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  • #31
    Fair, enough... Although I get you are not likely to follow the advice,  I write it for others that may.  No, just means start again one level higher.  Who is above your director?

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    • #32
      I also had a talk with the next admin up.  Shared too much in hindsight.  Although I didn't ask about PT work then, I did say I was considering leaving.  There was no talk of how to make things more satisfactory, it seemed more like simply mining for info about when I might turn my notice in.  That will probably make it easier to fire and replace me at some point, if they are so inclined.
      I sometimes have trouble reading private messages on the forum. I can also be contacted at [email protected]

      Comment


      • #33
        Kudos for trying!  What is your timeframe to not forfeit your benefits, and can you keep quiet and hang on until then?  What are you doing to relax and destress outside of work as others could benefit from your advice if they find themselves in a similar situation?  Thanks for sharing.  Apologies for pushing you so hard!

        Comment


        • #34




          Kudos for trying!  What is your timeframe to not forfeit your benefits, and can you keep quiet and hang on until then?  What are you doing to relax and destress outside of work as others could benefit from your advice if they find themselves in a similar situation?  Thanks for sharing.  Apologies for pushing you so hard!
          Click to expand...


          No worries!  Yes, I think I can hold on.  18 months would be the minimum for it to be worthwhile, and there are smaller payoffs that would be easier to forgo in 24 months, 30 months, 36 months, and ~39 months.  Most likely I'll evaluate the financial situation and work satisfaction at each one of those and see if it's enough to change the calculus.

          I did cut back at work about ~20% to 1.0 FTE.  Otherwise I've been reading more, trying to make healthy life changes, and following some of the advice in Happy Philosopher's blog.  Those make a difference, even if they haven't been life-altering yet.  There are some changes coming in my job description that could make things better, though the opposite is also a possibility.
          I sometimes have trouble reading private messages on the forum. I can also be contacted at [email protected]

          Comment


          • #35







            Ah, the famous “Why do some people..” people question.  My kids used to always ask me these when they were growing up.  IDK why the guy you know keeps working.  I will trust your answer that it is not about money.  I would turn the question to you, Lithium, like I used to with my kids.  Why do you keep working at a job you have stated in past threads that you do not enjoy?  Make a change.  Consider part-time sooner than later.  We have only ever worked part-time and are in no hurry to change.  Look to the examples of WCI, POF, Hatton, and Vagabond’s journeys to part-time medicine.  I have more trouble understanding when people push to work at a job they hate to reach a nebulous number before they change.  I do think generational issues play a role.
            Click to expand…


            Valid points.  I asked my director if I could go part-time and he said no.  I asked if I could structure my full-time work in a way that would provide more variety and possibly less stress, and that wasn’t accommodated either.  So I have the option of leaving and forfeiting substantial unvested benefits in favor of something I might like better, or sticking it out in order to accelerate financial independence.  I’ve crunched the numbers every possible way to try to find a mathematical justification to leave, since it’s easier to make decisions that way than try to decide between options with different uncertain trade offs.  When the list of pros compared to the list of cons is pretty similar on both ends, it seems more rational to stay and more emotional and impulsive to leave the status quo.

            I don’t want to sound like a help-rejecting complainer.  I know life is about making tough decisions, and I’m at a point where more info/advice isn’t likely to help.  Comes down to being ready to make a leap of faith.
            Click to expand...


            It sounds like you have made an effort to improve your work conditions, and I understand the significance of golden handcuffs.

            I was talking about this with my wife yesterday. For years, she asked me why I could not cut out the worst parts of my job (especially the every other weekend call), and for years, I answered that I simply could not. Bad on me. I should have worked harder to find the solution, rather than just sucking it up. It would have preserved my physical and mental health.

            In fact, as discussed elsewhere, I was able to drop the parts of my job that I no longer wanted to do and go part time. My attitude has shifted from "get me outta here ASAP'' to "this ain't so bad", and my timeline has moved from "one bad day away from quitting" to open ended. Quite a dramatic shift.

            Perhaps there is a still a solution for you out there, too.

