Working 2 days per week

[Tangerine123]

What specialties can mantain a private practice by working 2 days per week?

I would gladly sacrifice half of my income to work 2 days per week.

I know a derm that did this. She scheduled patients on Mondays and Wednesdays from 10am to around 4pm. Between her income and her husband's they had enough money for a family of 3. I estimate that their combined income was around 200-250k a year.

She was always so relaxed, positive and energetic. And she would dedicate her time to family/friends and hobbies. Tending her garden, taking her dogs out for a walk, going to her daughter's recitals, painting, hiking. A priceless lifestyle.

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[Chibucks15]

What specialties can mantain a private practice by working 2 days per week?

I would gladly sacrifice half of my income to work 2 days per week.

I know a derm that did this. She scheduled patients on Mondays and Wednesdays from 10am to around 4pm. Between her income and her husband's they had enough money for a family of 3. I estimate that their combined income was around 200-250k a year.

She was always so relaxed, positive and energetic. And she would dedicate her time to family/friends and hobbies. Tending her garden, taking her dogs out for a walk, going to her daughter's recitals, painting, hiking. A priceless lifestyle.

Any of them that can have private practice? I'm very confused by this. If you own the practice you can work however much or little you want, especially if you're willing to 'sacrifice half your salary'. I doubt you will maintain many loyal patients enough to build a solid patient base while only practicing 2 days a week though

 

[Tangerine123]

Any of them that can have private practice? I'm very confused by this. If you own the practice you can work however much or little you want, especially if you're willing to 'sacrifice half your salary'. I doubt you will maintain many loyal patients enough to build a solid patient base while only practicing 2 days a week though

I mean, I know it's doable in any case. But perhaps some fields can manage it easier than others. I see it hard to do in Psych for example, you have to follow your patients chronically. But stuff like derm? You can see most of your patients once and then never again

 

[deleted1064759]

I'm honestly surprised anyone would want to work that little. 2 whole days off is a lot of time.

 

[Tangerine123]

I'm honestly surprised anyone would want to work that little. 2 whole days off is a lot of time.

I think it's a valid thing if your career isn't your main focus/goal and you can economically sustain it.

I would be a happy stay at home dad for example, or go back to studying something new (as a hobby), develop other areas of my life that i've neglected so far.

 

[efle]

Well, in rads nighthawking the standard is 1 weeks on, 2 weeks off. But that means working night shifts for 7 days, then having weeks off at a time after. Often these gigs still offer you partner so you can easily clear 400k+ doing 120 shifts/year, that's probably the fastest way to work very little, but still retire young and stop working altogether if that's the long term goal.

Derm obvs as you mentioned can do less than full time.

ER can often do only 2 or 3 shifts per week, but that's again going to involve night shifts.

IM hospitalist often does 1 week on, 1 week off or some variant of that. Again if you're willing to do nights you can make a lot more / work a lot less.

 

[LunaOri]

Psychiatry, Emergency Medicine, Derm, Ophtho. After an IM residency, you could be a hospitalist or work urgent care, or part time in a group practice setting.

 

[Dr. Doctor MD]

Sorry, but no true private practice can function on 2 days per week except maybe psych. Overhead breaks down into fixed and variable overhead; and the fixed overhead for medical practices is enormous.

For example let's say your practice brings in $150k per work day, that's $750k per year in revenue. Let's say that operating an office 5 days a week would cost about $400k per year, that means you would make about $350k per year ($750k-$400k).

However if you ran your office only 2 days a week, your overhead wouldn't decrease linearly from 60% from $400k to $160k, it would likely only decrease a little bit due to the enormous fixed costs, let's say 2 days per week costs $250k to operate . Now you still bring in the same $150k per day ($300k per year) and your expenses are now $250k. Your take home is now $50k (300k-250k).

Also don't forget the pain in the butt and management time needed to run a practice that you can't bill for... So only 2 days per week is actually a lot more than two 8 hour days.

