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Grass is always greener.....are you happy with your choice of specialty?

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  • #46
    Rad here. Big representation in the thread and I echo much of what is stated above.

    We are also aggressively recruiting, but it is not easy in my neck of the woods. Studies have to be read. Admin looks at turnaround time with a magnifying glass. Then, under the same breath, ask why findings are missed and what is an acceptable miss rate! Some rads are fast and incredibly accurate, but not all. No rad is 100%.

    Being understaffed means much higher potential for making more money (100k+ more than expected). As a relatively younger rad who trained in brutal conditions on call, I am somewhat desensitized to attending life brutal conditions. I do fear burnout will someday catch up to me.

    One last point not mentioned is the ability to work from home for daytime shifts. A truly amazing perk! Can’t imagine any other specialty with the same salary that can compete.

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    • #47
      Originally posted by Nysoz View Post
      With General Surgery I still enjoy when things go well. When things don't, that's taken more of a toll than I expected. I could probably trudge through for 10 more years if I had to, but there's a reason why I'm going part time after getting FI. I don't regret choosing the specialty though.

      I couldn't picture myself doing anything else in medicine as a physician. I would probably enjoy being a first assist more as I love operating but hate the stress and worry of complications or poor outcomes.

      If not medicine, I'd probably be doing something with my hands. I really enjoyed volunteering for habitat for humanity and 'helping' build houses.
      I’m in cardiology with a similar take. Over the years the bad piles up. I think it’s hard to relate when you’re hands are directly tied to bad outcomes.. even if of no fault of your own.

      to me it perhaps it’s like a soldier that can only take combat for so long - eventually that fatigue wears you out (for some)

      Nice thing about cards is you can quit the tough stuff and just do clinic or read imaging studies. I can do that until I’m 90 if I had to

      so the versatility in cardiology is nice..as well as the money., call and lifestyle sucks though.


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      • #48
        I’m noticing a theme, rads and path, with little or no direct patient care, seem happy, while those with direct patient care are a mixed bag.

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        • #49
          Originally posted by STATscans View Post

          do you think eventually FM, EM and the basic primary care stuff can AND should be handled by 'mid-levels' ??

          And physicians will all be specialist or even sub specialist?
          Or do you want to see a mid level with no
          physician oversight when you go to the ER with an actual emergency? I sure as ************************ don’t.

          Comment


          • #50
            Not a physician - dentist, but very happy that when I decided to go to dental or medical school, it was too late to take MCATs for that year but just made it to DATs.
            In school, I thought I had made the wrong choice. 25 yrs later, very pleased with it.
            But it's great that most MDs here are very happy with their choice too. On Dentaltown forum, there is a lot more complaining and regret.

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            • #51
              Originally posted by GoBlueMD View Post
              Rad here. Big representation in the thread and I echo much of what is stated above.

              We are also aggressively recruiting, but it is not easy in my neck of the woods. Studies have to be read. Admin looks at turnaround time with a magnifying glass. Then, under the same breath, ask why findings are missed and what is an acceptable miss rate! Some rads are fast and incredibly accurate, but not all. No rad is 100%.

              Being understaffed means much higher potential for making more money (100k+ more than expected). As a relatively younger rad who trained in brutal conditions on call, I am somewhat desensitized to attending life brutal conditions. I do fear burnout will someday catch up to me.

              One last point not mentioned is the ability to work from home for daytime shifts. A truly amazing perk! Can’t imagine any other specialty with the same salary that can compete.
              It’s funny because it seems everyone says they are recruiting yet the job market is overall pretty neutral. Personally I think many PP rads are out of touch with what perspective job candidates desire(said as someone who recently accepted a PP position). Hence why tele is proliferating. PP has failed to innovate and respond to the market as a whole, hence they’re losing the battle.

              Comment


              • #52
                Originally posted by HikingDO View Post

                Do you want a mid level as your PCP?
                No. How do you find a good PCP? Serious question. Half of the PCP's aren't accepting new patients! No idea the workload (scheduling) or how they actually practice.
                Not a complaint, it is just I have no idea if I would just be a block on the schedule. I really feel like a monkey throwing darts. Sorry, I don't rely on the ratings on the website. Maybe I should but I have read so many tales of woe the 4.8, 4.9 and 5.0 seem to be the norm. Earliest appointment is in Aug 7. Only one of 9 shows open appointments.
                Looks like a DO
                from Lake Erie College of Medicine in Fla. No clue what I am getting.

                "Your money (and that of your insurance company) going into his wallet, is the biggest concern that Dr. XXXX has. For example, Dr. XXXX tells you that your insurance company policy forbids him from renewing your routine prescriptions, during your visit to him, for your annual physical exam. You must make a SEPARATE new visit to get your routine prescriptions! That’s what he told me, at least). Now WHY would your insurance company deliberately require extra office visits, and more insurance m"

                One star rating on Healthgrades excerpt above. 13 5star and 9 1star for a 3.4 average. Clear as mud. In my area, referrals will be in the same group regardless of the specialty. But, 4.8 on the hospital's website.