            Comment


            • #36










              Ah, the famous “Why do some people..” people question.  My kids used to always ask me these when they were growing up.  IDK why the guy you know keeps working.  I will trust your answer that it is not about money.  I would turn the question to you, Lithium, like I used to with my kids.  Why do you keep working at a job you have stated in past threads that you do not enjoy?  Make a change.  Consider part-time sooner than later.  We have only ever worked part-time and are in no hurry to change.  Look to the examples of WCI, POF, Hatton, and Vagabond’s journeys to part-time medicine.  I have more trouble understanding when people push to work at a job they hate to reach a nebulous number before they change.  I do think generational issues play a role.
              Click to expand…


              Valid points.  I asked my director if I could go part-time and he said no.  I asked if I could structure my full-time work in a way that would provide more variety and possibly less stress, and that wasn’t accommodated either.  So I have the option of leaving and forfeiting substantial unvested benefits in favor of something I might like better, or sticking it out in order to accelerate financial independence.  I’ve crunched the numbers every possible way to try to find a mathematical justification to leave, since it’s easier to make decisions that way than try to decide between options with different uncertain trade offs.  When the list of pros compared to the list of cons is pretty similar on both ends, it seems more rational to stay and more emotional and impulsive to leave the status quo.

              I don’t want to sound like a help-rejecting complainer.  I know life is about making tough decisions, and I’m at a point where more info/advice isn’t likely to help.  Comes down to being ready to make a leap of faith.
              Click to expand…


              It sounds like you have made an effort to improve your work conditions, and I understand the significance of golden handcuffs.

              I was talking about this with my wife yesterday. For years, she asked me why I could not cut out the worst parts of my job (especially the every other weekend call), and for years, I answered that I simply could not. Bad on me. I should have worked harder to find the solution, rather than just sucking it up. It would have preserved my physical and mental health.

              In fact, as discussed elsewhere, I was able to drop the parts of my job that I no longer wanted to do and go part time. My attitude has shifted from “get me outta here ASAP” to “this ain’t so bad”, and my timeline has moved from “one bad day away from quitting” to open ended. Quite a dramatic shift.

              Perhaps there is a still a solution for you out there, too.
              Click to expand...


              In my case, I actually cut out the part of my job I minded least, going from about 1.0/0.2 to 1.0/0.  The main component can either be 1.0 or 0, so I cut out the extra, which was never mandatory.  It's still been worth it.

              I don't blame admin for denying me.  Their decisions, even those concerning physician wellness, are ultimately business ones, and group dynamics, fear of setting precedent, and most of all replacability are big parts of the equation.  An important lesson I've learned is not to show my cards when they have the better hand.
              I sometimes have trouble reading private messages on the forum. I can also be contacted at [email protected]

              Comment


              • #37
                Lithium I think you have learned a life lesson.  Hospital administrators are not your friends.  They are looking at the situation from a totally different perspective.

                Comment


                • #38




                  He is 83 and was a doctor who became a lawyer in his late forties.
                  Click to expand...


                  .
                  Erstwhile Dance Theatre of Dayton performer cum bellhop. Carried (many) bags for a lovely and gracious 59 yo Cyd Charisse. (RIP) Hosted epic company parties after Friday night rehearsals.

                  Comment


                  • #39




                    I’ve always been partly amused/partly saddened by the retired surgeons who still frequent the surgeons’ lounge to read the paper or eat lunch, or seemingly just hang out. My last day of work will be the last day in the hospital, except as a patient.

                    I remember in some dumb humanities class I had to take in medical school how the instructor was almost appalled when we were taking about the “calling of being a physician,” and she asked me what I thought. I told her that being a physician was what I was doing with my life but not who I was as a person.

                    My current plan is to work another 15-20 years (I am 39 now and 3.5 years out of fellowship). At that time my youngest child will be 21 to 26 and my kids should be launched by then, hopefully with at least undergrad completely paid for. If I want extra money for something it should be pretty easy to obtain locums work somewhere, but I imagine I would be pretty picky about the options.

