Workaholicism...

[glorifiedresident]

Does anyone have an workaholic gene that's perpetually activated? early in my hospitalist career I was pretty hard core about working. I wanted the money and I enjoyed the work. Fast forward now many years later.. financially I'm in a good place now, and a few years ago I realized I didn't have to be doing extra shifts and in fact mathematically it wouldn't move the needle. But I still feel sometimes the urge to work extra shifts and be productive, I still enjoy the work. Can anybody relate? Does anyone have any good stories on workaholic hospitalists or doctors?

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[DrMetal]

Does anyone have an workaholic gene that's perpetually activated? early in my hospitalist career I was pretty hard core about working. I wanted the money and I enjoyed the work. Fast forward now many years later.. financially I'm in a good place now, and a few years ago I realized I didn't have to be doing extra shifts and in fact mathematically it wouldn't move the needle. But I still feel sometimes the urge to work extra shifts and be productive, I still enjoy the work. Can anybody relate? Does anyone have any good stories on workaholic hospitalists or doctors?

We can all relate, we're all workaholics. We've been chasing it since high school.

Get some nice time-consuming hobbies (golf, skiing). They'll make you seek more days off. A spouse and kids help too, but they're way more expensive and sometimes not as much fun.

 

[gutonc]

We can all relate, we're all workaholics. We've been chasing it since high school.

Get some nice time-consuming hobbies (golf, skiing). They'll make you seek more days off. A spouse and kids help too, but they're way more expensive and sometimes not as much fun.

I rarely agree with @DrMetal but I'm gonna +1 the *** out of this.

I think skiing and golf are stupid, but we've all got our things to keep us busy outside of work and I'm leaning into mine right now. So if skiing and golf, or racewalking and soju tasting are yours, more power to you.

 

[DrMetal]

I rarely agree with @DrMetal

You should try it more often. I'm a righteous man.

I think skiing and golf are stupid

Well, there's worse things you can do (cocaine, prostitutes, gambling . . .all of that at the same time).

 

[dozitgetchahi]

Does anyone have an workaholic gene that's perpetually activated? early in my hospitalist career I was pretty hard core about working. I wanted the money and I enjoyed the work. Fast forward now many years later.. financially I'm in a good place now, and a few years ago I realized I didn't have to be doing extra shifts and in fact mathematically it wouldn't move the needle. But I still feel sometimes the urge to work extra shifts and be productive, I still enjoy the work. Can anybody relate? Does anyone have any good stories on workaholic hospitalists or doctors?

“Good stories”?

I had the urge until I burned out during an overcompetitive, high octane rheumatology fellowship…I’ve kinda forced my life to go in different directions ever since (ie, not doing academia). Some days I really enjoy work, some days I’m less enthusiastic about it, and I have plenty of things I like doing to occupy the rest of my time. But I don’t let work control and consume my life, and I never will ever again.

 

[Entadus]

can not relate. QOL above all else. looking forward to getting some more hobbies.

 

[NewYorkDoctors]

yes I have a workahol gene

but this is more out of "necessity" in running a busy and profitable medical practice rather than work for work's sake. I am still on that "linear" part of the curve where more work equals more revenue.

I am not chasing profits for profits sake.

rather the patient load is rather high and if I take some time off, then everything piles up and S hits the fan as the saying goes.

it's not easy to "cut patients down."


I don't have to do any "Scholarly work" but I like to do those things (as a non academic physician) and work with the fellows on their cases, manuscripts, and doing lectures. Even if I cut out the meager scholarly work, I am not sure how much time I actually have...


luckkily all the work is doneon cloud based EMRs, telehealth platforms, and other technology that makes doing this much work far easier now adays than in years past and let's me bring work with myself to vacation! (sounds kinda sad but yes I am on vacation now and doing work as we speak in the dead of the night.)

 

[dgdg]

You just have to look at yourself and see what is healthy for your overall life. Everyone is different.
Some work a lot to avoid other things (ie family, hobbies, social groups, etc).
Some work a lot because they love what they do and are not ignoring other things.
Some are inbetween the two.

If you are questioning yourself, you should reflect. Work-"aholic" and "glofifiedresident", may be in jest, but it does raise some questions about how much you devote to work instead of possibly a more balanced lifestyle.
Give yourself a fair personal assessment, objectively listen to others' view of you, and make a plan.

 

[DrMetal]

I am on vacation now and doing work as we speak in the dead of the night.)

