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Medicine will steal your life

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  • Avatar avoOB 
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    Status: Physician
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    Joined: 10/28/2017

    Completely agree, as a 50+ yo OBGYN I had to set firm boundaries about work hours and made it a priority to be home at storytime and bedtime while the kids were young; returning at night to run inductions, etc.  We sometimes value or self-worth too much in our work sphere and it is important to extend that to our home life and prioritize family and other interests. I am enduring an 18 month waiting period to drop OB Call. It seems endless, and I am tired of all the weekends at the hospital and feeling sleep deprived 2-3 d per week. I am hoping the improvement in well-being offsets the drop in income.

     

    #213612 Reply
    Liked by Eye3md, hatton1
    q-school q-school 
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    Status: Physician
    Posts: 2333
    Joined: 05/07/2017

    I think my original point has been turned into more of a burnout focus. Whether you like medicine or not, controlling your hours as you would like takes an active effort. Medicine is a 24/7 thing and will try to make you be that way too. If you want to give a whole lot of time to your work, that’s great. Go for it. Medicine sure will take it if you let it. However, I would prefer to give a whole lot of time to my family and my personal endeavors.

    My original post is just saying that Medicine will steal my time from all other areas if I let it. You have to be pro-active in drawing your line in the sand on your time.

    You only get one life to live. Live it wisely.

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    Sure, but the problem is that many docs these days (perhaps most?) are unable to draw any sort of line in the sand because their group doesn’t allow it or it would cause their partners to resent them or they would lose benefits or they can’t afford to cut back for any number of reasons, etc.  Job security is often a big concern when you go to part time in a group practice.  You’re seen as less vital to the practice if you’re not willing to do a full time work load.

    If I had a private practice and could run it as I see fit, then sure, I could only be open for business Tues-Thurs 10-4 or something awesome like that…my only consequence to cutting back would be a decrease in revenue, which I could deal with as long as the practice was on solid ground from a business perspective.  This isn’t possible for docs in primary care who have to be available 24/7 either directly or through their partners covering for them and who are also responsible for such enormous patient loads.  It’s also not possible for hospital based practices who have patients admitted to them in the hospital setting.

    It’s much easier to control your work/life balance in a privately owned practice and especially if you’re a consultant only

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    huh? when is a primary care physician ever contacted in the middle of the night? vast majority of primary care people don’t even round in the hospital anymore and if they do it’s like a cursory thing and the hospitalist runs the show….

    I have literally no idea what you’re talking about. so your patient gets admitted to hospital and they call you and tell you at 2 am (which never happens IMO), do you rush in there and see them? come on.

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    our primary care physicians have had dramatic reductions in sleep interruption from the hospitalists, but they still field calls from outpatients, and they frequently are covering multiple nursing homes, so they still get paged when on call.  ymmv.

     

     

    #213623 Reply
    hatton1 hatton1 
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    Status: Physician
    Posts: 2910
    Joined: 01/11/2016
    I am hoping the improvement in well-being offsets the drop in income.

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    It will

    #213626 Reply
    Liked by BT
    Avatar llessac15 
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    Status: Physician
    Posts: 94
    Joined: 01/17/2016

    avoOB,

    I think some of the issue is like you said, too many docs put too much self worth into being a doc. My senior partner is one of those. He has no life outside of medicine and he gets so upset over the smallest of disruptions claiming it is “disrupting patient care”. When we realize this is just a job and our true self worth is located outside of medicine, we will be more inclined to protect our precious hours.

    #213643 Reply
    Liked by Eye3md
    Lordosis Lordosis 
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    Status: Physician
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    Joined: 02/11/2019

    Plenty of primary care take call. I hear about these no call jobs but they are all large groups in bigger cities because they can afford overnight nurse triage.

    Call is stressful. I agree that when you can be called at anytime and have to drop everything or be woken up at 2am it kinda sucks. However I am new to medicine and it is way better then my residency days. Also as a parent of young children they are much more disruptive then work.
    FI will give me the leverage I need to dump the call at some point in my career.

    “Never let your sense of morals prevent you from doing what is right.”

    #213724 Reply
    Liked by Dusn
    Avatar SValleyMD 
    Participant
    Status: Physician
    Posts: 403
    Joined: 05/12/2016

    The profession needs to figure this out

    There is no reason imo for any patient to be able to directly call a doc in the middle of the night

    Hospital systems should all have a RN or NP fielding calls. Emergency? Go to the er. Otherwise wait until the am.

    Sorry but I think it’s ridiculous that a clinic doc is taking “call”.. our system they don’t but sounds like many still do.

    Very few docs should also have to go in in the middle of the night to admit a pt. Should have robust Hospitalist teams with mid levels to tuck in at night.

    The concept of “call” needs to change to be pure emergency based at night.. not a bunch of docs acting like residents for the rest of our life.