                    I remember in residency seeing an old general surgeon. His kids were vascular and general surgeons who did approaches for one of our spine surgeon’s ALIFs. They’d let their dad come in and close, and I had to stand there and watch him put vicryl through the skin on his subcutaneous layer over and over because he couldn’t see. Not for me, thanks.
                    Click to expand...


                    We have a retired OB/GYN who gave up his practice at least a dozen years ago and now is in his 70’s. He is an unlikeabke fellow who spends more time in the doctors lounge than anyone, ranting and raving about politics and health care and whatever the topic of the day.

                    I remember talking to a plastic surgeon colleague who was initially quite pleased that the OB/GYN was retiring, so that now he could eat a peaceful lunch without listening to the diatribe du jour. Little did any of us know that the retirement meant that he would become a fixture, on his soapbox, in our lounge, Both sad and comical.

                    Comment


                    • #40
                      Hearing all these stories of retired physicians staying in the docs lounge...how do they even get in? Soon as docs are retired around here, their badges are inactivated.....

                      I think physicians have a very difficult time retiring for many reasons. A major one is the fact that a large percentage of physicians have not cultivated interests, hobbies, or relationships outside of medicine. The prerequisites, training, and finally the occupation itself lends people having to invest the vast majority of their time to the profession. No wonder doctors don't enjoy their retirement. They have not built the social structure necessary to enjoy a fulfillment retirement.

                      Comment


                      • #41





                        He is 83 and was a doctor who became a lawyer in his late forties. 
                        Click to expand…


                        Did he enjoy practicing law (and/or enjoy it more than medicine)? What branch/specialty of law did he practice? Did he work in Big Law, go solo, or other?

                        I sometimes think that I might want to start an encore career in law, but most lawyers seem to hate the law. Also, I suspect job opportunities would be limited for an old law school graduate.
                        Click to expand...


                        I've also thought about getting a law degree, mostly to give me the tools to speak Legislation and to get the connections of Big Politics.  But shortly--just like my thought of drinking less espresso--the idea passes!

                        I have a friend who got a JD and then an MD.  He hated law, but loves medicine.  Every time I see him I try to talk him into getting involved in policy and he just chuckles and shakes his head....

                        In my shop, the old-timers tend to show up at grand rounds (and parties) more so than the lounge.  I think this is really cool.  I like hearing their stories--crazy cases like weird TB or abdominal pregnancies.

                        I believe the med staff by-laws grant honorary staff privileges, that is how their badges still work.

                        Comment


                        • #42







                          He is 83 and was a doctor who became a lawyer in his late forties.
                          Click to expand…


                          Did he enjoy practicing law (and/or enjoy it more than medicine)? What branch/specialty of law did he practice? Did he work in Big Law, go solo, or other?

                          I sometimes think that I might want to start an encore career in law, but most lawyers seem to hate the law. Also, I suspect job opportunities would be limited for an old law school graduate.
                          Click to expand...


                          Yes, he liked practicing law quite a bit. He also loved the practice of clinical medicine - he was a pulmonologist - but started to get burned out by the administrative issues and other downers of medicine. He became interestedly in the legal aspects of death and dying, and was (is!) very strident on issues of patient rights and self-determination. He ended up in his own practice, and when my mother went to law school a few years later (at 48)  they formed a firm and practiced together. He did some plaintiff’s medical malpractice, some work relating to nursing home issues, and quite a bit of elder law in which his medical knowledge was advantageous. He liked the mental challenge, but I think just as much he enjoyed a new professional gig after many years of practicing medicine.

                          As far as many lawyers hating law, maybe it’s different when you choose it later in life because you want to do it. Many people go to law school because they are good at school and couldn’t figure out something else to do. I also have a number of friends who like law because they enjoy the chess match against the opposition. Law generally speaking is a better outlet for competitive urges than medicine is.
                          My Youtube channel: https://www.youtube.com/channel/UCFF...MwBiAAKd5N8qPg

                          Comment


                          • #43
                            The older I get and the better I am at my work; the more mature I am and the longer my relationships with my patients; the less I want to FIRE and get out of dodge. That was my dream when I was 29 and childless. 15 years later the awareness of the incredible privilege it is to care for patients and to have the relationships with human beings that I have grows every day. I do not want to work full time forever but I would have a hard time walking away from my job tomorrow, even though I could (financially). I’m ready to knock it down a little or buy more PTO, but not sure how or when that will happen.