Why? This is terrible, you're on vacation. Turn it off!

Reminds me of the backlash against MOC, when the ABIM actually tried to praise someone for doing LOK questions while on vacation. How neurotic are we?!

 

[glorifiedresident]

Why? This is terrible, you're on vacation. Turn it off!

Reminds me of the backlash against MOC, when the ABIM actually tried to praise someone for doing LOK questions while on vacation. How neurotic are we?!

View attachment 382676

I'm currently preparing for ABIM board recertification, no LKA questions for me, one and done for 10 years...

 

[glorifiedresident]

You just have to look at yourself and see what is healthy for your overall life. Everyone is different.
Some work a lot to avoid other things (ie family, hobbies, social groups, etc).
Some work a lot because they love what they do and are not ignoring other things.
Some are inbetween the two.

If you are questioning yourself, you should reflect. Work-"aholic" and "glofifiedresident", may be in jest, but it does raise some questions about how much you devote to work instead of possibly a more balanced lifestyle.
Give yourself a fair personal assessment, objectively listen to others' view of you, and make a plan.

you raise some good points. for me, working as a hospitalist provides something to do. when rounding, I get to work usually at 8 (after school dropoff) and finish my work and out the door usually between 1-2pmm early enough where i can pick my kids up from school and make dinner. if I had longer days, then i would definitely not work extra and likely cut back.

 

[gutonc]

I'm currently preparing for ABIM board recertification, no LKA questions for me, one and done for 10 years...

I'm currently trying to make the decision on this. I've talked to half a dozen colleagues and they were evenly split on LKA vs 10 year. I can see dis/advantages to both.

10y - just get it done. Study "hard" for a few months, take a day off, sweat it for a couple of months waiting for the result and then forget about it for another decade. I've never failed an exam in my life, and did much better on my onc boards that pretty much any other medicine related exam I've ever taken (MCAT --> ABIM), so I wouldn't sweat it that hard. Even still, it's a high stakes exam.

LKA - 30 Qs a quarter. I can probably bang those out in an hour or less. Get ongoing CME. Might even learn something while looking up answers I didn't know off the top of my head. I love "gamified" learning. Yes, I'm a tool, I'm OK with that. I would probably dig the dopamine rush every time I finished my question set. No need for a focused/dedicated study period. But...I worry it will get tedious and I'm definitely not the best at being proactive on things like this.

 

[BillBill1219]

I get to work usually at 8 (after school dropoff) and finish my work and out the door usually between 1-2pmm early enough where i can pick my kids up from school and make dinner. if I had longer days, then i would definitely not work extra and likely cut back.

How is it possible to work 5-6 hour days routinely? And this is week on/week off?

 

[dozitgetchahi]

I'm currently trying to make the decision on this. I've talked to half a dozen colleagues and they were evenly split on LKA vs 10 year. I can see dis/advantages to both.

10y - just get it done. Study "hard" for a few months, take a day off, sweat it for a couple of months waiting for the result and then forget about it for another decade. I've never failed an exam in my life, and did much better on my onc boards that pretty much any other medicine related exam I've ever taken (MCAT --> ABIM), so I wouldn't sweat it that hard. Even still, it's a high stakes exam.

LKA - 30 Qs a quarter. I can probably bang those out in an hour or less. Get ongoing CME. Might even learn something while looking up answers I didn't know off the top of my head. I love "gamified" learning. Yes, I'm a tool, I'm OK with that. I would probably dig the dopamine rush every time I finished my question set. No need for a focused/dedicated study period. But...I worry it will get tedious and I'm definitely not the best at being proactive on things like this.

I’m firmly in the “every 10 years” department. I do plenty of other CME (that is frankly better than the LKA questions anyway). I’m much happier keeping my brain free of the ABIM and its kooky questions for 10 year intervals. If you’re worried about possibly failing it, then take it a year early and give yourself an extra year in case you fail…but the recert exams are easier than the initial cert exams, and apparently they let you use Uptodate on them now too…

 

[glorifiedresident]

How is it possible to work 5-6 hour days routinely? And this is week on/week off?

Our census ranges from 8-11, no admits while rounding. Round and go. Before going to work I do prerounds note pending from home and I do logon from home after work to look stuff up etc but overall it’s a good gig.

 

[glorifiedresident]

I'm currently trying to make the decision on this. I've talked to half a dozen colleagues and they were evenly split on LKA vs 10 year. I can see dis/advantages to both.