Theoretically can you run a private practice for only 2 days a week? Maybe, but not likely, and even if you somehow could you'd make almost nothing and your $/hour worked would be appalling.

If you only want to work 2 days a week in a private practice, Psych is your only real option (no EMR, no supplies, no large office).

The other option for 2 day work weeks is joining a group in a specialty with interchangeable shift work (EM/Rads/Anesthesia). You may take a small paycut to only work 2 days per week, but you'll still make a lot of money.

 

[Tenk]

I'm honestly surprised anyone would want to work that little. 2 whole days off is a lot of time.

Spoken like a true dirty communist.

 

[deleted1064759]

Spoken like a true dirty communist.

I'm a meritocratic laissez-faire capitalist, thanks for asking.

 

[simpler2]

This should be doable for a private practice geared towards cosmetics and non-essential "medical" care. It is also very reasonable for non-clinical care jobs (academics, research, medical journalism). For a good amount of essential clinical work, you will either poorly serve in your job capacity or burden a colleague with the work you don't attend to for days you are off or both. I'm baffled why anyone would pursue clinical medicine with the hopes of one day carvings out the "priceless lifestyle" described.

 

[Gambino.]

If you truly only want 2 days a week than EM would be the best fit. We had attendings sign on 20 hour/week contracts as well as others that wanted to spend time with their kids doing locums/PRNs. No patient continuity and no office overhead cost for you.

 

[Mass Effect]

I mean, I know it's doable in any case. But perhaps some fields can manage it easier than others. I see it hard to do in Psych for example, you have to follow your patients chronically. But stuff like derm? You can see most of your patients once and then never again

Actually, it's exceedingly easy in psych. Why do you think otherwise? You can see a mix of psychopharm and therapy or all psychopharm or all therapy. You charge cash only by the hour. This is being done in Manhattan, Beverly Hills, and every place in between. Heard from a friend with a boutique practice on the Upper West Side he charges $500/hr, no insurance, but he's been at it for 20 years with tons of experience so he's very in-demand.

 

[Mass Effect]

IM hospitalist often does 1 week on, 1 week off or some variant of that. Again if you're willing to do nights you can make a lot more / work a lot less.

You can do this for psych as well. Also don't forget locums. You can be a standard locums person or traveling locums person, work when you want, don't work when you dont.

 

[Mass Effect]

If you only want to work 2 days a week in a private practice, Psych is your only real option (no EMR, no supplies, no large office).

The other option for 2 day work weeks is joining a group in a specialty with interchangeable shift work (EM/Rads/Anesthesia). You may take a small paycut to only work 2 days per week, but you'll still make a lot of money.

While I agree with your premise, what makes you think there's no EMR for psych?

The other thing the OP can do with psych is get a cush academic job. They're almost always hiring because hardly any psychiatrists want to do academics and you could easily negotiate a two day work week though you'd get paid crap.

 

[ACSurgeon]

Critical care. You can work 8-12 hour shifts as often as you want. Pay isn’t bad either.

 

[libertyyne]

any medical specialty would be able to offer you a two day work week, provided you are flexible on when those two days are.
IM
FM

If you are willing to take a 50-60 % pay cut you should be able to get a job.

Private practice would only work if you have little overhead and do cash only patients.

You could potentially even carve out a surgical subspecialty with alternating OR and Clinic days , but it might be though to OR time, and I am assuming that if you want to only work 2 days a week you probably do not want to go through a surgical residency.

 

[Dr. Doctor MD]

While I agree with your premise, what makes you think there's no EMR for psych?

The other thing the OP can do with psych is get a cush academic job. They're almost always hiring because hardly any psychiatrists want to do academics and you could easily negotiate a two day work week though you'd get paid crap.

I'm not implying that there aren't EMRs for psych, but if you are starting your own business and working 2 days a week as a psychiatrist, investing in epic or whatever other EMR seems foolish. Just do paper charts and do cash pay only or take the penalty from insurances for paper charts.