                            I want to tell a story about the kind of thing that happens in my work that makes it worth doing, even though there is so much else I like to do and would love to do. Someday I’ll tell the story. And I will walk away from full time work someday, between 45 and 50 years old, despite stories like that. But while I don’t live and breathe medicine like an earlier generation of docs did, it is definitely more than a job and for those who get to that point there is something wrong with your employer, or there is something wrong with you.

                            Retention is a major, major consideration in our group (multi-specialty, about 500 providers) and letting a good person go rather than knocking down to 0.8 or 0.6 - well, it would never happen. Of course, there are some providers we won’t be flexible with, and that’s frankly because they have personality deficits that make them less desireable to keep around. Our group values good eggs. And there are a few providers we can’t be flexible with - ie, the only orthopedist in town. But in general, if we can do something reasonable to keep someone, we will.

                            Comment


                            • #44







                              Ah, the famous “Why do some people..” people question.  My kids used to always ask me these when they were growing up.  IDK why the guy you know keeps working.  I will trust your answer that it is not about money.  I would turn the question to you, Lithium, like I used to with my kids.  Why do you keep working at a job you have stated in past threads that you do not enjoy?  Make a change.  Consider part-time sooner than later.  We have only ever worked part-time and are in no hurry to change.  Look to the examples of WCI, POF, Hatton, and Vagabond’s journeys to part-time medicine.  I have more trouble understanding when people push to work at a job they hate to reach a nebulous number before they change.  I do think generational issues play a role.
                              Click to expand…


                              Valid points.  I asked my director if I could go part-time and he said no.  I asked if I could structure my full-time work in a way that would provide more variety and possibly less stress, and that wasn’t accommodated either.  So I have the option of leaving and forfeiting substantial unvested benefits in favor of something I might like better, or sticking it out in order to accelerate financial independence.  I’ve crunched the numbers every possible way to try to find a mathematical justification to leave, since it’s easier to make decisions that way than try to decide between options with different uncertain trade offs.  When the list of pros compared to the list of cons is pretty similar on both ends, it seems more rational to stay and more emotional and impulsive to leave the status quo.

                              I don’t want to sound like a help-rejecting complainer.  I know life is about making tough decisions, and I’m at a point where more info/advice isn’t likely to help.  Comes down to being ready to make a leap of faith.
                              Click to expand...


                              Sometimes, the decisions shouldn't be financial/mathematical. You may look back on this one day. Did you go and try all the things you wanted to try? See all the things you wanted to see? Taken a risk or a leap of faith that made you grow as a person or changed your entire perspective? By definition, the answer very often has to be "no" if you stop working full time when you are old.

                              Consider doing a "fear setting" exercise. https://www.youtube.com/watch?v=5J6jAC6XxAI

                              Everyone should probably do something like the above every few years, just IMO.

                              Comment


                              • #45




                                The older I get and the better I am at my work; the more mature I am and the longer my relationships with my patients; the less I want to FIRE and get out of dodge. That was my dream when I was 29 and childless. 15 years later the awareness of the incredible privilege it is to care for patients and to have the relationships with human beings that I have grows every day. I do not want to work full time forever but I would have a hard time walking away from my job tomorrow, even though I could (financially). I’m ready to knock it down a little or buy more PTO, but not sure how or when that will happen.

                                I want to tell a story about the kind of thing that happens in my work that makes it worth doing, even though there is so much else I like to do and would love to do. Someday I’ll tell the story. And I will walk away from full time work someday, between 45 and 50 years old, despite stories like that.
                                Click to expand...


                                I don't know the specific story you want to tell, of course, but I feel the same way about my work. It's an absolute privilege and honor to do what I do, to know what I know about people and to share in the lives of those that trust me with their care. I nearly always leave my office grateful for the interactions and opportunities I've had during my work day. I feel pretty loyal to my patients, so I can see why some would have a hard time walking away from people they've known for decades.

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