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Satisfaction/enjoyment practicing medicine

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  • Avatar SValleyMD 
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    Status: Physician
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    I was liking the job okay until I got my “pulse survey” back today and was told that I’m in the 30th percentile nationally and that I have some personality flaws I need to work on!

    #33253 Reply
    Avatar Antares 
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    Status: Physician
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    I’m with Zaphod on this. I may have been overly harsh by giving the lowest rating in this thread of a 5 (I’m hereby raising that to a 6), but note that at age 58, I would have given a lower rating at many earlier times in my career. That’s because I have more ability to structure my practice as I wish now. I’ve always liked my work itself. But the issue has forever been that I have many interests, and the practice of medicine is not nearly enough to satisfy me. It’s always been a compromise to me to have a job, any job. The way I often think about it is that there are a thousand things worth doing, and I spend a huge chunk of my time doing only one of them. This is the way I’m wired.

    #33255 Reply
    Zaphod Zaphod 
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    ^^^^I blame medical schools for changing their practice to getting students with more diverse interests and hobbies. You get what you ask for.

    #33259 Reply
    Avatar Complete_newbie 
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    It is incredible that all these applicants have these diverse resumes (hey I got a nobel prize, did triathlon x 3 in two weeks, went to some village and found unobtanium etc) and then turn them into a single focused MD doing focused things (mostly algorithmic).

     

    #33275 Reply
    Avatar SValleyMD 
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    Total tangent – but It’s actually incredible how competitive and how random medical school admission is.

    My brother was a d1 athlete (football), 34 equivalent Mcat (on the new scale), 3.7+, published, tons of volunteering and service, went to top 25 school that is a blue blood in football before transferring to pretty good private school and he has a total of 4 interviews out of 20 schools and just hoping to get into one. He was late in the cycle but still. Not sure how anyone gets in these days. I know I wouldn’t be able to and I’m just a couple years out of fellowship.

    #33277 Reply
    Avatar squirrel 
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    Status: Physician
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    Joined: 01/26/2016

    You have a point there. However I think that could be said for a lot of fields (the excitement and challenge decreases for anything and I imagine it becomes more automatic?).

    For me I am finishing my 5th year out.  It was a little lower about 3 years out maybe a 7 out of 10 but I would say now is 8.5 (so opposite trend).  The difference came when I said to myself, METRICS BE DAMNED!   I am in the mid point in my group of patients seen, RVUs, etc.  Being not the slowest, I don’t have a target on my back ever.  Also I work all nights.  Based on all of this, no one is going to fire me or discipline me.  They need me too much.  I decided to not even pay attention to the metrics anymore.  This made a huge difference.  I feel I am paid fairly and my income is fairly stable from month to month (only goes up or down a lot if I work more or less).  I go to work, eager to see patients, I enjoy the business when it if crazy busy, and taking extra time with patients when it is slow.

    I am ED and work in about 5 different facilities which I think keeps it mixed up enough for me and don’t feel stagnant (different populations at each facility so the joys and headaches are different).

    #33287 Reply
    Liked by Zaphod
    Zaphod Zaphod 
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    You have a point there. However I think that could be said for a lot of fields (the excitement and challenge decreases for anything and I imagine it becomes more automatic?).

    For me I am finishing my 5th year out.  It was a little lower about 3 years out maybe a 7 out of 10 but I would say now is 8.5 (so opposite trend).  The difference came when I said to myself, METRICS BE DAMNED!   I am in the mid point in my group of patients seen, RVUs, etc.  Being not the slowest, I don’t have a target on my back ever.  Also I work all nights.  Based on all of this, no one is going to fire me or discipline me.  They need me too much.  I decided to not even pay attention to the metrics anymore.  This made a huge difference.  I feel I am paid fairly and my income is fairly stable from month to month (only goes up or down a lot if I work more or less).  I go to work, eager to see patients, I enjoy the business when it if crazy busy, and taking extra time with patients when it is slow.

    I am ED and work in about 5 different facilities which I think keeps it mixed up enough for me and don’t feel stagnant (different populations at each facility so the joys and headaches are different).

    Click to expand…

    I agree, I dont think its at all uncommon.

    #33301 Reply
    Avatar HLM 
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    Status: Physician
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    Joined: 04/01/2016

    I’m chiming in just to add a lower number and had a little more gloom to the discussion. 😉

    Last year this time, I’d have said 3. I am paid well for what I do, I have a schedule that works well for me and my family, and I really like and respect the other docs in my group. These are people who I enjoy hanging out with outside of work as much as I respect them for the work they do. Also, sometimes I see really interesting things that I puzzle over and the problem solving aspect of medicine is what drew me in. And occasionally, I feel like I make a real connection with a patient and their family and it feels like I’m doing important and useful work.

    So why the 3?