                It is a jungle out there finding PCP's. You guys need to get paid more!

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                • #53
                  I’m satisfied with my career, but am realistic that there are pros and cons:

                  pros:
                  - I have the best patients. For real. They are smart, funny, bad*ss, tough. I haven’t attracted too many crazy ones, but maybe haven’t been around long enough to yet? The best thing about my job is getting to make a real difference in the lives of my patients, some of whom have been with me my whole (short) career
                  - it’s the perfect mix of challenging, but I can handle it. Technically, I feel like I am constantly learning but also good at what I do. Intellectually, I can know what I need to know. Not gonna lie: understanding hyponatremia was never my jam. I’ve learned it and forgotten it several times now.
                  - I have saved lives. That’s a pretty cool thing to say. It’s meaningful to me.
                  - I love my partners. Landed in a group that mentors young doctors and doesn’t eat them. I chose an employed position to finish
                  childbearing, build my practice, not have to worry about overhead so didn’t have too much expectation. I feel like I’ve found a hidden ruby in a pile of seaweed.
                  - even though it is an employed position, I have a lot of control over my schedule and 6 weeks off a year + holidays. Not bad. I know I could probably make more $ elsewhere but because our financial house is in order, I don’t need to.


                  cons:
                  - unpredictable hours. Getting up for deliveries in the middle of the night is physically tough for me. Wipes me out 48hrs later. Ironically the next day is not so bad, it’s the day after that I feel like death. I can do this for a while longer, but no way can I do it until 65yo.
                  - it’s stressful. I haven’t had a bad outcome yet, but I’m not kidding myself. It’s because I am at the beginning of my career. If I’m the norm, a lawsuit or three will come my way. Even worse is the thought of a unexpected maternal or fetal death. *shudder*
                  - the EMR. Ugh.

                  For now the pros way outweigh the cons. Would rather do this any day than have a desk job like the hubs. But super jealous that the hubs gets to sleep every night and never takes weekend call.

                  We are kidding ourselves if we expect the perfect job. There is good and bad to everything.


                  Comment


                  • #54
                    Originally posted by Dusn View Post

                    I know ophthos who see 100 patients a day and they’re definitely missing stuff — they just might be working too fast to realize it. I think the patient volumes is a growing problem across medicine.
                    . I think this issue of too many patients —> poor quality of care is universal across medicine, not just rads.
                    I agree with this. I don’t see 100 pts per day but I’ll sometimes see 70+. Yes, I’m paid VERY VERY well but I HATE it. I can’t just go and cut my pt volume in half because these pts would have no where else to go (they’d have to drive hours away to see another retina doc). All of my partners are very busy like this too. Problem is, we’ve been trying to recruit another doc for 3-4 years now, and cannot get anyone. There are too many retina jobs and not enough retina candidates. I like what I do but wish it wasn’t so darn busy day to day.

                    Comment


                    • #55
                      Originally posted by ObgynMD View Post
                      I’m satisfied with my career, but am realistic that there are pros and cons:

                      pros:
                      - I have the best patients. For real. They are smart, funny, bad*ss, tough. I haven’t attracted too many crazy ones, but maybe haven’t been around long enough to yet? The best thing about my job is getting to make a real difference in the lives of my patients, some of whom have been with me my whole (short) career
                      - it’s the perfect mix of challenging, but I can handle it. Technically, I feel like I am constantly learning but also good at what I do. Intellectually, I can know what I need to know. Not gonna lie: understanding hyponatremia was never my jam. I’ve learned it and forgotten it several times now.
                      - I have saved lives. That’s a pretty cool thing to say. It’s meaningful to me.
                      - I love my partners. Landed in a group that mentors young doctors and doesn’t eat them. I chose an employed position to finish
                      childbearing, build my practice, not have to worry about overhead so didn’t have too much expectation. I feel like I’ve found a hidden ruby in a pile of seaweed.
                      - even though it is an employed position, I have a lot of control over my schedule and 6 weeks off a year + holidays. Not bad. I know I could probably make more $ elsewhere but because our financial house is in order, I don’t need to.


                      cons:
                      - unpredictable hours. Getting up for deliveries in the middle of the night is physically tough for me. Wipes me out 48hrs later. Ironically the next day is not so bad, it’s the day after that I feel like death. I can do this for a while longer, but no way can I do it until 65yo.
                      - it’s stressful. I haven’t had a bad outcome yet, but I’m not kidding myself. It’s because I am at the beginning of my career. If I’m the norm, a lawsuit or three will come my way. Even worse is the thought of a unexpected maternal or fetal death. *shudder*
                      - the EMR. Ugh.

                      For now the pros way outweigh the cons. