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  • CM
    replied




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

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  • Hatton
    replied
    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.

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  • Lithium
    replied










    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.
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    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.
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    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.
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    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.

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  • VagabondMD
    replied







    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.

    Leave a comment:


  • Lithium
    replied




    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!
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    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.

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  • Dr. Mom
    replied
    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!

    Leave a comment:


  • Lithium
    replied
    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.

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  • Dr. Mom
    replied
    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?

    Leave a comment:


  • Lithium
    replied




    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.

    Leave a comment:


  • Dr. Mom
    replied
    Ah, the famous "Why do some 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.

    Leave a comment:


  • kingsnake
    replied
    I really like our EMR, way better than paper charts. I hated looking around for charts and then trying to decipher illegible notes. I also lose much fewer pens now.

    I have no desire to work 5 days a week ever again now that I work 4 days a week. I am liking my JOB less and less every year due to hospital admin, insurance companies, and less appreciative patients. I am employed so have no sense of ownership at all. I think I'm FI but want enough to basically live off dividends and interest....

    Leave a comment:


  • BladeRunner
    replied









    I’m a 58 yo boomer, and I have never met these noble individuals.




    Everything was on paper when I left medicine around the turn of the century, and everything was electronic when I returned. It’s a great benefit. Multiple physicians can use the chart at the same time (no waiting), and we can access everything from home. I don’t have to go down to radiology to see a film now. There are a few minor annoyances with order entry, but overall e-records beat paper records from my point of view. I don’t understand why electronic systems are so unpopular (except that it would be a great hassle and expense to install in a small private practice).
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    Agree with both of these.

    As I’ve said in other forums the EMR-bashing among older docs is a bunch of hogwash. We do everything else in our lives online, it’s 2017, medicine is going to be computerized. I know several older docs who complain incessantly about the clunky, difficult EMR and then spend hours a day playing on their iPhones. The rare times we have to use paper charts now (e.g. computer downtimes) it’s amazing that people didn’t revolt against this system well before it went away. I do a medicolegal case discussion for my residents involving a torsion case on paper charts and it’s absolutely incredible how little of the chart is even legible.
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    As an older (54 YO) doc in private practice group that has to this point spent/borrowed $1.1mil on EMR, I don't think that that anyone would argue against the increased convenience of extracting information from electronic medical records. The primary issue in our case is the inefficiency of Data Input. Older doc's often never took typing in the past and Dragon Speak still is somewhat clunky. EMR has actually decreased the number of patients our physicians are able to see each clinic, cutting into revenues, and adding significantly to our expenses. It is a simple math problem from a financial standpoint.

    Working harder and making less is the stark reality that many physicians are facing, both young and old, and some, both young and old, will bow out, as this forum attests.

    As an aside, IMO, the government missed an incredible opportunity to increase efficiency and cut cost in healthcare when they failed to mandate that these systems be able to communicate with each other from the very beginning. Much of the data would have needed to be entered only once, especially from the patient's perspective. Asking an 82 year old with mild dementia to list all of their medications every time she sees a new doc is utterly ridiculous.

     

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  • RogueDadMD
    replied
    My father is 70 and a practicing FP/psychiatrist.  He works more hours than most people on this forum and probably as many hours as most people in training.  He works because it's his purpose -- it's what he wants to do with his time.

    He's tried to go part-time by cutting clinic hours, and has always ended up picking up other part-time jobs doing inpatient work almost immediately and ended up working as many or more hours.

    A year ago he took a part-time job driving a few hours to a prison to do psychiatry there.  He was literally spending a couple days living in some small town and staying in a motel -- he was working so hard at home with clinic and inpatient work he actually thought this would be an easier job than his regular job.  We tried to talk him out of it since it was a crazy idea, but didn't work.

    He didn't stay long in that job for a few reasons (including longer hours than he expected), but I think the inability to bring in his iPhone into the prison to entertain himself was the dealbreaker.   :lol:

     

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  • Lithium
    replied
    I graduated med school in 2010.  I didn't mind the old EMR we have and would rather use it than paper charts.  CPRS at the VA was great.  The one implemented this year is horrendous.  Littered with bugs, unsafe (has inaccurate displays of current meds), intrusive, cumbersome, and doesn't handle free text orders.  And often when I put orders in they disappear into some unknown rabbit hole, or I can see them but the nurses can't.  The click-box documentation increases liability.  And administration uses it to shovel more extraneous documentation requirements on us for the sake of data mining.

    In theory EMR is great; in practice it absolutely can exacerbate burnout.

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  • Hatton
    replied
    "older" doctors ****************************** about EMRs because most people hate change.  I have paper office charts because of money.  It would be costly to do this at 60 with no chance of recouping the cost.  If I intended to practice 20 more years I would of already done it.

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