell patients regularly that they can’t have surgery for 4-5 weeks even though I could squeeze them in a few weeks sooner if I wanted to. I am rural and therefore don’t always have someone in house with a foot infection but can always hand them off to Gen Surg or Ortho if I’m leaving town. I did around 5,800-5,900 wRVU my first year with the above scheduling limits and it wasn’t as full as it is now for the first 5-6 months. A little above median MGMA production, with median $/wRVU compensation ($54). So not counting quality bonuses or benefits, gross pay of around $320k. If my current production levels continue into next year, I should do something closer to 7,000 wRVU in year 2. So more like $380k yearly gross pay with 75-80 clinic encounters per week, 4 surgical cases per week, inconsistent inpatient work and a month of vacation. I’m sure the people who regularly complain about being busy, not getting vacation, always being on call, having some obligation to treat every patient who comes through the ED/inpatient floor, etc. make more money than I do. But I’ll happily continue to purposefully limit my work load in exchange for compensation that realistically caps out at $400k…at least until negotiating a higher $/wRVU compensation figure.

The OP, just like everyone else in medicine, needs to learn to say “no.” Especially when you are like the OP and have other jobs available. What are they gonna do, fire you? Ok, go work elsewhere.

This is what I am going to mimic. Ortho PP isn't working for me, but more so due to problems with repayment mainly by IHS. I have to have Medicaid first deny then submit to IHS. I have literally 75k of money that haven't been paid on over the last year. Some months are good some are great some are bad all based on how money comes in and expenses go out. If the hospital doesn't give me this then I will leave. I have clearly demonstrated the significant need for a pod where I am. I will give up some autonomy for guarantee in compensation and some security. If I leave, Ortho isn't hiring another pod, someone isn't coming in and doing private practice, so the option is MSG or Hospital. At the MSG would still be on collections vs RVU at the hospital. And I don't want collections. And each month having zero idea what my compensation will.ve has caused enormous stress. Some of this is self inflicted. Had to amnio that my office billed wrong and took 6 months to collect. But people wanted to be paid early, so I had to pay before receiving payment, and then another 15k bill paid earlier than should have....so my AR is all messed up.

 

[CutsWithFury]

Before I left my hospital job I was doing 800-1000 RVUs per month. I grossed 450-470K my last two years.

I flamed out because I never said no to the volume. Always doubled booked. Sometimes tripled booked. Fought with ortho on a regular basis to eat up as much of the ankle work as possible. Just "made myself available" constantly to get as much volume as possible.

When the hospital admin saw I was all about the dollars they rewarded me by overbooking because I was literally the only person on staff who was willing to run themselves into the ground. They will keep feeding the monster because the amount of money they are making off me and the downstream revenue I am generating is undeniable.

Ultimately though it is not sustainable. I gained 30 lbs over the course of 5 years, stopped exercising, became extremely difficult to work with and I was crappy husband and father.

Leaving was the best thing that ever happened to me.

I moved on to locums work where I get paid more money than I was making at my hospital job if you can believe that. If I could do locums at major hospitals indefinitely I would. It's been literally the only time in my career where I feel I have been being fairly compensated for my time and training. It has been literally the only time in my career I felt like I was being compensated similarly to what a foot and ankle orthopedist makes even though it still is not as much. I am finishing up a contract and it has been the best job in my life. I've worked hard, did good cases, got a lot of sleep, went to the gym. Wow what a turn of events.

Ultimately I would like to return to permanent work and lay down some roots but I am going to ride this locum wave as long as I can. I am taking some time off for 1.5 months then doing another contract for 6 months after that.

 

[sloh]

Sorry to hear but these type of jobs - especially Kaiser in NorCal - come with these obligations. I have friends at Kaiser and other systems that take an absurd amount of call since it’s so damn busy. Residents and fellows want this volume coming out new but they soon realize what you mention above. Have you tried taking less call and/or other community providers also share call? Maybe try taking more call on weekdays to offload weekends? Possible for a 4 day work week instead of 5? Take an admin day off every other week? I’m glad you’re taking time off with your family as that is a big priority, your health and well being comes first. To me, taking call is the most draining and if you can mitigate this part to some degree I feel
It’ll make your work week more manageable.

Is this true for Kaiser in SoCal as well?

 

[CutsWithFury]

Is this true for Kaiser in SoCal as well?

I doubt it. Kaiser SoCal is a little more conservative in terms of ankle work/volume from my understanding. Ortho has a bigger presence there. I doubt Kaiser podiatrists in southern California are as busy as NoCal podiatrists. But I could be wrong.

The sad thing about Kaiser is that it used to be one of the most coveted jobs in podiatry because of the base salary and benefits. But there are no RVU incentive bonuses and the cost of living in California is a joke. In my opinion working at Kaiser is not that great anymore.

Some major DPMs on the ACFAS lecture circuit have recently left Kaiser for these reasons. They would rather work for private ortho groups or for themselves where their earning potential is much higher.

 

[DYK343]

Before I left my hospital job I was doing 800-1000 RVUs per month. I grossed 450-470K my last two years.

If I did my math right you were only making about $40 an RVU? Seems really low (assuming 470k and 1000RVU/month)

 

[wakaflocka88]

Is this true for Kaiser in SoCal as well?

Negative. Very different culture as ortho has a strong presence. Kaiser NorCal - they punt everything to podiatry because there is no incentive to work harder there. Everyone tries to work as little as possible because as mentioned above, zero productivity incentive. It will always be a coveted job based on the volume, variety, good pay, good benefits but you WILL be worked to the bone no matter what. To me it’s silly to work that hard and not be compensated but many will disagree with me.

Quite a few highly regarded pods at Kaiser have left for PP or MSG jobs for the above reasons - working more for the same pay. I had offers but I chose my MSG over Kaiser for these reasons. In podiatry, “Kaiser trained” is thrown around left and right for “prestige.” Outside of DPM world, no one has a clue or gives a sh** what that even means.

 

[CutsWithFury]

If I did my math right you were only making about $40 an RVU? Seems really low (assuming 470k and 1000RVU/month)

$44-45 at different RVU tiers

 

[CutsWithFury]

Negative. Very different culture as ortho has a strong presence. Kaiser NorCal - they punt everything to podiatry because there is no incentive to work harder there. Everyone tries to work as little as possible because as mentioned above, zero productivity incentive. It will always be a coveted job based on the volume, variety, good pay, good benefits but you WILL be worked to the bone no matter what. To me it’s silly to work that hard and not be compensated but many will disagree with me.

Quite a few highly regarded pods at Kaiser have left for PP or MSG jobs for the above reasons - working more for the same pay. I had offers but I chose my MSG over Kaiser for these reasons. In podiatry, “Kaiser trained” is thrown around left and right for “prestige.” Outside of DPM world, no one has a clue or gives a sh** what that even means.

Outside the speciality of Podiatry being trained at a Kaiser hospital is not impressive.

 

[newfeet]

How is everyone managing to keep a healthy work life balance? I work in a hospital system doing a lot of limb salvage call. Busy OR, call, clinic combined with staffing shortages has been challenging last year or so. I've pretty much had to decrease my productivity by reducing number of clinic patients I see but in a wRVU system that means your pay is lower. Two friends that switched from this job to private practice because of hectic work conditions. I do have other job offers with higher salary and higher wRVU conversion factor but I think it will be the same challenges as my current job as they are hospital employed jobs. Not sure if the grass is greener.

Would like to start a discussion on this thread to see how everyone else is managing a healthy balance between work and life.

I have been taking some lavish vacations with family to avoid work stress and turn my phone off on weekends when I am not on call but then I get punished with ton of messages when I get back to work.

I have terrible work-life balance because I chased the high salaries and loan forgiveness which took us to rural locations. Work has always been great but the life part not so much. My wife ended up hating both locations after a few months.

I am hoping things will change now that we are moving to a suburban town. It still isn't the ideal location but I will have a 5 min commute and I will finish clinic on most days at 330.

I am looking at a switch to private practice in a few years. The plan is to start my own practice in a location that is warmer and we both like.

 

[NatCh]

Not sure how useful my input will be since it seems like a lot of you are employed physicians and are therefore subject to different rules of engagement than those of us in private practice but I feel like I have a really good work/life balance. I do my best to set boundaries. Learn how to say no. Don't feel as if you have to do everything for everyone. Do only the work that you want and be okay with another provider doing the work that you find soul-sucking. You're not going to save humanity by doing podiatry. Admittedly, it's easier to carry through with this approach when your debt is low or gone.

 

[SouthPod7]

Ultimately I would like to return to permanent work and lay down some roots but I am going to ride this locum wave as long as I can. I am taking some time off for 1.5 months then doing another contract for 6 months after that.

You're going back to locums? Did you decline both hospital job offers you had (I think it was one from a VA and one from a community hospital)?

 

[CutsWithFury]

You're going back to locums? Did you decline both hospital job offers you had (I think it was one from a VA and one from a community hospital)?

The VA job is still being offered but they still have not heard from their admin about a salary offer or contract. Its been 4 months since HR called me offering the job. It’s a VA in California. From what I hear VAs in California can take up to one year for the applicant to finally start.

The other hospital job offer is in a questionable rural area therefore I told them I would come out there as a locums to get a feel for the area and hospital and they accepted. If I like it after locums I’ll sign on permanently.

 

[SouthPod7]

The VA job is still being offered but they still have not heard from their admin about a salary offer or contract. Its been 4 months since HR called me offering the job. It’s a VA in California. From what I hear VAs in California can take up to one year for the applicant to finally start.

The other hospital job offer is in a questionable rural area therefore I told them I would come out there as a locums to get a feel for the area and hospital and they accepted. If I like it after locums I’ll sign on permanently.

4 months with no contact is insane! Don't they know how much circumstances can change in that timeframe? How does that VA recruit anybody?

 

[CutsWithFury]

4 months with no contact is insane! Don't they know how much circumstances can change in that timeframe? How does that VA recruit anybody?

I’m not going to lie it is completely insane. This particular VA is located in one of nicest cities in California and yet their podiatry staff is grossly understaffed. Yet they want to add more podiatrists. Yet they take forever to onboard…

Doesn’t make much sense

 

[dtrack22]

but I feel like I have a really good work/life balance.

It helps when you have cash paying ultra marathoners and mountain bikers…and a sugar momma 😉

 

[NatCh]

It helps when you have cash paying ultra marathoners and mountain bikers…and a sugar momma 😉

Most of my income comes from my OnlyFans page.

 

[Shiyuan]

I agree with the “just say no” comments. Learn your limitations and avoid burnout.

For me, it comes to avoiding the unnecessary hospital stuff... Why drive to the hospital for a basic stable DFU new consult that A) is a waste of time/gas and B) won’t make a lick of diffrence with your already large patient panel?

Also, I recommend not going back to clinic after your scheduled outpatient surgery day.... Take the rest of the day for note catchup, op report dictations, etc. and get home to see your family! I realize this may not be fully realistic for everyone here... but those extra half-days off once/twice a month are healthy for you, spouse and kiddos. Just my 2 cents.

 

[dtrack22]

Most of my income comes from my OnlyFans page.

Well I wasn’t gonna out you here but I will admit it’s worth the $10/mo subscription…

 

[dtrack22]

Also, I recommend not going back to clinic after your scheduled outpatient surgery day....

Someone’s PP boss isn’t going to like that…you’ll have the owners wife, I mean “office manager,” on your ass for not coming back to knock out some routine foot care after surgery

 

[NatCh]

Someone’s PP boss isn’t going to like that…you’ll have the owners wife, I mean “office manager,” on your ass for not coming back to knock out some routine foot care after surgery

OMG get far away from any office where the owner's spouse is on staff. The heinous Spouse/Manager is a sure way to kill morale. Even when they're not on staff if they're someone who thinks they need to take part in management then they're toxic. Blahhhh.