 

[Tenk]

While doing a few shifts a month in any field is fine for a veteran attending, you’re gonna be a pretty crappy doctor regardless of whatever field you enter if you do that straight out of residency.

As one of my favorite retired surgeons used to say: “it took me five years to learn how to operate, then five years to learn when to operate, then five years to learn when not to operate.

 

[michaelrack]

It would not be too difficult to piece together 2 days of independent contractor psych work at community mental health clinics

 

[VA Hopeful Dr]

any medical specialty would be able to offer you a two day work week, provided you are flexible on when those two days are.
IM
FM

If you are willing to take a 50-60 % pay cut you should be able to get a job.

Private practice would only work if you have little overhead and do cash only patients.

You could potentially even carve out a surgical subspecialty with alternating OR and Clinic days , but it might be though to OR time, and I am assuming that if you want to only work 2 days a week you probably do not want to go through a surgical residency.

It's not that easy to do in traditional FM. Patients aren't going to be happy only being able to see you 2 days per week. Your partners aren't going to be happy having to pick up the slack.

You can use FM for stuff like urgent care where this would work pretty easily.

 

[libertyyne]

It's not that easy to do in traditional FM. Patients aren't going to be happy only being able to see you 2 days per week. Your partners aren't going to be happy having to pick up the slack.

You can use FM for stuff like urgent care where this would work pretty easily.

Not sure if this is regional or not , but my health system had a bunch of FP docs doing two days a week at the clinic . These were mid to late career folks , but it seemed like they were open to people making their own hours .

 

[Chibucks15]

Not sure if this is regional or not , but my health system had a bunch of FP docs doing two days a week at the clinic . These were mid to late career folks , but it seemed like they were open to people making their own hours .

They probably already built a practice then it’s a lot easier. Seems to be overlooked on here but it takes a couple years of full time and more to build up a patient base that is under your care. Talking to some private practice specialists you can’t just waltz in and work 2 days a week and expect to be sustainable.

Plus with the maldistribution of physicians I doubt clinics will be okay with the young guns mailing it in right out the gate haha

 

[VA Hopeful Dr]

Not sure if this is regional or not , but my health system had a bunch of FP docs doing two days a week at the clinic . These were mid to late career folks , but it seemed like they were open to people making their own hours .

Yeah if you're later in a career it's more possible. We have a guy who is coasting into retirement working 2.5 days/week but that's after 40 years of 5 days/week.

I should have been more clear: no one is going to hire you if you want to start working 2 days a week. You have to have built your practice before people let you slow down that much or go somewhere where they are desperate enough to not care either way.

 

[popopopop]

Local outpatient clinic network in my city has 3x 12s for their FM/IM docs. Despite loving inpatient medicine, I would highly consider outpatient IM if I can get a job like this.

 

[libertyyne]

They probably already built a practice then it’s a lot easier. Seems to be overlooked on here but it takes a couple years of full time and more to build up a patient base that is under your care. Talking to some private practice specialists you can’t just waltz in and work 2 days a week and expect to be sustainable.

Plus with the maldistribution of physicians I doubt clinics will be okay with the young guns mailing it in right out the gate haha

Yeah, im not disagreeing, this is situational , but these folks would also see the walkin's from the partners or the overflow. So they may not have a large choice in patient selection. But all i was implying is that it is possible.

 

[Mad Jack]

It's tough to work that little in most fields because a lot of overhead costs are more or less fixed, like licensure, CME, building space, etc. So you may have 100k of expenses working two days a week but 130k of expenses for working 5 days a week. If you're pulling in, say, 350k a year full time after 480k of gross, you would be pulling 140ish in the same job working two days a week. It's doable, but the returns are better the more you work. Urgent care, ER, and anesthesia are easier to land shift work by the day in, but you'll often be paying for your own health insurance and benefits

 

[smq123]

What specialties can mantain a private practice by working 2 days per week?

I would gladly sacrifice half of my income to work 2 days per week.

