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EM for the long run

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  • #46
    Yes, I understand what you are saying. While I don't think my job cares if I pay Bob $1000, they do care that we all work a certain number of nights.

    Sure. EM is great for many people. I never said it wasn't. I just think people need to hear all sides. And there are a lot of bad jobs and a fair amount of burnout in EM.


    • #47
      First thread I see after logging in after a while and...

      Eh people posting here are a minority IMHO. They have time to log in and post, stands to reason they have comfortable jobs where they are happy.

      A LOT of physicians aren't happy with their jobs. Reasons are multiple.

      From a neutral non-medical point of view, doctors aren't great at diversifying "outside of medicine" skills. How can they if they toil away in med school for x years and in residency for y years (yes...insert ortho jokes here). So they sort of feel trapped in their jobs.

      I got nothing in terms of advice to snowcanyon, but I do think one should expand beyond medicine ASAP. Have side hobbies, gigs, and think broad and wide. Don't just make medicine/your job define your routine. Usually this leads to more opportunities and career altering changes (for the positive).


      • #48

        Yes, I understand what you are saying. While I don’t think my job cares if I pay Bob $1000, they do care that we all work a certain number of nights.
        Click to expand...

        Are you overestimating this concern?

        This is a classic case where I would ask forgiveness rather than permission. If you are employed I really doubt your hospital cares about shift distribution as long as the shifts are covered.

        It sounds like you have almost nothing to lose by trying to give away nights for a premium at least. The worst they can do is tell you to stop but they aren't going to fire you over it. Your small internal free market might set a price at which you become a popular guy who will pay money to give away nights that other people don't mind that much!

        I hate nights but I would probably take this deal once a month if someone was willing to trade a shift with me + pay me an extra $1k to take their night. That's right around where it would become worth it to me.


        • #49
          How do you know no one will take your nights/weekends/holidays till you try? That’s my thought as well. I believe our anesthesia provider’s going rate is $4500 for one partner to take another’s weekend.

          To make this relevant to the OP, live will below your means early in your career so you can pay to work less later.

          But my impression is even in the best group setups you’re still gonna work a high percentage of weekends, nights, holidays, especially as your total shifts drop. I seem to recall from his twitter that WCI worked back to back weekends or something like two weekends out of three. But that was all he worked for the month!


          • #50
            Snowcanyon- I think some of your comments are misguided. for instance, admin being non-clinical. Completely disagree. You can work on clinical pathways, QA projects etc. You can impact your own practice, your colleagues practice and the clinical outcome of your patients.. you can also impact and optimize your scheduling if you wish.

            I always viewed EM as a canvas to paint on. It provides a guaranteed income, but you can develop your own niche/colors that allows you to practice for well beyond “10 years”.