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How to ease into retirement?

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  • #16
    I’ve been doing locums for a year. I’d rather do it part time but it’s been basically full time during COVID. My contract is up at the end of April, but they probably need me through August. I don’t want to work full time in the summer so I’m trying to negotiate a reduced schedule until they hire a replacement.

    I’ve concluded that I can’t keep going through a job search, credentialing and asking for reference letters every 6-12 months, so I’m not sure where that leaves me when this locums gig is up. I don’t see many job listings for long term part time work. The ones I do see are unattractive geographically (urban NE) or practice setting (outpatient, ECT, telepsych). I’ve noticed some part time corrections work in acceptable locations, but until I actually work in a prison it’s hard to know if I’d like it or absolutely loathe it.

    If I just can’t find anything I like I might just work in the local free clinic, if that’s enough to get me past credentialing committees while I figure out whether to **** or get off the pot.

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    • #17
      Academic, VA, and Kaiser are options to consider -- ie large institutions which you can negotiate a per case/lower volume/ part time -- as long as the references and prior history are good, have seen this in all three institutions in the surgical subspecialties

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      • #18
        Originally posted by Lithium View Post

        Is there a functional or financial difference between two docs dropping down to 0.5 FTE vs. doing a 50/50 job share?

        Is part of the reason it’s a difficult sell because of the cost of benefits? In the case of retirement benefits the baby can be split without increasing the overall budget but I don’t see how health insurance coverage can be cut in half.
        Yes it's about the benefits. For example in our organization 0.8+ FTE gets full health insurance, below that it's prorated. Say health care costs $25,000 per family per year. Two docs sharing one job equally each want $25,000 of health insurance so they need to pay about $25,000 each. How much does the employer pay? It's not that it's a hard problem to solve, it's just not been a priority for the organization. Usually it means each doc will get full benefits and maybe 40% pay for half time work.

        With older docs retiring and women representing half of all medical students, organizations should be actively considering nontraditional job arrangements to be competitive in the market.

        Btw if you want about a 0.6 FTE of inpatient only send me a note, we're hiring.
        Last edited by FIREshrink; 01-30-2021, 05:04 PM.

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        • #19
          I was a hospital-employed surgical specialist at a rural hospital for several years. The closest I got to working part-time was taking Friday afternoons off for a few years, then I added taking Monday mornings off for my final year - essentially working 4 days a week (but still 24/7 call) that final year.

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          • #20
            Originally posted by FIREshrink View Post

            Yes it's about the benefits. For example in our organization 0.8+ FTE gets full health insurance, below that it's prorated. Say health care costs $25,000 per family per year. Two docs sharing one job equally each want $25,000 of health insurance so they need to pay about $25,000 each. How much does the employer pay? It's not that it's a hard problem to solve, it's just not been a priority for the organization. Usually it means each doc will get full benefits and maybe 40% pay for half time work.

            With older docs retiring and women representing half of all medical students, organizations should be actively considering nontraditional job arrangements to be competitive in the market.

            Btw if you want about a 0.6 FTE of inpatient only send me a note, we're hiring.
            I think job share 7 on 7 off or some such would be nice in some ways for inpatient psych.

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            • #21
              Originally posted by childay View Post

              I think job share 7 on 7 off or some such would be nice in some ways for inpatient psych.
              there was a 14 on 14 off job, 9 hour days, that would job share well to 7 on, 21 off. sweet! but i don’t want to move, or leave my job.

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              • #22
                Originally posted by StarTrekDoc View Post
                Academic, VA, and Kaiser are options to consider -- ie large institutions which you can negotiate a per case/lower volume/ part time -- as long as the references and prior history are good, have seen this in all three institutions in the surgical subspecialties
                I agree. But even in academics , it is hard to be completely “off”. They are always calling you for your pts or sending messages , even if you negotiate a day off . Just hard to be part time in surgical specialty , I know some folks who have done it though . For sure, you can cut down the number of clinics or OR, but it will be hard to go out of town or things like that .

                I was called on my weekend off for ER consult ( not my pt , but my specialty ), that’s the only time I told the ER doc , how would you feel if I call you at your home after your shift .

                Part time works very well for acute care/ICU etc .

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                • #23
                  Originally posted by Lordosis View Post
                  You say the area is hard to recruit. Can you negotiate a better version of your job where you are? They may view it as better than losing you all together.

                  Worst case you cannot and leave. The benefits of being FI

                  One major reason that I want to leave is the location.