I know a derm that did this. She scheduled patients on Mondays and Wednesdays from 10am to around 4pm. Between her income and her husband's they had enough money for a family of 3. I estimate that their combined income was around 200-250k a year.

She was always so relaxed, positive and energetic. And she would dedicate her time to family/friends and hobbies. Tending her garden, taking her dogs out for a walk, going to her daughter's recitals, painting, hiking. A priceless lifestyle.

The truth is is that, while many physicians may WANT to do this, they financially cannot.

Based on your other posts, it looks like you go to medical school in Germany. I am guessing that medical school in Germany, like in many European countries, doesn't cost the equivalent of 4 luxury vehicles. (Seriously, I could have bought a nice Mercedes or BMW for every single year of medical school tuition.)

The problem is, if you only work 2 days a week, it is unlikely that you will make enough to pay off your loans quickly. This is even more true if you are the main income-earner in your family.

There are several physicians who work part time. But most are either a) on the cusp of retirement and just gradually cutting back, or b) married to someone who makes decent money so that they don't have to worry about paying the bills AND their loans on a relatively small income.

 

[AMEHigh]

Well family medicine gives you a lot of options if you’re open to stuff outside of just traditional private practice. The part-time private practice jobs I’ve seen are 3 days a week for people starting out.

Outside of that you could do a variety of things with FM like urgent care, telemedicine, prison medicine, abortion care, university student health, employer care (big corporations often have their own doctors on site & I know someone who does that 1 day a week), etc. There are probably more options but those are the ones that came to mind quickly as I know multiple FM people who do those type of things making their own schedule weekly.

 

[Splenda88]

I'm honestly surprised anyone would want to work that little. 2 whole days off is a lot of time.

I am surprised that you're surprised about that.

 

[mwsapphire]

One of our family friends worked part time ( 2.5 days a week) right outta family med residency so she could focus on being a mother. My understanding is, she was employed, not running her own practice, and all this really did is hit the pause button on her career progress. She then started working full time and opening her own practice. She had that one for a few years, and then it closed and she opened a new one just a year or two ago. She's doing pretty well.

For reference her oldest of 4 kids is a sophomore in college.

 

[Splenda88]

The truth is is that, while many physicians may WANT to do this, they financially cannot.

Based on your other posts, it looks like you go to medical school in Germany. I am guessing that medical school in Germany, like in many European countries, doesn't cost the equivalent of 4 luxury vehicles. (Seriously, I could have bought a nice Mercedes or BMW for every single year of medical school tuition.)

The problem is, if you only work 2 days a week, it is unlikely that you will make enough to pay off your loans quickly. This is even more true if you are the main income-earner in your family.

There are several physicians who work part time. But most are either a) on the cusp of retirement and just gradually cutting back, or b) married to someone who makes decent money so that they don't have to worry about paying the bills AND their loans on a relatively small income.

There are ER docs who work 2 days/wk (20-24 hrs) and still make 200k+ year... Even IM docs can crack 150k+ working 24 hrs/wk. If one continues to live like a resident for a few years, you should have no problem to pay back student loan.

This is not directed at you. It seems like the top 3% income earners kind of don't realize the average family of 4 are doing ok on a 75-90k/year salary, and a lot of them have debts, albeit not our astronomical debt.

 

[sloh]

For PM&R, subacute rehab work typically consists of 2 rehab facilities twice per week, which is a total of 4 days per week. Each day consists of about 4-5 hours of work. Around 350-450k.

And it’s totally fine to start off half-time with only 1 rehab facility working twice per week. It’ll land you in the 200k ballpark.

 

[Splenda88]

For PM&R, subacute rehab work typically consists of 2 rehab facilities twice per week, which is a total of 4 days per week. Each day consists of about 4-5 hours of work. Around 350-450k.

And it’s totally fine to start off half-time with only 1 rehab facility working twice per week. It’ll land you in the 200k ballpark.

I did not know PM&R can do that well... That is good.

 

[sloh]

I did not know PM&R can do that well... That is good.