 

[Scrantonicity]

OMG get far away from any office where the owner's spouse is on staff. The heinous Spouse/Manager is a sure way to kill morale. Even when they're not on staff if they're someone who thinks they need to take part in management then they're toxic. Blahhhh.

I second this...precisely the environment I'm leaving. The main reason I never pushed for partnership. Couldn't pay me enough to stay...

 

[NatCh]

Well I wasn’t gonna out you here but I will admit it’s worth the $10/mo subscription…

Thanks for your support!

 

[NatCh]

Thanks for your support!

Well that killed the vibe...

 

[Scrantonicity]

Vibe is intact. We're just staring in shocked silence.

 

[NatCh]

Vibe is intact. We're just staring in shocked silence.

$10 please

 

[Scrantonicity]

 

[Homo sapien]

how do you find podiatry locum work

Before I left my hospital job I was doing 800-1000 RVUs per month. I grossed 450-470K my last two years.

I flamed out because I never said no to the volume. Always doubled booked. Sometimes tripled booked. Fought with ortho on a regular basis to eat up as much of the ankle work as possible. Just "made myself available" constantly to get as much volume as possible.

When the hospital admin saw I was all about the dollars they rewarded me by overbooking because I was literally the only person on staff who was willing to run themselves into the ground. They will keep feeding the monster because the amount of money they are making off me and the downstream revenue I am generating is undeniable.

Ultimately though it is not sustainable. I gained 30 lbs over the course of 5 years, stopped exercising, became extremely difficult to work with and I was crappy husband and father.

Leaving was the best thing that ever happened to me.

I moved on to locums work where I get paid more money than I was making at my hospital job if you can believe that. If I could do locums at major hospitals indefinitely I would. It's been literally the only time in my career where I feel I have been being fairly compensated for my time and training. It has been literally the only time in my career I felt like I was being compensated similarly to what a foot and ankle orthopedist makes even though it still is not as much. I am finishing up a contract and it has been the best job in my life. I've worked hard, did good cases, got a lot of sleep, went to the gym. Wow what a turn of events.

Ultimately I would like to return to permanent work and lay down some roots but I am going to ride this locum wave as long as I can. I am taking some time off for 1.5 months then doing another contract for 6 months after that.

 

[CutsWithFury]

how do you find podiatry locum work

Be handsome

 

[zircushio]

Be handsome

In this economy?!

 

[AttackNME]

I’d say these coaches are more scam than good. Maybe a book from the library will provide more useful info. It all comes down to how much you value your personal time, period. As Dtrack said, he purposely sets up his schedule and I do so too to maximize my family time. Others have different goals - I have friends with families that want to take call 24/7 because they love being abused by the ED (just kidding) and others that want to make $800k. Good for them. You have to figure out what’s best for you because you only live once. It’s easy to work more but once you let it snowball it will be very hard to scale back as quickly as you like.

Podiatry life coaching? Is that a thing? Know anyone paying for it?

 

[AttackNME]

How is everyone managing to keep a healthy work life balance? I work in a hospital system doing a lot of limb salvage call. Busy OR, call, clinic combined with staffing shortages has been challenging last year or so. I've pretty much had to decrease my productivity by reducing number of clinic patients I see but in a wRVU system that means your pay is lower. Two friends that switched from this job to private practice because of hectic work conditions. I do have other job offers with higher salary and higher wRVU conversion factor but I think it will be the same challenges as my current job as they are hospital employed jobs. Not sure if the grass is greener.

Would like to start a discussion on this thread to see how everyone else is managing a healthy balance between work and life.

I have been taking some lavish vacations with family to avoid work stress and turn my phone off on weekends when I am not on call but then I get punished with ton of messages when I get back to work.

