Coach Posted October 2, 2009 Report Share Posted October 2, 2009 I'm still wet behind the ears when it comes to knowledge of the life of a surgeon, so hopefully this isn't a dumb question. I've read about the brutual work hours for most surgeons. What I can't really understand is (after residency) why you can't manage you work hours down? Are you literally forced to work 24/7? I thought one could go into private practice, decide how many patients to see and then manage your overall workload to still have a life. Not that I'm expecting to work 9 -5, but couldn't a private pratice surgeon manage their own time and schedule down to maybe a 50-hour week and still make a good living? I'd also like to better understand the difference (workload) for private practice versus being employed by a hospital. Link to comment Share on other sites More sharing options...
Jochi1543 Posted October 2, 2009 Report Share Posted October 2, 2009 I don't know how they do it, but it's definitely possible (and you don't have to be a plastic surgeon or something). We had a general surgeon come in and lecture and he said he usually starts at 7:45 and is out of the hospital around 5, if I remember correctly; and he said he works 1 night out of 10. So it's not bad at all. However, he said something like "I spend 40% of my time teaching," and I'm not sure if these hours include his teaching time or not. Link to comment Share on other sites More sharing options...
The_B Posted October 2, 2009 Report Share Posted October 2, 2009 It is possible, but difficult. The surgeon who Jochi mentioned obviously works at a teaching hospital as he didn't have to round on his patients prior to the OR, as his/her resident did it for them. So yes, if you are in a teaching hospital, you can generally have a pretty decent life as a surgeon. However, if you are in the community (where you would make more money), you'll be required to round on your own patients. Most surgeons (though not all), do this prior to the OR in the morning. This means being at the hospital sometimes at 6am. Furthermore, call is usually spread out between yourself and your colleagues. This may be something like 1 in 3 or 4 depending on how many of you there are. Now you are right, once you are done training, you are independent and can make your own schedule. Having said that, for a hospital to hire you, they will require you accept call coverage. So you may only wish to work two days of the week, but you may have to do call more often. Generally, hospitals worry about call coverage, not day time work. This is how surgeons end up being so busy in most settings. Link to comment Share on other sites More sharing options...
Neptune Posted October 2, 2009 Report Share Posted October 2, 2009 I good friend of the family is a surgeon, and while he admits he'd love have a bit more free time (i.e. some free time as opposed to his present none), he won't cut back on his hours because he feels an obligation to serve the needs of the community in which he works. Surgery waitlists are quite long as it is, and if he worked fewer hours he'd be making this problem worse instead of better. It's true that people have very different motivations for entering medicine and also for choosing a specialty. Some people work like dogs to earn more money, and some work like dogs because they feel it is their duty to do so. Personally I'd feel like a bit of a jerk if I was one of the few people around capable of performing a complicated medical procedure and I chose to spend my Wednesdays golfing instead of treating patients. Not to say that having a work-life balance isn't important, but I think that when a reduced workload means people go without essential medical treatment, it's easy to be pressured into working overtime. Link to comment Share on other sites More sharing options...
Coach Posted October 2, 2009 Author Report Share Posted October 2, 2009 Now you are right, once you are done training, you are independent and can make your own schedule. Having said that, for a hospital to hire you, they will require you accept call coverage. So do most surgeons end up working for a specific hospital (teaching hospital or in the community) instead of working for themselves in a private practice setting? That's the part where I don't have a clear picture: if one could own your practice and manage your schedule, why would a surgeon (after residency) enter into a work contract with a hospital who will stipulate call hours? Is it mandatory to be contracted to a hospital? BTW, Neptune your post makes a lot of sense! Link to comment Share on other sites More sharing options...
Wut? Posted October 2, 2009 Report Share Posted October 2, 2009 That's the part where I don't have a clear picture: if one could own your practice and manage your schedule, why would a surgeon (after residency) enter into a work contract with a hospital who will stipulate call hours? Is it mandatory to be contracted to a hospital? No. But enter the moral debate of private vs public health care. Link to comment Share on other sites More sharing options...
flying kumquat Posted October 2, 2009 Report Share Posted October 2, 2009 What do you mean by private practice? Do you mean, having your own private surgical centre? Doing all same-day procedures and/or staffing your centre overnight with staff able to take care of your post-op patients? Or do you mean working in a non-academic hospital? I'm not in surgery, but I would be very surprised to hear of hospitals letting a surgeon operate in their (staffed, equipped) ORs and admit their patients post-op without a little call coverage in return. It just makes sense to me; however, those in the know are free to correct me. Link to comment Share on other sites More sharing options...
ploughboy Posted October 2, 2009 Report Share Posted October 2, 2009 why would a surgeon (after residency) enter into a work contract with a hospital who will stipulate call hours? Is it mandatory to be contracted to a hospital? To operate, you need an operating room. Link to comment Share on other sites More sharing options...