I actually just quit Kaiser to do that. The ROI wrt compensation/hr worked wasn’t worth it to me (uncompensated work returning
patient messages and phone calls). I’m working 6 days per week because I want to hustle a bit but they were very open to me working only 1 rehab facility twice per week. Also, when I’m only working 4 hours/day, working 6 days is easy. And I can scale back whenever.

I know this because I’m working for 2 companies right now: 2 facilities for 1 company, and 1 facility for the other company.

 

[Splenda88]

I actually just quit Kaiser to do that. The ROI wrt compensation/hr worked wasn’t worth it to me (uncompensated work returning
patient messages and phone calls). I’m working 6 days per week because I want to hustle a bit but they were very open to me working only 1 rehab facility twice per week. Also, when I’m only working 4 hours/day, working 6 days is easy. And I can scale back whenever.

I know this because I’m working for 2 companies right now: 2 facilities for 1 company, and 1 facility for the other company.

Wow.. That is great. Based on what you are saying, your projected income should be in 500k-600k in 2021. I don't know why I thought you were an emergency doc...

 

[sloh]

Wow.. That is great. Based on what you are saying, your projected income should be in 500k-600k in 2021. I don't know why I thought you were an emergency doc...

Hahaha not an EM doc at all! I just like to visit their subforum bc tbh, lots of their most difficult patient population overlaps with what PM&R sees in chronic pain and even acute/subacute rehab. I also strongly considered EM as a specialty when I was a med student and that forum played a major role in dissuading me

 

[calivianya]

They probably already built a practice then it’s a lot easier. Seems to be overlooked on here but it takes a couple years of full time and more to build up a patient base that is under your care. Talking to some private practice specialists you can’t just waltz in and work 2 days a week and expect to be sustainable.

Plus with the maldistribution of physicians I doubt clinics will be okay with the young guns mailing it in right out the gate haha

I imagine this is regional. Would you really have to take time to build up a patient base if the patients in the area are desperate for care? Watched that happen with my dad - he had pretty labile insulin dependent T2DM before he died. It was unusual for him to be able to get an endocrinologist appointment in less than 3 months. Waited 2+ months for urology (as a patient with an indwelling cath) and ID. Even his PCP had at least a 1 month wait.

I would think any patient having a major problem would jump to a new doc if they had an urgent problem but couldn’t be seen for 2+ months. Most people who have good health insurance would prefer going to a doctor’s office over showing up at the ED because they had to wait until they became critical to get care.

 

[fecalith]

Forensic Path. You can work locums or day rates. Some jobs go as much as $2000 per day up to 3 days a week. Others go for $120/hour up to 10 hours a day and some go by $800-1000 per case up to 3 cases a day. No responsibilities other than writing reports and sometimes court. No patient follow ups lol

 

[deleted804295]

What specialties can mantain a private practice by working 2 days per week?

I would gladly sacrifice half of my income to work 2 days per week.

I know a derm that did this. She scheduled patients on Mondays and Wednesdays from 10am to around 4pm. Between her income and her husband's they had enough money for a family of 3. I estimate that their combined income was around 200-250k a year.

She was always so relaxed, positive and energetic. And she would dedicate her time to family/friends and hobbies. Tending her garden, taking her dogs out for a walk, going to her daughter's recitals, painting, hiking. A priceless lifestyle.

You can work however much or little as you want as a physician. Even in a hospital you could have 2 days a week worked into your contract.

 

[deleted804295]

I think it's a valid thing if your career isn't your main focus/goal and you can economically sustain it.

I would be a happy stay at home dad for example, or go back to studying something new (as a hobby), develop other areas of my life that i've neglected so far.

If you want to be a bum you can also live in your parents basement.

If you hate the idea of being a physician so much that you would only work 2 days a week why go into it?

 

[deleted804295]

Spoken like a true dirty communist.

I dont get it.

2 days a week working is so... LITTLE.

