Hours Physicians work

[Guest peachy]

Lol Peter. :lol You're goin' to Ottawa anyways, so it doesn't REALLY matter.

 

I was quite taken aback by the tone of the original message too (and agree with your response) ... but I'm willing to give the OP the benefit of the doubt on the basis of being new here, I think. We don't want to scare all the lurkers out there from making a first post!! :b

[Guest MayFlower1]

you're right peachy...it just gets my back up when people make sweeping generalizations about issues they may not be that familiar with.

 

j282, I don't mean to come down on you...and I don't hold grudges...but diplomacy and openmindedness go a long way in this forum

 

Peter

[Guest FrenchyMed]

I would like to add that I am currently a public servant in Ottawa. Both my parents were before me and many of my friends are too.

 

Although SOME employees are slackers (just like everywhere else), MOST actually care about their work and want to make a difference and serve Canadians well. I think that this attitude against public servants is a load of you know what! People think that because they pay taxes, they have a right to criticize. I would like you all to remember that public servant ALSO pay taxes...

 

I am not a slacker. I aspire to become a physician. I hope to bring valuable insight and experience from my work in the government.

 

I'd like to see you guys deal with people who call you at work to give you crap because you don't work hard enough (I work more hours than what I get paid for, BTW) and that you have to do what they tell you to because their taxes pay for your salary and that if you do not fix their problem right away, they'll call their MP!!!

 

I have learned to bite my tongue and remain diplomatic. I think that, along with other qualities, would make a good physician...

 

My 2 cents.

 

PS: sorry if I'm getting off topic but this thread really pissed me off!

 

FrenchyMed

[Guest Mimicat65]

I just want to add as well, that being dedicated and "working hard" and "working long hours" is not necessarily restricted to physicians and others earning six-figure incomes. I have neighbors (and now friends ) who have three young children, and who work incredibly hard just to maintain their status as "working poor" rather than sponging off EI or welfare system. The husband goes to work (heavy equipment repair technician in private sector manufacturing plant - non-unionized) at about 6 am (often 6 days/week) and often gets called in on Sundays if there is a glitch or breakdown. He gets home most days by 3:30 then heads out at 4 to a second job until about 8 or so. His wife, works at a local grocery store to help pay the bills. They probably make about $30k as total family income - hardly "cushy". Both are very hard-working, but don't have the benefit of higher education (which I remind you is a priviledge!) to help boost them into better-paying jobs.

 

I only point this out because I find that we (in a forum such as this) sometimes forget that not everyone earns 6 figures.... generalizations can be really dangerous guys - lets remember to be "critical thinkers".

 

Mimi

[Guest j282]

Here's an interesting article:

 

www.canada.com/ottawa/ott...640F3A0C20

 

From the Ottawa Citizen ironically. In relation to this discussion, the hours noted as typical for a Family doc are 54.5 Hours per week (with an income BEFORE income tax of 99,300)

 

It was also interesting to note that the doctor interviewed (Dr. Maher) knows of several people working for the gov't who earn $60,000 for in his words "do next to nothing" I personally don't believe in this attitude but I do think it plays in to Newbee's comment that physicians feel they really do have it worse than anyone else and are the only people hard done by. I guess in defense of my own earlier ignorant comments regarding gov't workers was in preperation for my own bratty attitude that I must assume once I graduate med school

 

Peace:

[Guest MayFlower1]

j282,

 

I believe you have misquoted the article with the following statement:

 

From the Ottawa Citizen ironically. In relation to this discussion, the hours noted as typical for a Family doc are 54.5 Hours per week (with an income BEFORE income tax of 99,300)

 

The statement made in the article was:

 

Family doctors and general practitioners in 1999-2000, working a typical 54.7-hour week, on average billed OHIP $168,300 a year, according to Ontario Medical Association figures. Their average net earnings after overhead expenses is $99,300, the OMA reports.