    I have many frustrations about my job that really seemed to come to a head for me last year. Some (like the commute) are entirely my fault because I’m not willing to move closer. I also get bored easily. I am humble enough to know that the longer I practice medicine, the more I realize how much I don’t know–I’m not pretending I’ve seen it all. It’s just that most nights (I’m a peds nocturnist) I see things that are bread and butter and aren’t particularly challenging. Others, are beyond my control–an administration that seems antagonistic or indifferent to doctor’s needs/wants/input, an environment that has caused a mass exodus of the experienced nurses who I loved working with and who have now been replaced with very inexperienced nurses who often make me want to bang my head on a wall, some dysfunctional groups of docs outside of our group that I have to deal with regularly.

    I hired a career coach last winter and realized I wasn’t really ready to make the leap out of medicine so this year I am trying to focus on the positives. So right now I’d say my satisfaction is around a 5 or 6.

    But if someone handed me a winning Megamillions ticket, I’d definitely tell my director to start looking for a replacement for me. I’m not sure I’d quit entirely but I would go down in hours a lot.

    Having said all this, I sometimes wonder if job and life satisfaction is more related to individual temperament then anything that is happening at the job. I think some people are just wired to see positives and others more wired to focus on the negatives.

    Avatar PNWskindoc 
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    Status: Physician
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    Joined: 01/10/2016

    I’d say I’m at a 6-7. I’m currently in PP although I think I’d be better suited for academics. I’m just a few months out from residency and I probably work more than most dermatologists, which admittedly isn’t all that much (5 days a week / 35-40 patients a day and possibly adding a Saturday clinic every other week). I’m working this much out of necessity (tons of student debt, saving up for house, etc…) but I’m sure I would enjoy my job much more if I was able to cut back and work on my own terms.

    #33345 Reply
    The White Coat Investor The White Coat Investor 
    Keymaster
    Status: Physician
    Posts: 4284
    Joined: 05/13/2011

    I’m with Zaphod on this. I may have been overly harsh by giving the lowest rating in this thread of a 5 (I’m hereby raising that to a 6), but note that at age 58, I would have given a lower rating at many earlier times in my career. That’s because I have more ability to structure my practice as I wish now. I’ve always liked my work itself. But the issue has forever been that I have many interests, and the practice of medicine is not nearly enough to satisfy me. It’s always been a compromise to me to have a job, any job. The way I often think about it is that there are a thousand things worth doing, and I spend a huge chunk of my time doing only one of them. This is the way I’m wired.

    Click to expand…

    That’s one big reason I ended up in EM.

    Site/Forum Owner, Emergency Physician, Blogger, and author of The White Coat Investor: A Doctor's Guide to Personal Finance and Investing
    Helping Those Who Wear The White Coat Get A "Fair Shake" on Wall Street since 2011

    #33351 Reply
    Liked by Zaphod
    Avatar hightower 
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    Status: Physician
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    Joined: 12/07/2016

    I have a bit of a complex situation now, so I’ll try to just summarize…

    Worked as a daytime hospitalist for about the last 5 and 1/2 years.  I’d give this position a 3 or 4 on the satisfaction scale.  Its gotten worse over the last 3 years, I would have given it a 6 or something before that.  Our schedule is crazy.  We are expected to work blocks of days that are sometimes 9 days long.  12 hour days (we answer our pager from 8-8).  And the patient load has seriously increased.  18-22 is the new norm on rounding days.  Used to be 12-15 at this hospital.  Admitting shifts are insane.  Its overwhelmingly busy at times and not safe for patient care in my opinion.  Our leadership changed as well and I quite frankly don’t respect the people in charge.  The work is also just a bad fit for my personality.  I’m an introvert and do better working in quieter environments with fewer interruptions and many other things like that.  I’m sick of picking up a list full of 20 patients that I didn’t admit and then suddenly being responsible for a million and one problems and having to discharge them from the hospital after they’ve been admitted for 3 weeks and I just met them, etc.  SO, I’ve gotten out of it.  I’m currently working as a nocturnist for the same group and my job satisfaction is way up.  Its quieter, I’m dealing with fewer patients/shift, the work doesn’t come home with me, I’m working fewer days, fewer hours, and have more control over my schedule.  I’m also only dealing with the acute, new problems as they come in from the ED.  I dont’ have to dig through weeks of progress notes on patients I don’t know.

    However, this is only temporary.  I’m moving to an outpatient opioid treatment center position this summer.  Its going to be regular hours, no weekends, no holidays, no call.  Fewer patients per day, a more focused visit.  Lots of positives.  It does pay less however.  Additionally I worry that it might be boring or not satisfying.  But, I’m going to give it a chance because I may also really like it.  I just won’t know until I try it.  I have a friend there who loves it.  So, I’m hoping for a good experience.  The only other thing I worry about with this position is that it will likely be more difficult to get time off for travel.  My wife and I travel a lot.  However, we’re also planning on starting a family this year, so the traveling will have to slow down soon anyway.  We’ll just see I guess!