That's how much I'd work in retirement. The old adage goes; once you stop working you die

 

[RangerBob]

For PM&R, subacute rehab work typically consists of 2 rehab facilities twice per week, which is a total of 4 days per week. Each day consists of about 4-5 hours of work. Around 350-450k.

And it’s totally fine to start off half-time with only 1 rehab facility working twice per week. It’ll land you in the 200k ballpark.

That's insanely good compensation for SNF work. Is that including stipends from the facilities?

Most inpatient PM&R directors are probably earning that same amount with full time work.

 

[slowthai]

For PM&R, subacute rehab work typically consists of 2 rehab facilities twice per week, which is a total of 4 days per week. Each day consists of about 4-5 hours of work. Around 350-450k.

Wait, how are we just hearing about this? This is truly Plenty of Money & Relaxation. It's objectively better than derm.

 

[calivianya]

If you want to be a bum you can also live in your parents basement.

If you hate the idea of being a physician so much that you would only work 2 days a week why go into it?

How many years have you worked for pay? Just curious. I felt like that in my early 20s but after I worked full time from 16 until 30 before going to med school, I think working 2 days a week as a physician sounds nice. I would want to work 0 days per week if I was going into something I didn’t want to do. When I got to the point that I wanted 0 days of work per week (but obviously couldn’t just quit at the time), that’s when I started taking the med school prereqs.

You can love your job but love being off work more. It’s okay to have a desirable life outside of your job.

 

[Prehealth1011]

For PM&R, subacute rehab work typically consists of 2 rehab facilities twice per week, which is a total of 4 days per week. Each day consists of about 4-5 hours of work. Around 350-450k.

And it’s totally fine to start off half-time with only 1 rehab facility working twice per week. It’ll land you in the 200k ballpark.

That is a whole lot of $$$. Were these jobs always available for PMR grads? I thought typical PMR grads are getting low 200s.
One of our PMR aspirant friends told me apparently they even have non-accredited pain fellowships that exclusively take PMR grads and these are still decent enough to get you a well paying gig in case you don't match into ACGME pain.

 

[sloh]

That's insanely good compensation for SNF work. Is that including stipends from the facilities?

Most inpatient PM&R directors are probably earning that same amount with full time work.

I don’t get any stipends from facilities. Reimbursements are mostly from Medicare for 99306, 99308, 99309 with some additional from commercial insurance companies.

The logistics for this type of works out really nicely. I don’t have to sit in a clinic all day. I’m also only a consultant, not primary; no pagers, nights, holidays, call. As a resident in acute inpatient rehab, I always felt like I was babysitting patients functioning as internist-lite. As a consultant in SAR, I can just focus on rehab/MSK related issues. It’s not the most glamorous job but depending on goals, it’s a good option. I also work in LA, what most would consider a saturated market for physicians.

 

[sloh]

That is a whole lot of $$$. Were these jobs always available for PMR grads? I thought typical PMR grads are getting low 200s.
One of our PMR aspirant friends told me apparently they even have non-accredited pain fellowships that exclusively take PMR grads and these are still decent enough to get you a well paying gig in case you don't match into ACGME pain.

For Kaiser outpatient MSK in LA, starting salary is around 220k with full benefits. You cap out at 280k if you make partner year 4. Get ready to bend over backwards at the altar of patient satisfaction though. Job is more like customer service.

Yes, the 1099 SAR jobs are available for new grads. I’d say it’s relatively new and more residents are finding out about it. Residents don’t get much exposure to it in residency though because it’s not as glamorous as sticking placebo needles in people and obsessing over ultrasound 😛

 

[Tangerine123]

Guys, this was just hypothetical. I'm already in my Psych residency. I was just curious if something like that was attainable. Some of you pointed out facts and technicalities that I wasn't aware of. Good info to have in the back of your mind.

 

[sliceofbread136]

I plan to eventually go to part time pulm/sleep with a day or two of clinic (hoping mostly telemedicine) and a day of reading sleep studies. Pretty sure I could maintain that until death