Guest newbee Posted March 18, 2003 Report Share Posted March 18, 2003 I have noticed alot of discussion about the long hours Physicians have to work(after residency). I was wondering just exactly how long these hours are? Are we talking till 10-11pm at night + weekends. The reason I ask is the impression I get is that physicians have it really cushy with their offices closing at 5pm and no hours on the weekend(except for walk in clinics where there is a rotating schedule). Sound like a pretty laxidaisy exisitence to me. So what's all the fuss about, are they just big complainers, or is their some substance behind their complaints? How long do Surgeons have to work, perhaps it is this group of physicians that have to put in the long hours. Sorry for my ignorance, I'm just trying to learn more about the specifics of the profession. Thanks in advance for the information Newbee Link to comment Share on other sites More sharing options...
Guest MayFlower1 Posted March 18, 2003 Report Share Posted March 18, 2003 hey newbee, The hours a physician works is extremely variable. My wife is a physician...she works hard but doesn't work excessively hard...she's a family physician...typical week: Monday - start at noon...see patients until 4:00pm...chart for another 1 or 2 hours...typically finished by 6 Tuesday - full day - 8-4 with a lunch break...again, charting for 1 to 2 hours at the end of the day...actually dictating, as opposed to charting manually. Wednesday - also a full day...same as tuesday Thursday - same as tuesday and wedneday Friday - 8-noon...an hour of charting and then it's home for the weekend My wife also works a few times a month at the after hours clinic...you can either pay about 700 bucks a month to enable your patients to be seen there or work between 2 and 4 times a month, making a about 1.5K for a day of work...and get "free" after hours coverage for your patients. On the days you have clinics at the after-hours clinic...you have to do "home call"...essentially, triage over the phone for the night...occasionally have to pronounce someone dead or go to a nursing home to assess someone. That's it...in a nutshell...but then there are some of our friends who work way way harder than that...not very balanced, in my opinion. At the end of the day, it's really up to you. We value our time together outside of work...you can achieve reasonable balance if you desire.... However, that being said, be prepared for heck as a medical student and resident! Peter Link to comment Share on other sites More sharing options...
Guest newbee Posted March 18, 2003 Report Share Posted March 18, 2003 Mayflower: That is really cushy (about 35-40 hours a week) and she makes $100,000 after taxes! That's like someone making $170,000 before taxes. Most jobs require at least those many hours and more and make nowhere near $160,000 per year! Wow, I really will have to ask doctors if they want some cheese to go with their 'whine' when they complain about their hours. I think the're probably just used to having it so easy and don't know what everyone else faces in the real world for 1/4 their salary. Damm I can't wait to go to med school. Newbee:p Link to comment Share on other sites More sharing options...
Guest dangrrgrrl Posted March 18, 2003 Report Share Posted March 18, 2003 Don't forget about being at the hospital at 7 am to see any of your patients that are admitted plus (if you're dedicated) in the evening. Also, depending on where you live, any call you do for Emerg...and if you do Obstetrics...those pesky early morning deliveries. Cushy definitely isn't the word that comes to mind (insert smile here). Link to comment Share on other sites More sharing options...
Guest cheech10 Posted March 18, 2003 Report Share Posted March 18, 2003 The hours also differ depending on specialty, call schedule, type of call (home vs. in-house), and academic vs. community settings. There can be great variation in hours worked by various physicians, so check this out before you belittle the complaints of the doctors you know. Keep in mind as well that residency (and clerkship for that matter) involve a number of years with many more hours worked and much lower pay. Link to comment Share on other sites More sharing options...