The_B Posted October 2, 2009 Report Share Posted October 2, 2009 So do most surgeons end up working for a specific hospital (teaching hospital or in the community) instead of working for themselves in a private practice setting? That's the part where I don't have a clear picture: if one could own your practice and manage your schedule, why would a surgeon (after residency) enter into a work contract with a hospital who will stipulate call hours? Is it mandatory to be contracted to a hospital? BTW, Neptune your post makes a lot of sense! As has been said, you need an OR to be a surgeon. In theory, if you could hire your own nurses, have an accredited OR setting, along with the equipment, and convince one of your anesthesiology friends to work there... then you would still need a step down area and....I think you get the point. You need to work out of a hospital. BTW, Neptune be careful. Sure you may wish to save the world and help as many as you can. But there is nothing wrong with wanting a day off to spend with family and friends. Or traveling to see the world. One of the reasons many people go into medicine is because it offers a variety of features. The ability to help others is but one of these things. If you don't maintain that work-life balance, you will be hard pressed to be a good surgeon in the long run. So don't let the pressure of work ever make you feel bad about wanting more. But this bit isn't directly related to the thread, so I'll stop there. Link to comment Share on other sites More sharing options...
A-Stark Posted October 3, 2009 Report Share Posted October 3, 2009 So do most surgeons end up working for a specific hospital (teaching hospital or in the community) instead of working for themselves in a private practice setting? That's the part where I don't have a clear picture: if one could own your practice and manage your schedule, why would a surgeon (after residency) enter into a work contract with a hospital who will stipulate call hours? Is it mandatory to be contracted to a hospital? BTW, Neptune your post makes a lot of sense! I'm sorry, but what planet are you living on? Almost all surgeons will take call, and I don't know why you think that call ends with residency - maybe with some family docs, but even public health physicians will be on call from time to time. Link to comment Share on other sites More sharing options...
AndreaM Posted October 3, 2009 Report Share Posted October 3, 2009 Another point to think about is that even if you do have a private practice you will still need to be on call for your patients in the night. Different specialties have different level of call rates though. An Ob/Gyn will have calls at night when they are on call, whereas a dermatologist will have fewer night time emergencies than the average specialist. Link to comment Share on other sites More sharing options...
Coach Posted October 3, 2009 Author Report Share Posted October 3, 2009 I'm sorry, but what planet are you living on? Almost all surgeons will take call, and I don't know why you think that call ends with residency - maybe with some family docs, but even public health physicians will be on call from time to time. Easy now - don't get so offended. I started this thread by saying the following, "I'm still wet behind the ears when it comes to knowledge of the life of a surgeon, so hopefully this isn't a dumb question." If I am not mistaken, this forum exists for the sharing of information and provides opportunity for questions to be asked. As a newbie I was curious why I was reading stories of surgeons working countless hours and (potentially) having little work/life balance. My post was for me to better understand their reality, and I think the folks who replied on this thread helped me understand that reality. Link to comment Share on other sites More sharing options...
coastalslacker Posted October 7, 2009 Report Share Posted October 7, 2009 To get OR time you need hospital privileges. To get privileges you need to take call. If you are at a hospital with 5 surgeons of your speciality, you will be on 1 in 5. etc etc. Outpatient procedures are increasingly being done in privately run clinics with ORs. This will not go away, it will only expand. I have no interest in getting in a debate about the rightness/wrongness of this, public vs private blah blah blah. Work/life balance is very difficult to achieve in a surgical residency. My idea of work/life balance as an orthopaedic resident makes many of my non-surgical friends cringe, laugh and shake their heads in pity. Whatever, my job is way better. And, to have that job as a career I have to put in some long hours for a little while. Once residency is over, do whatever you want-no one else will care as long as you cover your share of call. The dirty secret is that surgeons like what they do, which is why some keep working so much. And that is why lots of other specialities like to work as little as possible..... Me, I am going to work a 4 day week plus call, which I envision working out to a 50-60 hour week. Damn right I am going golfing on Fridays. peace. Link to comment Share on other sites More sharing options...
coastalslacker Posted October 7, 2009 Report Share Posted October 7, 2009 my bad, I am golfing on Wednesdays. My complicated medical procedures will have to wait. Link to comment Share on other sites More sharing options...
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