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                  • #24
                    Originally posted by nephron View Post
                    I think that you just have to find a vascular surgeon that is too busy and wants to off load some of his/her routine work some months. The vascular surgeons that I work with seem over-worked and would be better off with some part time help rather then staying until 7-8 at night declotting our accesses or place new catheters. I would imagine that it would just take approaching a few groups and seeing if the full time people were willing to come up with some sort of arrangement where you could help out when you want to in exchange for them making money off your work in exchange for covering for your patients when you were not available. I think that there is a shortage of vascular surgery everywhere, especially as IR gets more and more busy, but maybe that's just my perception because people don't like to deal with my patients.
                    My lifestyle at my current job is actually pretty good. Pretty rare for me to stay late and working past 5pm. I have been trying to limit my practice to mostly elective cases.

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                    • #25
                      Finding a part-time job or true job share is going to be hard for a VS.

                      How about finding a position where I can take more than the standard 4 weeks of vacation a year? Say, 8 weeks a year? Is it possible? Is it more likely at a private practice? I think it will be less likely at a very rigid health care system where all the employed docs get the standard 4-week vacation.

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                      • #26
                        Can you take general surgery call too? If so, I know our hospital would entertain a vascular surgeon that could help with call coverage.... but that means hot gallbladders, appys, bowel obstructions, etc. I live in a HIGHLY desirable location and lots of the medical staff are part time. Life is good.

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                        • #27
                          Originally posted by hw View Post
                          Finding a part-time job or true job share is going to be hard for a VS.

                          How about finding a position where I can take more than the standard 4 weeks of vacation a year? Say, 8 weeks a year? Is it possible? Is it more likely at a private practice? I think it will be less likely at a very rigid health care system where all the employed docs get the standard 4-week vacation.

                          Vacation time varies so much between different groups. I imagine if you can find a larger VS group, with a similar thought pattern as you (cherish family time, don’t want to kill his or herself) then yo may be able to find a practice situation with a lot more vacation time

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                          • #28
                            Originally posted by nephron View Post
                            I think that you just have to find a vascular surgeon that is too busy and wants to off load some of his/her routine work some months. The vascular surgeons that I work with seem over-worked and would be better off with some part time help rather then staying until 7-8 at night declotting our accesses or place new catheters. I would imagine that it would just take approaching a few groups and seeing if the full time people were willing to come up with some sort of arrangement where you could help out when you want to in exchange for them making money off your work in exchange for covering for your patients when you were not available. I think that there is a shortage of vascular surgery everywhere, especially as IR gets more and more busy, but maybe that's just my perception because people don't like to deal with my patients.
                            this seems like the best option to me.

                            find a busy group where folks just need a little breathing room.

                            maybe do something like cover call for 10 days a month or something like that? only do emergency cases, limited clinic.

                            another creative idea w/ vascular would be can you attach to a nephrology group and just do dialysis access work? not sure how fun/rewarding this is as a surgeon but i'm guessing you could stay relatively busy while having a fairly controllable life.

                            also i think this would be easier to do in gen surg right? use the base training rather than specialty? surely can't be hard to find gen surg call out there?

                            there's also always vein work.... i know it's not exciting but i've never called anyone in for a varicosity.

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                            • #29
                              Not a doc (obviously) but we have at least 2 clients who have done quite well cold-calling groups offering 1099 services. There are so many creative ideas above and I’m sure there is a solution for you. An observation from life lived - almost everyone I’ve ever known has a great idea, genius sometimes. But only those who implement and follow through, fail, adjust, and continue (as many times as necessary) are successful. The willingness to do this is imbedded in only a tiny % of people. You must be willing to get out of your comfort zone. Good luck.
                              Our passion is protecting clients and others from predatory and ignorant advisors. Fox & Co CPAs, Fox & Co Wealth Mgmt. 270-247-6087

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                              • #30
                                Originally posted by hw View Post
                                Finding a part-time job or true job share is going to be hard for a VS.

                                How about finding a position where I can take more than the standard 4 weeks of vacation a year? Say, 8 weeks a year? Is it possible? Is it more likely at a private practice? I think it will be less likely at a very rigid health care system where all the employed docs get the standard 4-week vacation.
                                My system gives me 8 weeks of time per year, but that's only after 7 or 10 years. That includes cme, vacation, holidays. But it seems like enough for now. But I also only work 4 days a week (plus call) which is also considered full time here. So I only work about 4.25*45 = 190 days per year.

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