Guest misagh Posted March 18, 2003 Report Share Posted March 18, 2003 Hello, don't have lots of time to add a big spiel here, but just wanted to shed some light on medicine as being "cushy", esp. in regards to hours worked... One of the aspects of medicine that makes it one of the most challenging vocations out there is the fact that you are dealing with real people, real problems, real stresses and burdens all the time, both in the presence of the patient and when you've "called it a day". Perhaps some would agree with me when I say that even those hours that you are not working directly with patients, you are no doubt thinking about those people whose lives you've affected or will affect. For some, a mental discipline is often needed to emotionally and psychologically "detach"* themselves from the ordeals and stresses of serving our fellow man. (*hate that term in this context, but can't think of a better word right now) Medicine, in my humble opinion, cannot be classified as a typical 9-5 job in any sense. No other "career" out there that I'm aware of intimately demands the kind of mental, emotional, ethical, and psychological discipline and _balance_ needed both on-the-job and in downtime. Just my 2 farthings worth... Link to comment Share on other sites More sharing options...
Guest MayFlower1 Posted March 18, 2003 Report Share Posted March 18, 2003 great point cheech... my wife did many 33 hour shifts every two days (1 in two call very often and one in three on other, slack weeks) when she was in residency...she has definitely paid her dues... ...also, let's not forget that while these are the "office" hours I've quoted, there are lots of other unaccounted for hours devoted to planning and maintain the business. Finally, as the clinic is so "well oiled" with respect to the administrative side, she is able to see many, many patients in the hours she is working. During a typical 4 hour shift, she is seeing an average of between 25 and 30 patients...there are two 4 hour shifts in a full day...so, while the hours seem "cushy" they really aren't as you're running your butt off during the hours that you are working...and literally drop dead when you get home...only to awake to another day... Peter Link to comment Share on other sites More sharing options...
Guest jmh2005 Posted March 19, 2003 Report Share Posted March 19, 2003 Newbee, I think that you are grossly overstating how good that sounds or how easy it is...don't forget about the 6 to 10 years you put in (do you know what residency entails?) AFTER your 4 year degree and your 2 year Masters... I apologize for sounding cynical, but that's really not a lot of money when you look at certain jobs which require the same and even less hours than Peter described. Many in business (who sit at a desk for 7 or 8 hours) make easily double or triple that with the education I had PRIOR to medicine...Definately a comfortable lifestyle, don't get me wrong, but there is a lot more than just seeing patients as Peter just stated, which is not covered by the fee schedule... Link to comment Share on other sites More sharing options...
Guest shutterbug Posted March 19, 2003 Report Share Posted March 19, 2003 Hey Peter. I've heard complaints from many family docs that the paper work is horrendeous and that its only getting worst. But, from the sounds of it your wife seems to be able to manage this all right. Is it a matter of getting into a 'system' ? How does your wife manage the paperwork, what does she think about it?...if you don't mind me asking. Thanks. Link to comment Share on other sites More sharing options...
Guest Ian Wong Posted March 19, 2003 Report Share Posted March 19, 2003 Moved out of the General Premed forum into the Med Students forum... Ian Link to comment Share on other sites More sharing options...
Guest newbee Posted March 19, 2003 Report Share Posted March 19, 2003 Well, I understand what everyone is saying but as Mayflower's wife has demonstrated this "horredous" paper work is really an extra 1hr or 2hr at the end of the day if your efficient and a 2 1/2 long weekend sounds pretty sweet also despite the presssure cooker/sweatshop style of medicine that she chooses to practices when she is at work. Jmh2005 I'm just curious what degree you had prior to medschool that would allow you earn double or triple what doctors earn? Did you have a career prior to medicine and if so why the switch? Again, folks I fully disclose my ignorance, I'm just trying to understand the ACTUAL realities of the profession. Thanks again in advance for the comments:) Link to comment Share on other sites More sharing options...
Guest calvindog Posted March 19, 2003 Report Share Posted March 19, 2003 It is very important for people thinking of going into this field that the hours of work are great and tiring. You may take Mayflowers post to heart and add up the hours to come up with 35-40 hours per week but that does not portray an accurate picture of what you can expect from this job. ( I think Mayflower was trying to allude to that) The hours at work are tiresome and mentally draining. If you have your own practice you not only have to put in the hours to see patients but also have to run a business! That alone is a fulltime job. As time goes on, all these things will become easier as you become more prolific with your time but I caution anyone who thinks you are going to make $100K without busting your butt even after Med school-it just doesn't turn out that way. Cheers:hat Link to comment Share on other sites More sharing options...