10y - just get it done. Study "hard" for a few months, take a day off, sweat it for a couple of months waiting for the result and then forget about it for another decade. I've never failed an exam in my life, and did much better on my onc boards that pretty much any other medicine related exam I've ever taken (MCAT --> ABIM), so I wouldn't sweat it that hard. Even still, it's a high stakes exam.

LKA - 30 Qs a quarter. I can probably bang those out in an hour or less. Get ongoing CME. Might even learn something while looking up answers I didn't know off the top of my head. I love "gamified" learning. Yes, I'm a tool, I'm OK with that. I would probably dig the dopamine rush every time I finished my question set. No need for a focused/dedicated study period. But...I worry it will get tedious and I'm definitely not the best at being proactive on things like this.

Are you referring to the internal medicine or oncology boards? For internal medicine the vast majority of people choose the lka questions, I’m actually not sure why because the one and done really appeals to me more but there’s a heavier time commitment for sure if you plan on studying. I’m doing all the MKSAP questions then I’ll feel very confident.

 

[rokshana]

Are you referring to the internal medicine or oncology boards? For internal medicine the vast majority of people choose the lka questions, I’m actually not sure why because the one and done really appeals to me more but there’s a heavier time commitment for sure if you plan on studying. I’m doing all the MKSAP questions then I’ll feel very confident.

Doing the LKA for IM and I like it… no prep time, no buying mksap, takes an hour generally…

 

[gutonc]

Are you referring to the internal medicine or oncology boards? For internal medicine the vast majority of people choose the lka questions, I’m actually not sure why because the one and done really appeals to me more but there’s a heavier time commitment for sure if you plan on studying. I’m doing all the MKSAP questions then I’ll feel very confident.

Oncology. I let IM lapse 4 years ago. Makes it much easier for me to tell patients "sorry, I'm not qualified to manage your DM/HTN/HLD/etc". Not that I can't, or don't kinda know how, just that I have no interest in that and now I have a good excuse.

 

[NewYorkDoctors]

Oncology. I let IM lapse 4 years ago. Makes it much easier for me to tell patients "sorry, I'm not qualified to manage your DM/HTN/HLD/etc". Not that I can't, or don't kinda know how, just that I have no interest in that and now I have a good excuse.

"What Patients Want" - instant, concierge, specialist, PCP hand holder, instant overnight access without paying for it all rolled into one.


addendum: i've met a lot of patients in NYC (not just snooty rich old money but also immigrants) who are very proud that "[my] cardiologist is also my PCP."

but that same sentiment does not seem to apply when the nephrologist is also PCP lol

 

[RainerMaria]

I can't imagine wasting 8 hours of my life sitting in a Pearson center ever again. At least with the LKA I can sit with my laptop next to my kids on the couch while they watch Bluey. Not quality time but at least not away all day for mind numbing hours of my life I won't get back.

Also when I am due for re-cert I will be infinitely busier and the idea of closing up shop for a day and moving patients around will be a headache. It's one thing if I'm doing it for CME or vacation but doing it for ABIM is depressing.

 

[glorifiedresident]

The way I see it is, once I pass this test in April, I won't have to spend anytime thinking about ABIM for 10 years, no questions to think about. And my employer will pay me for the day of the test.

 

[osprey099]

Does anyone have an workaholic gene that's perpetually activated? early in my hospitalist career I was pretty hard core about working. I wanted the money and I enjoyed the work. Fast forward now many years later.. financially I'm in a good place now, and a few years ago I realized I didn't have to be doing extra shifts and in fact mathematically it wouldn't move the needle. But I still feel sometimes the urge to work extra shifts and be productive, I still enjoy the work. Can anybody relate? Does anyone have any good stories on workaholic hospitalists or doctors?

I think upbringing matters the most. My immigrant parents used to work blue collar jobs and crazy hours, never complained. Just put their head down and worked and worked. Having seen that throughout my childhood, the "work" I do now pales in comparison in terms of labor intensity, IMO. I'm an oncology fellow with <4 months till graduation. Honestly, residency and fellowship have been easy. The hardest part is matching into desired residency and matching into desired fellowship, because these events are largely out of your control. The actual work is not "difficult" at all compared to what my parents had to go through when they first came to the states. Long hours and hard work don't scare me. In fact, I have moonlighted significantly throughout residency and fellowship. Just for some context, I have averaged approximately 50 nights (7p-7a) of moonlighting per year for the past 2 years as a fellow, in addition to my regular duty hours. In contrast, I have some co-fellows who refuse to moonlight or work an hour more than they are supposed to. It all comes down to perspective and upbringing.