    Avatar Panscan 
    Participant
    Status: Resident
    Posts: 719
    Joined: 03/18/2017
    Disability Insurance

    The profession needs to figure this out

    There is no reason imo for any patient to be able to directly call a doc in the middle of the night

    Hospital systems should all have a RN or NP fielding calls. Emergency? Go to the er. Otherwise wait until the am.

    Sorry but I think it’s ridiculous that a clinic doc is taking “call”.. our system they don’t but sounds like many still do.

    Very few docs should also have to go in in the middle of the night to admit a pt. Should have robust Hospitalist teams with mid levels to tuck in at night.

    The concept of “call” needs to change to be pure emergency based at night.. not a bunch of docs acting like residents for the rest of our life.

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    a nurse doesnt know what an emergency is or not. everyone will go to ED. that’s where a physician adds value, saying “no you’re fine” instead of ” go to ED and get a CT”

    not sure how a midlevel helps admit people over night. a doctor should evaluate the patient, not rely on a midlevel. pretty sure a hospitalist can do their job and admit the patient.

     

    #213740 Reply
    Avatar Panscan 
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    Joined: 03/18/2017

    thats the entire reason why nurse lines suck, they just tell everyone to go to ED and add to costs and ED overutilization, because they don’t have the training to diffuse a situation and say ” no you are fine” (a problem also seen with midlevels)

    #213741 Reply
    Liked by wonka31
    Avatar SValleyMD 
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    Status: Physician
    Posts: 403
    Joined: 05/12/2016

    Sure. If the Hospitalist are forced or willing then they can admit. Nps are more than capable to handle phone calls.

    #213744 Reply
    Avatar Panscan 
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    Joined: 03/18/2017

    ok then everybody goes to the ED.

     

    forced or willing? so the person is sick enough to be admitted to the hospital, but they don’t need to be seen by a doctor?

    #213747 Reply
    CM CM 
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    Status: Physician
    Posts: 999
    Joined: 01/14/2017

    on call, insurance, and EMR

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    worried about lawyers

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    These are the four horsemen.

    I would add what q-school calls “drinking from a firehose.” When working as an equity analyst I could take a break to walk across the street to Starbucks, usually chatting with a colleague along the way. I had time to make a phone call to handle miscellaneous personal matters. Now I don’t have any spare moments until the last patient is seen.

    However, I can cope with the firehose, the insurance denials, the EMR, and the lawyers. It’s call that ruins quality of life.

    Erstwhile Dance Theatre of Dayton performer cum bellhop. Carried bags for Cyd Charisse (gracious). Hosted epic company parties after Friday night rehearsals.

    #213754 Reply
    Liked by Eye3md
    Avatar Financial Naive MD 
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    Status: Physician
    Posts: 29
    Joined: 05/05/2019

    EMR!  Technology is supposed to make life easier.  How come other fields are able to find ways of using technology to increase their productivities, and we can only find EMR to decrease ours.  Luckily, I still get more enjoyment in medicine than doing other things.  So I will stick with it for awhile.

    #213755 Reply
    Liked by MaxPower
    Lithium Lithium 
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    Status: Physician
    Posts: 1054
    Joined: 02/15/2016

    One of the best things about my job is that I can show up at whatever time of day I want and work at whatever pace I feel like. If it is 20 degrees or raining when I wake up, I can wait two hours. I bike to work over 95% of the time. The only one of the horsemen that is a major headache for me is EMR, though administration is now reinstating call (not overnight… yet). If you have fewer than two, consider yourself lucky.

    #213762 Reply
    Avatar SValleyMD 
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    Status: Physician
    Posts: 403
    Joined: 05/12/2016

    “Forced or willing” for the Hospitalist to actually admit the patient. Most of the hospitals I’ve worked at the Hospitalists could pick and choose what they were willing to admit in regards to subspecialist pts.. I realize at other places that’s not the case and they admit nearly everything which Is how it should be everywhere – basically a subspecialist or non shift worker (family Med) should never come into the hospital to admit a pt at night unless it’s critically important

    #213766 Reply
    Avatar fasteddie911 
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    Status: Physician
    Posts: 281
    Joined: 05/31/2016

    “Forced or willing” for the Hospitalist to actually admit the patient. Most of the hospitals I’ve worked at the Hospitalists could pick and choose what they were willing to admit in regards to subspecialist pts.. I realize at other places that’s not the case and they admit nearly everything which Is how it should be everywhere – basically a subspecialist or non shift worker (family Med) should never come into the hospital to admit a pt at night unless it’s critically important

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    Agree with this and yeah it’s definitely hospital dependent.  Most hospitals I’ve seen, the hospitalist/ICU teams are good about doing all admissions and handling things except for very serious/concerning issues.  As such specialists rarely get called in and everyone seems happy.

    #213826 Reply

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