Guest aneliz Posted March 19, 2003 Report Share Posted March 19, 2003 Working conditions are entirely dependent on specialty, size of practice (ie individual vs group), region of practice, and many other factors...like season, patient demographics, etc. Some docs have it good...like the dermatologist that works 9-4 and is never on call....others don't live this lifestyle - ever. I did an elective with an obstetrician...he is 60 years old. He is on call 1 in 10...which isn't too bad considering that the OB residents are 1 in 4. As an example of one of the day/night/day on-call periods that I spent part of with him: Day 1 8 AM - Grand rounds with the residents Followed by clinical duties including a couple of C-sections 2 PM - late for PCL session with us (meds 1) because of a C section. Teaches us until 4 PM...his pager goes off multiple times during our PCL session and he leaves to go back to deal with clinical obligations directly from our session. 6 PM - A couple of us page him to find out if there is any 'action' on the obstetrics ward that is worth coming down for. He says there will be....come on down. 6:30 PM - 3:30 AM: He spends teaching 4 first years meds, 1 clerk and a resident. During this time there are three births. At 3:30 AM the 4 first years leave (we have class at 8 the next morning). There were 2 more births later that night which equals little if any sleep for him, the clerk and the resident. At 8 AM, the clerk and the resident that were on overnight go home (off duty). The doc that they worked with goes to his clinic for the morning and is booked to do surgery all afternoon... He has been doing this for years...and will continue to do it until he retires... I personally wouldn't call this a 'cushy' lifestyle... Link to comment Share on other sites More sharing options...
Guest MayFlower1 Posted March 19, 2003 Report Share Posted March 19, 2003 shutterbug, The paperwork IS horrendous. We (my wife, her business partner with 20+ years of experience and me with a human factors background) took a YEAR prior to opening her practice to design custom "paperwork" (medical forms, test ordering sheets, patient info sheets, their billing system, etc.) which took advantage of 20+ years of medical practice plus my human factors background. These forms minimize the docs work and maximize time that can be devoted to patients. We easily save the time for a few patients over the course of a day. Also, we have 2.5 full time admin people and 2 full-time nurses which also take care of some of the other paperwork like contact with WSIB, etc. One of our admin people also does transcription every day...the docs dictate rather than have to write...saves a bunch of time. So, what we have done really is (1) eliminate significant amounts of admin time by applying human factors and organization and (2) downloading it to "non revenue generating" staff, wherever possible. Hope this helps. Peter Link to comment Share on other sites More sharing options...
Guest MayFlower1 Posted March 19, 2003 Report Share Posted March 19, 2003 Aneliz, You speak words of wisdom...I think you know my wife did the first 2 years of an obs/gyn residency...it sounds like your time was "cushy" in comparison (sorry, I couldn't resist). She really wanted to do obs/gyn...but the lifestyle was, well, not a lifestyle at all... I did an elective with an obstetrician...he is 60 years old. He is on call 1 in 10...which isn't too bad considering that the OB residents are 1 in 4. One in four wouldn't have been so bad...she was often on call 1 in 3 or 1 in 2...and performing surgery when this tired :eek She would literally come home (which was dangerous in and of itself...driving a car when you're this tired) and crash for the entire day...only to wake up and start all over again that evening (when on 1 in 2). At 8 AM, the clerk and the resident that were on overnight go home (off duty). The doc that they worked with goes to his clinic for the morning and is booked to do surgery all afternoon... You got to go home at 8:00am? That WAS "cushy" My wife typically had to do rounds until 9:30am or 10:00am as well. He has been doing this for years...and will continue to do it until he retires... This was the straw that broke the camel's back. My wife thought "If this is only going to happen in residency...I can handle it for a few more years...AS LONG AS IT GETS BETTER." Guess what...I don't think it does...just as you have so correctly pointed out...obs/gyn are in high demand...babies continue to be born...etc., etc. This is DEFINITELY NOT a cushy profession. Peter I personally wouldn't call this a 'cushy' lifestyle... Link to comment Share on other sites More sharing options...