 

[TexasMed22]

I think upbringing matters the most. My immigrant parents used to work blue collar jobs and crazy hours, never complained. Just put their head down and worked and worked. Having seen that throughout my childhood, the "work" I do now pales in comparison in terms of labor intensity, IMO. I'm an oncology fellow with <4 months till graduation. Honestly, residency and fellowship have been easy. The hardest part is matching into desired residency and matching into desired fellowship, because these events are largely out of your control. The actual work is not "difficult" at all compared to what my parents had to go through when they first came to the states. Long hours and hard work don't scare me. In fact, I have moonlighted significantly throughout residency and fellowship. Just for some context, I have averaged approximately 50 nights (7p-7a) of moonlighting per year for the past 2 years as a fellow, in addition to my regular duty hours. In contrast, I have some co-fellows who refuse to moonlight or work an hour more than they are supposed to. It all comes down to perspective and upbringing.

Just out of curiosity, what have your hours been like as an oncology fellow (not including optional moonlighting)? I have heard it can be a very demanding 3 years between inpatient, clinic, research, and studying.

 

[dozitgetchahi]

I think upbringing matters the most. My immigrant parents used to work blue collar jobs and crazy hours, never complained. Just put their head down and worked and worked. Having seen that throughout my childhood, the "work" I do now pales in comparison in terms of labor intensity, IMO. I'm an oncology fellow with <4 months till graduation. Honestly, residency and fellowship have been easy. The hardest part is matching into desired residency and matching into desired fellowship, because these events are largely out of your control. The actual work is not "difficult" at all compared to what my parents had to go through when they first came to the states. Long hours and hard work don't scare me. In fact, I have moonlighted significantly throughout residency and fellowship. Just for some context, I have averaged approximately 50 nights (7p-7a) of moonlighting per year for the past 2 years as a fellow, in addition to my regular duty hours. In contrast, I have some co-fellows who refuse to moonlight or work an hour more than they are supposed to. It all comes down to perspective and upbringing.

There is nothing wrong with allowing time for recreation and the enjoyment of one’s life. I can safely say that the lifestyle of an internal medicine resident means that you’re working harder than the vast majority of Americans. I worked to the point of burnout in my own fellowship - expectations for research and extracurricular nonsense were so high that moonlighting was not going to be possible unless I wanted my sleep (and energy levels) to drop well past a point where it would have been sustainable.

Having seen my own parents (who worked themselves into bad health problems by middle age), my “perspective and upbringing” led me to choose a specialty with less hours which allowed me to actually “have a life” outside of being a doctor. I do very well for myself, too. You may wish to consider what your ultimate goals are in this short life, and whether you’d like to do a bit more than just put your nose to the grindstone.

 

[osprey099]

Just out of curiosity, what have your hours been like as an oncology fellow (not including optional moonlighting)? I have heard it can be a very demanding 3 years between inpatient, clinic, research, and studying.

Our fellowship is very year 1 heavy. Year 1 is about 9 months of inpatient rotations, 2 outpatient rotations and 4 weeks vacation. No research time. No moonlighting allowed.

Years 2 and 3 are both 6 months outpatient clinics, 6 months research (you still have your continuity clinic during research time) with 4 weeks vacation sprinkled in there. Allowed to moonlight (only night shifts available) during year 2 and 3.

Research has not been enforced that stringently. I had a project that ended up in a rejected abstract and another QI project on the side that's ongoing. Also writing a couple of book chapters for one of our attendings but idk if that qualifies as "research." As far as studying, I study almost every day. Scored 90%tile + on both ASCO and ASH ITE as a second year.

I still had time to go on some very nice vacations with my wife. I don't have hobbies though. My wife also takes care of 99% of the household chores and making/prepping meals, etc.

 

[HemeOncHopeful19]

Our fellowship is very year 1 heavy. Year 1 is about 9 months of inpatient rotations, 2 outpatient rotations and 4 weeks vacation. No research time. No moonlighting allowed.

Years 2 and 3 are both 6 months outpatient clinics, 6 months research (you still have your continuity clinic during research time) with 4 weeks vacation sprinkled in there. Allowed to moonlight (only night shifts available) during year 2 and 3.