 

This isn't saying typical hours of family docs was 54.5 hours per week. What the article says is that a general practitioner working 54.7 hours a week, on average billed 168,300. This is quite a different statement. I would guess, based on our experience and that of several of our colleagues and friends, that the average number of hours for a family physician with their own business or practicing as part of a group which they have at least partial ownership of, would be closer to 70-80 hours of work...not all of which are billable.

 

Let's say, for a moment, that 54.7 hours a week was "typical"...that's still a whole lot work than most people (i.e., most are required to work 37.5 hours per week). Also, factor in overhead, lack of benefits and bonuses, lack of disability coverage...amount of education..amount of responsibility...etc.,etc., that most other people have...it's definitely not a cake walk.

 

I think the following numbers are very interesting and more indicative of how difficult it is (i.e., how much you have to work) to run a family medicine practice:

 

A family doctor bills OHIP $54 for a one-hour patient checkup (the gas or fuel oil company can charge $110 for a furnace checkup). A doctor receives $25 for a minor assessment while paying an average overhead cost of $15 to $17 per visit

 

First...$54 for one hour of work? Give me a break...if you worked 37.5 hours a week...and assuming you had NO OVERHEAD OR TAXES...you would only make $105,300 a year (assumes you work 52 weeks a year...no vacation...no benefits, etc, 37.5 hours a day and only do physicals billable at 54 bucks an hour)...subtract an average of 35% overhead (many people pay more...currently we are at about 40% with our own clinic)...which leaves you with...68,445 prior to taxes...take off another chunk for taxes...that's not a lot of money...many people from other professions and trades make way more than this...

 

...to make a hundred grand after taxes in FM, let me tell you, you're working your butt off both inside and outside of your clinic hours...

 

Peter

[Guest statementofclaim]

If a doctor who has been been out of school for ten plus years is happy making $75K a year and loves his work... great! More power to her/him. If that doc is not happy, then I think she/he needs some serious help. I'm sure MayFlower1 can jump in here with some advice.

 

I agree very much that Family Docs are not compensated properly for their services. That being said, I don't need my MBA to figure out that their something very wrong with the set-up of a practice where a doctor is working hard and taking home $75K. The plumber and electrician that article talks about has long since figured out how to run a business with far fewer worries over multiple suppliers, contracts, etc.. Hell, docs have one billing source for the vast majority of their income, OHIP

[Guest MayFlower1]

statementofclaim,

 

You make great points...they key is if you are happy with what you are doing, regardless of what you are making.

 

I think what I was reacting too in earlier posts in this thread was the statement that family docs have "cushy" jobs and don't work an outrageous amount of hours. It would be interesting to see what the average number of hours is, correcting for both billable and non-billable hours.

 

I also agree with you here:

 

That being said, I don't need my MBA to figure out that their something very wrong with the set-up of a practice where a doctor is working hard and taking home $75K.

 

Yup...operating and accounting efficiencies are key to increasing margin while delivering first class medical care.

 

The plumber and electrician that article talks about has long since figured out how to run a business with far fewer worries over multiple suppliers, contracts, etc.. Hell, docs have one billing source for the vast majority of their income, OHIP

 

Yup...yup...and what kind of preparation do most graduating family docs get with respect to the business side of medicine? Zippo...or perhaps...a lecture or two. This is one area I think deserves more attention in Family Medicine training.

 

Peter

[Guest j282]

54 Hours a week is not light, that was my point all along. the hours you quoted previously were quite low relative to my experience.

 

Newbee took your (Mayflower's hours) totalled them and came to 35-40 hrs per week. A previous statement I made indicated that those kinds of hours were very low (more likely seen with doc's that have outside family responsiblities ie. infants or personal health issues) relative to the many physicians that I have spoken with including both instructors in my program, friends and family members.

 

54 hours + seem more realistic, not cushy at all once you add up the "non billable" time that is added on top. Previously you had stated that 35-40 hours was what most of friends faced, now the story is most of your friends pull 54 - 70 hours. I'm not really sure what your saying, it seems that it's whatever is the opposite of what I state or whatever you think I state.