Guest MayFlower1 Posted March 19, 2003 Report Share Posted March 19, 2003 newbee, sorry...the paperwork is horrendous...and, many have pointed out, there is lots of non-billable work associated with running a business...the first year (6 months planning and first 6 months of operation) were horrendous also...many, many, 80 hour weeks for both of us...it's only starting to be an 8am-6pm job very recently. Don't think for a moment that any area of medicine is "cushy"...it's not...it a ton of responsibility...a ton of training to get there...it's tiring/draining and a lot of work...there's just no way around it. The pay is actually quite dismal relative to all the things you have to do to get there, maintain yourself, etc. Bye the way, there are tons of jobs that make equal or significantly more revenue than docs. My personal career has been one of them. A tough day has typically been 8:00am to 2:00pm, easily making 100K or more...if you want to make tons of money, medicine is a poor choice...do a trade (e.g., electrician, plumber) or open your own business...believe me. Peter Link to comment Share on other sites More sharing options...
Guest Carolyn Posted March 19, 2003 Report Share Posted March 19, 2003 newbee, I don't believe that Mayflower's wife's hours are overly typical. Many people choose family medicine because they can set some limits in terms of hours (one of my good friends is a FP - she is only working 4 days a week as she is raising a family as well)... Many other family physicians work 5 full days a week, have an evening open, do lots of on call (at least 1 day a week), may do walk-in clinics, emerg shifts, deliver babies etc. Few family physicians have the luxury of a partner like Mayflower to help devise a system which helps decrease the amount of paperwork so significantly (1 - 2 hr at the end of the day is not typical!)... To look at hours worked you really need to specify which specialty. Most specialties with few exceptions (eg. Derm) will not have the 8 - 6 hours at all... Most are expected to work weekends. Many are expected to come into the hospital in the middle of the night when they are on call... Yes this includes most surgeons, but also medicine, pediatrics, etc... The other part that is not included in this is the work at home. Lifelong learning means that there is a heck of a lot of reading to do when you get home. I do not subscribe to the fact that doctors work way more hours (except during residency) than other professionals, but I definitely don't think that the word cushy is appropriate. Link to comment Share on other sites More sharing options...
Guest Kirsteen Posted March 19, 2003 Report Share Posted March 19, 2003 Hi there, This thread offers some interesting insight into the variation in physician work experiences. I'd like to add a little bit, and perhaps shed a little light onto the life of at least one hospital-based surgeon. Over almost a year now I've seen my boss in action as burn surgeon in one of TOs larger hospitals. Typically, his schedule is a rotation of: one week on the unit (and on call) and one week in surgery, with a week (give, but usually take, a few days) of rest in between. When he's on call he's typically there when I get in to the office in the morning, and quite often that means he's been there all night. On those days, when he can, he'll go into his office and take a 20 minute catnap and then head back out onto the ward. During the surgical weeks he's normally in the operating room working on 1-2 cases per day from darkness to darkness (early morning to night). Two weeks ago was a particularly hectic week where he spent 150 hours straight, at the hospital. His burn surgeon colleagues have a lifestyle not unlike this; therefore, my boss is not unique with respect to workload. This might give you an idea of why, occasionally, he'll ask me, "Are you sure you want to get into this profession?". Cheers, Kirsteen Link to comment Share on other sites More sharing options...