I’m in private practice now after working for a VA for awhile, I usually have 1 day a week where I have no clinic, I take a decent amount of call but I round infrequently, makes limb salvage life easier, making more money with less stress than being at the VA even after the bill passing promotion

 

[CutsWithFury]

I’m in private practice now after working for a VA for awhile, I usually have 1 day a week where I have no clinic, I take a decent amount of call but I round infrequently, makes limb salvage life easier, making more money with less stress than being at the VA even after the bill passing promotion

What was your salary in the VA? I find it hard to believe you are making more in private practice if you were being paid 200-240k starting salary at the VA.

 

[AttackNME]

What was your salary in the VA? I find it hard to believe you are making more in private practice if you were being paid 200-240k starting salary at the VA.

Bumped up to 200k when the bill passed. But now after a year of hustling in priv practice I’m netting well over 240k. Had actually a very good boss and contract that gives me bonus based on 30% of my collections. I slowed down the hustle cus I have built my patient base and have a very efficient clinic with 2 MA’s usually and better life balance now

 

[CutsWithFury]

Bumped up to 200k when the bill passed. But now after a year of hustling in priv practice I’m netting well over 240k. Had actually a very good boss and contract that gives me bonus based on 30% of my collections. I slowed down the hustle cus I have built my patient base and have a very efficient clinic with 2 MA’s usually and better life balance now

How many years were you under 200k? Then how many years did you work once you were bumped up to 200k?

The bill passing was awhile ago. I can understand if you wanted to take a stab at PP if you were making 140-160k as a VA employee for several years.

But working in the VA right now IMHO is a much better option than most podiatry associate positions considering they should be starting at least at 200k, you get a 15k production bonus, you get base salary increases every two years, you get great benefits and end up with a decent pension as well.

 

[AttackNME]

How many years were you under 200k? Then how many years did you work once you were bumped up to 200k?

The bill passing was awhile ago. I can understand if you wanted to take a stab at PP if you were making 140-160k as a VA employee for several years.

But working in the VA right now IMHO is a much better option than most podiatry associate positions considering they should be starting at least at 200k, you get a 15k production bonus, you get base salary increases every two years, you get great benefits and end up with a decent pension as well.

I was doing it for 2 years at 120k, and when I knew the pay raise was coming I already decided I’ve had it with the administrative tasks and lack of control over my schedule. I saw the physician contract to get pay raise involved being a part of committees and doing lectures and academic stuff, which I don’t like any of that stuff, doesn’t make me excited to keep doing VA work.

I really did get lucky finding a good PP gig, I have potential to more than double the 200k salary in a few years without killing myself with partnership opportunities. My boss actually recognizes my value! I realize that I’m in the minority with PP situations reading through the forum but just wanted to share that good opportunities in PP do exist, don’t want people to completely give up hope!

 

[Pronation]

I was doing it for 2 years at 120k, and when I knew the pay raise was coming I already decided I’ve had it with the administrative tasks and lack of control over my schedule. I saw the physician contract to get pay raise involved being a part of committees and doing lectures and academic stuff, which I don’t like any of that stuff, doesn’t make me excited to keep doing VA work.

I really did get lucky finding a good PP gig, I have potential to more than double the 200k salary in a few years without killing myself with partnership opportunities. My boss actually recognizes my value! I realize that I’m in the minority with PP situations reading through the forum but just wanted to share that good opportunities in PP do exist, don’t want people to completely give up hope!

This is a very strange post. I'm glad you were able to get find a gig that you are satisfied with. I just wanted to warn residents looking for jobs that this is not the norm - there is a high chance that you will get completely and utterly screwed when you join a pod private practice.

 

[wakaflocka88]

This is a very strange post. I'm glad you were able to get find a gig that you are satisfied with. I just wanted to warn residents looking for jobs that this is not the norm - there is a high chance that you will get completely and utterly screwed when you join a pod private practice.

I echo AttackNME. out of residency, I had an offer from a very ethical solid PP group - 6 pods in the group and all are well trained, honest good people. I chose to join an ortho group in town instead but looking back, I would have been happy in that group too.