    I’m hiking the John Muir Trail this summer though, right before I start my new position.  Pretty darn excited about that!  I give that a 10/10 satisfaction score:)

    Zaphod Zaphod 
    Participant
    Status: Physician, Small Business Owner
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    Joined: 01/12/2016

    I have a bit of a complex situation now, so I’ll try to just summarize…

    Worked as a daytime hospitalist for about the last 5 and 1/2 years.  I’d give this position a 3 or 4 on the satisfaction scale.  Its gotten worse over the last 3 years, I would have given it a 6 or something before that.  Our schedule is crazy.  We are expected to work blocks of days that are sometimes 9 days long.  12 hour days (we answer our pager from 8-8).  And the patient load has seriously increased.  18-22 is the new norm on rounding days.  Used to be 12-15 at this hospital.  Admitting shifts are insane.  Its overwhelmingly busy at times and not safe for patient care in my opinion.  Our leadership changed as well and I quite frankly don’t respect the people in charge.  The work is also just a bad fit for my personality.  I’m an introvert and do better working in quieter environments with fewer interruptions and many other things like that.  I’m sick of picking up a list full of 20 patients that I didn’t admit and then suddenly being responsible for a million and one problems and having to discharge them from the hospital after they’ve been admitted for 3 weeks and I just met them, etc.  SO, I’ve gotten out of it.  I’m currently working as a nocturnist for the same group and my job satisfaction is way up.  Its quieter, I’m dealing with fewer patients/shift, the work doesn’t come home with me, I’m working fewer days, fewer hours, and have more control over my schedule.  I’m also only dealing with the acute, new problems as they come in from the ED.  I dont’ have to dig through weeks of progress notes on patients I don’t know.

    However, this is only temporary.  I’m moving to an outpatient opioid treatment center position this summer.  Its going to be regular hours, no weekends, no holidays, no call.  Fewer patients per day, a more focused visit.  Lots of positives.  It does pay less however.  Additionally I worry that it might be boring or not satisfying.  But, I’m going to give it a chance because I may also really like it.  I just won’t know until I try it.  I have a friend there who loves it.  So, I’m hoping for a good experience.  The only other thing I worry about with this position is that it will likely be more difficult to get time off for travel.  My wife and I travel a lot.  However, we’re also planning on starting a family this year, so the traveling will have to slow down soon anyway.  We’ll just see I guess!

    I’m hiking the John Muir Trail this summer though, right before I start my new position.  Pretty darn excited about that!  I give that a 10/10 satisfaction score:)

    Click to expand…

    Sounds like you’re actively changing things to better fit you. It may be boring, but thats pretty normal, and I think hectic and stressful are poor substitutes/trade offs for boring anyway. Sounds like there will be all kinds of new additions that can make up for work not being super interesting. Work can be a 6 and life can still be a 10, and it averages out pretty great.

    #33365 Reply
    Liked by hightower, hatton1
    Avatar Kamban 
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    Status: Physician
    Posts: 2250
    Joined: 08/01/2016
    Earnest refinancing bonus
    I’m hiking the John Muir Trail this summer though, right before I start my new position. Pretty darn excited about that! I give that a 10/10 satisfaction score:)

    Click to expand…

    That is exciting and I wish you the best. The Appalachian trail is about 100 miles from my home but I have never hiked it and only been on it a few yards while visiting Harper’s Ferry National park

    #33377 Reply
    Avatar jjandjab 
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    Status: Physician
    Posts: 34
    Joined: 10/19/2016

    Radiologist – almost 12 years. Id say 9/10 right now. As with some of the other seasoned docs, it has gone up and down over the years.

    – First 5-ish years, 10/10. Perfect 3 man group in small community hospital with 2 people I respected and enjoyed and trusted completely

    – Then one awesome partner left; ended up hiring a jacka** who interviewed like really nice guy, but was a horrible partner/disrupter once in the department, so down to maybe 3/10 as I had to fire him. Long 6 months.

    – Then hired good partner, so back to 8/10… But the cuts/bundling/downturn in radiology reimbursement was in full-swing.

    – But then the real gut punch – small hospital closed due to large debt and cratering finances – despite a robust and profitable radiology department. But we had no recourse, obviously – nowhere to work, no outside imaging center, and no local group hiring. A clear 0/10 professionally. Ouch.

    – Did some locums. Went to teleradiology, nights, for a while. 4/10. The freedom was nice, but couldn’t do the overnights like a resident.

    – Now employed small hospital radiologist again. Awesome gig as only work every other week, no night call, but get full-time pay and benefits, etc…

    Above score would be 10/10… but I take away 0.5 point as I have to be away from family for a few nights every other week as the hospital is about 2hrs 15 minutes from my home and commuting each day would be way too long (kids in high school and so don;t want to move). And I take off the last 0.5, because if I was truly Financially Independent at the level I am aiming for, I might just do locums or weekend teleradiology.

    #33423 Reply
    Avatar kingsnake 
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    Status: Physician
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    Joined: 01/04/2017

    GI, 8/10…work 4 days a week usually, our call sucks, make high 6 figures on an rvu basis, like procedures hate clinic…setting myself up to FIRE….

    #33469 Reply
    Liked by Zaphod

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