Guest j282 Posted March 19, 2003 Report Share Posted March 19, 2003 Hello all: New to the board (med student, ONT School) I would like to add that the Family Doctor hours discussed earlier are in no way representative of what one can expect in medicince. I only know of one physician who works the hours mentioned,and the reason is she is a Female Family Doc who has a 6 month and two toddlers at home. Physicians have very strong work ethics, with a tremedous load of responsibility to their patients, this all translates into a extended hours. I'm sorry but those kinds of hours discussed in the aformetioned post are relatively unheard of outside of new mother Docs or physicians who have elected to reduce their hours due to serious health conditions or disabilities. What I can tell you is that medicine will reward you in so many ways so that the hours will be justified. As many of my collegues are interested in being intellectually challenged and being on the cutting edge of expertise and knowledge, the majourity are heading into specialties, specialties that will demand extremely long and stressful hours, but in the end will be well worth the challenge. In my opinion doctors don't get compensated enough. If it were up to me I would cut out some other services that the Government seems to waist so much money on (without any return whether economic or social benefit) and pour that into health care. You probably can make a good salary outside of medicine, but I believe most professions will be demanding to some extent. The only option (cushy jobwise) that I can think of is a government job, where employees are paid a boatload of money to work on hocus pocus studies that never gel into something useful, or bizarre positions (Representative of public relations for flag owners, comes to mind) just to pay workers who enjoy two hour lunches and surf the net for a good part of the afternoon while collecting a six figure paycheck. If that's what you're looking for, you just won't find that in medicine. It's not a place for slackers, there are too many over achievers with a strong sense of responsibility towards their patients for the "typical" government job mentality to ever manifest itself. Peace Link to comment Share on other sites More sharing options...
Guest peachy Posted March 19, 2003 Report Share Posted March 19, 2003 Hey j282, welcome to the board. My brother works for the Canadian government and he works absolutely crazy hours to do an amazing job. I have no intention of comparing the hours he works to any other profession, but there are hard workers (and there are slackers) in EVERY profession. No matter what. So I take a little bit of offense to a sweeping generalization like "Because you work for X you don't work as hard as Y". Life just doesn't work that way, imho. Link to comment Share on other sites More sharing options...
Guest j282 Posted March 19, 2003 Report Share Posted March 19, 2003 Thanks Peachy for that reminder: I'm still a little rattled after reading a disclosure report a friend of mine prepared for the management consulting firm that he works for. The study was to determine the inefficiences with gov't positions. He bascially stated that he was appalled at what he saw and the type of slacking would never be tolerated in the private sector. Workers often openly stated that they headed for the gov't positions in search for relaxed hours and a fat paycheck. The only risk to their jobs was potential injury during the stampede for the exit doors as soon as it was 4:30pm. However you are absolutely right,there are postions even within the public sector which are insanely demanding (finance , Law (DOJ)) are two that come to mind among the many that exist. I would like to apologize for my sweeping generalization, and I would like to emphasize that there isn't a free meal ticket, any job that pays 6 figures will require a great deal of time, stress and responsibility. BTW this is a terrific resource, one that I wish was in existence when I was going through the selection process. Thanks again (apologies to your brother Peachy;) BTW what does he do for the gov't) Peace Link to comment Share on other sites More sharing options...
Guest MayFlower1 Posted March 20, 2003 Report Share Posted March 20, 2003 j282, I would like to add that the Family Doctor hours discussed earlier are in no way representative of what one can expect in medicince. I only know of one physician who works the hours mentioned,and the reason is she is a Female Family Doc who has a 6 month and two toddlers at home. Actually, these are quite representative of FM. We have several friends who keep approximately the same hours...some a bit more...some a bit less. I apologize, but your sweeping generalization is just not correct...and somewhat insulting to women and those with children in my opinion. My wife actually works her butt off...both inside and outside of the practice. This actually IS representative of family medicine...if you're doing more clinical hours than this then you or those you know may be not very efficient or working way too much and leading a very unbalanced life. Physicians have very strong work ethics, with a tremedous load of responsibility to their patients, this all translates into a extended hours. Sorry, this is just @#$! My wife actually has one of the strongest work ethics of anybody I know and she also has a HUGE sense of responsibility to her patients. Hours worked doesn't equate to "responsibility to patients" just