Research has not been enforced that stringently. I had a project that ended up in a rejected abstract and another QI project on the side that's ongoing. Also writing a couple of book chapters for one of our attendings but idk if that qualifies as "research." As far as studying, I study almost every day. Scored 90%tile + on both ASCO and ASH ITE as a second year.

I still had time to go on some very nice vacations with my wife. I don't have hobbies though. My wife also takes care of 99% of the household chores and making/prepping meals, etc.

Bro… get some skis.

You’ll thank me later

 

[dgdg]

There is nothing wrong with allowing time for recreation and the enjoyment of one’s life. I can safely say that the lifestyle of an internal medicine resident means that you’re working harder than the vast majority of Americans.

I'm sure many others work as hard, the unskilled with two part time jobs still not making a living wage but having others in the household to support a roof over their head, not quite yet homeless. The physical day laborers who age much faster due to their environment. Others may not work nearly as much, but I haven't seen data. I feel we are too heavy on the extremes, economically, in our country.

As far as we -
In residency (20 something yrs ago ) we averaged 90 hour weeks except for the few precious outpatient rotations they gave us. Hopefully no one was sick and you had to go back on the wards to fill in as backup. Our IM training was only 3 yrs, but if you worked 90+ hours per week with scant time off, in dog years that would be 6+ years of actual 'full time' training. Along the way, esp in internship, you were constantly terrified that you were going to unintentionally harm someone with a mistake. If you had a nice resident/attending, it made things better. It was 3 years of constant adrenaline.

 

[rokshana]

I'm sure many others work as hard, the unskilled with two part time jobs still not making a living wage but having others in the household to support a roof over their head, not quite yet homeless. The physical day laborers who age much faster due to their environment. Others may not work nearly as much, but I haven't seen data. I feel we are too heavy on the extremes, economically, in our country.

As far as we -
In residency (20 something yrs ago ) we averaged 90 hour weeks except for the few precious outpatient rotations they gave us. Hopefully no one was sick and you had to go back on the wards to fill in as backup. Our IM training was only 3 yrs, but if you worked 90+ hours per week with scant time off, in dog years that would be 6+ years of actual 'full time' training. Along the way, esp in internship, you were constantly terrified that you were going to unintentionally harm someone with a mistake. If you had a nice resident/attending, it made things better. It was 3 years of constant adrenaline.

They will eventually need to lengthen residency.

 

[gutonc]

Doing the LKA for IM and I like it… no prep time, no buying mksap, takes an hour generally…

I can't imagine wasting 8 hours of my life sitting in a Pearson center ever again. At least with the LKA I can sit with my laptop next to my kids on the couch while they watch Bluey. Not quality time but at least not away all day for mind numbing hours of my life I won't get back.

Also when I am due for re-cert I will be infinitely busier and the idea of closing up shop for a day and moving patients around will be a headache. It's one thing if I'm doing it for CME or vacation but doing it for ABIM is depressing.

The way I see it is, once I pass this test in April, I won't have to spend anytime thinking about ABIM for 10 years, no questions to think about. And my employer will pay me for the day of the test.

I finally pulled the trigger and went with LKA. All of the above are great arguments, but for me, it came down to "no prep time". Sure, the test itself is only a day out of my life, but the prep work I did for it the first round probably amounted to 2-3 weeks of full time study (spread out over 4 months or so). Let's be generous though and say I spent the equivalent of 10 workdays (80 hours) on initial certification.

After signing up for LKA, I just launched into it. I was on my out of town night (I commute an hour each way to my new job so 1 night a week, I stay in town so I can reduce my commute) so I typically take my laptop with me somewhere to have dinner. While waiting for my food to come (and while having a beer), I spent 30 minutes doing 25 of my 30 questions. Most were up-to-date with current practice, including data published in the last 18 months. I got 2 of those wrong. The next morning, while drinking my coffee, I did the other 5 (missed one), so banged them all out with a 90% in <45 minutes. That maths out to 3 hours a year, which over the course of a 10 year cycle, is less than half the time I would reasonably spend on prepping for and taking the 10 year exam.

I'll be honest, if you'd asked me this question a couple of years ago, I would have been squarely in the "10 year" camp. But, at least for the Med Onc exam, I found the LKA questions to be more relevant to actual practice and more updated than the 10 year exam was when I took it. They're actually pretty decent CME even.