 

On a side note the OMA does offer courses and workshops on Practice management that you can take once you are a member. I think that there is so much info to cover in any professional school that trying to squeeze in practice management 101 while helpful would not slip nicely into a schedule that's bursting at the seams. There are alot of people who also want to go into Hospital Specialties, research, teaching etc rendering such information unnecessary from their percepective.

 

Cheers

[Guest MayFlower1]

J282,

 

54 Hours a week is not light, that was my point all along. the hours you quoted previously were quite low relative to my experience.

 

The initial number I quoted was for her own practice...if you add up the hours, theoretically, it works out to between 37 and 42 hours of clinic/charting time. In practice it's typically the 42 hours.

 

Then there's the after-hour clinic...that's a 4-hour clinic per week plus 13 hours of home call (that's from 8pm after the clinic until 9am the next morning)...that brings the total up to 59 hours of being responsible for patients a week. Then there is the non-clinic (and that, of course, means non-billable) work after charting and seeing patients...for clinic organization, staff meetings, billing, pharmaceutical rep meetings, points activities to maintain your medical licence, office infrastructure problems, and the list goes on...at LEAST another dozen hours a week.

 

54 hours + seem more realistic, not cushy at all once you add up the "non billable" time that is added on top. Previously you had stated that 35-40 hours was what most of friends faced, now the story is most of your friends pull 54 - 70 hours. I'm not really sure what your saying, it seems that it's whatever is the opposite of what I state or whatever you think I state.

 

I believe what I said was that my wife's hours are pretty typical for FMs that we know...however I also indicated some work a bit more...and some a bit less.

 

With respect to saying whatever is the opposite of what you say...I don't see it that way...I'm just trying to give you the perspective of someone very close to Family Medicine...I'm merely trying to share data I'm familiar with to show that while FM may be more balanced than other specialties, it is far from "cushy"...

 

On a side note the OMA does offer courses and workshops on Practice management that you can take once you are a member. I think that there is so much info to cover in any professional school that trying to squeeze in practice management 101 while helpful would not slip nicely into a schedule that's bursting at the seams. There are alot of people who also want to go into Hospital Specialties, research, teaching etc rendering such information unnecessary from their percepective.

 

Thanks for the OMA stuff...I was aware of this...I believe the practice management "course" is a one or two day lecture. If you have info contrary to this I'd really appreciate knowing where I can find out about it...my wife is a member so I would assume we have access.

 

I do agree with you, for sure, on squeezing this info into the medical school curriculum...after suggesting that I realized that my view was quite narrow...that some specialties don't require nearly as much business saavy. It would be nice, however, if you could choose to do such a course as an elective during medical school or have it as an optional module during clerkship...or residency. I think it would make it much easier for graduating docs, who could benefit from the information, to make a smooth transition from "academics" to "the real world".

 

Anyway, thanks for your perspectives...alternate views are always appreciated as they generate more discussion!

 

Peter

[Guest j282]

No problems dude!

 

Thanks for your perspective as well One thing that I find annoying about communicating in this medium is that the voice to voice contact allows so many communication cues that are often lost through noted messages. Without intonation, laughter, smirks etc. I think it becomes pretty darn easy to misunderstand the mood in which something is being said. A good example would be my gov't worker comment which was just off the tip of my tongue, without thought sort of jokey, although it came across as really jerkish.

 

In any case, it's still a great resource and it allows us to communicate with some really neat people that we may not otherwise have the opportunity to meet.....such as Mayflower

 

On a side note, the workshop you mentioned is the one I was thinking of. I've heard that out of those work-shops physicians from the same area often meet and then have their own monthly get togethers on the side to discuss practice issues and new ideas (both financial and otherwise). I think this is a terrific idea as well !

 

Cheers

[Guest statementofclaim]

FYI. The most recent OMA magazine/journal contains suggested 3rd party and non-insured billing schedules. It also does a nice breakdown of a per hour fee calculation. For those of you in Ontario, it would be available at a medical school library or from someone who is a member.

 

Later...