the same as "hard work" doesn't get you an "A". I'm sorry but those kinds of hours discussed in the aformetioned post are relatively unheard of outside of new mother Docs or physicians who have elected to reduce their hours due to serious health conditions or disabilities. OMG, I'm not even going to comment on this quote...it's outragous... As many of my collegues are interested in being intellectually challenged and being on the cutting edge of expertise and knowledge, the majourity are heading into specialties, specialties that will demand extremely long and stressful hours, but in the end will be well worth the challenge. In my opinion doctors don't get compensated enough. I hate to tell you, but FM is also extremely challenging. The suggestion that you have to be in a specialty to be challenged intellectually or in any other way is absolutely absurd. FM is a great career...very challenging...very rewarding...very important. It is no wonder adcoms are looking more for balanced individuals...the perspective you hold is very old school...very unhealthy...and very condescending. The only option (cushy jobwise) that I can think of is a government job, where employees are paid a boatload of money to work on hocus pocus studies that never gel into something useful, or bizarre positions (Representative of public relations for flag owners, comes to mind) just to pay workers who enjoy two hour lunches and surf the net for a good part of the afternoon while collecting a six figure paycheck. I've worked for the government...this in no way captures the essence of the government. I can tell you, first hand, they do not get paid a "boatload" of money. Sure, the govt is a bit screwed up...actually, a lot screwed up...but you couldn't pay me to work there anymore. By the way, I was a senior manager at Statistics Canada...while the pay I received was relatively low compared to other positions I've held and the one I currently hold in the private sector, I can tell you the work that I was doing was incredibly important and useful. If that's what you're looking for, you just won't find that in medicine. It's not a place for slackers, there are too many over achievers with a strong sense of responsibility towards their patients for the "typical" government job mentality to ever manifest itself. Overachieving isn't necessarily better or healthy. How about life balance? How about wanting to do more than work 80 hours a week? How about those that love you and that you love? I can tell you one thing...on your death bed you won't be thinking about "Oh, I was such a great worker...many hours...such patient responsibility"... ...just some food for thought. I would suggest doing a bit of homework before generating such sweeping generalizations. Peter Link to comment Share on other sites More sharing options...
Guest NBer Posted March 20, 2003 Report Share Posted March 20, 2003 hey all... not to keep on this topic, but I also take offense to that...I think it is definitely an extreme generalization..while I work in gov building, I am not a gov employee...a contractor... my boss...yes, he probably makes a nice 6 figure salary, but in no way did he make his way there by working 8 hour days...he is a scientist, and works more than any other prof I have ever encountered... for ex...while finishing my MSc data collection in his lab, I would be in the lab long hours...7am until after midnight...he was usually here when i arrived...and often leaves around 4, but to return around 6:30 and some days would be here after I left at midnight... I really don't like when people generalize about all "types of jobs"...the govt is very diverse in its departments, and employees...i really don't think it is fair to say they all have cushy, well-paying jobs...and there are many more departments besides law and finance that work hard...I also know many gov employees in my building that do not have job security or phat paycheques... sorry to rant...I guess I took it a bit personally...:rolleyes Link to comment Share on other sites More sharing options...
Guest peachy Posted March 20, 2003 Report Share Posted March 20, 2003 Yup and no problem, j282. My brother works in telecom regulation. I (and I bet pretty much all Canadians) also find waste in the government apalling. But there are poor employees and waste in any area, possibly concentrated in public sector jobs with strong unions. For example, nearly all public school teachers work INCREDIBLY HARD. But then there are the very few that do basically nothing - they can't be fired or even reprimanded in any way because of very strong unions. Kids suffer, and teachers get a bad reputation. I totally agree with you wrt no free tickets out there. To do well in ANY profession, you need to work hard. You can bet that the people stampeding to leave at 4:30 aren't the ones getting promotions... This board is, indeed, a tremendous resource. We are lucky to have it as premeds! It would be interesting to know what school you're at j282, if you're willing to post that. (Most of the current meds students on this board post their school and year, but not their names) Link to comment Share on other sites More sharing options...
Guest MayFlower1 Posted March 20, 2003 Report Share Posted March 20, 2003 peachy, I'd like to know the school too...if it supports such attitudes you can bet I wouldn't want to go there! Peter Link to comment Share on other sites More sharing options...
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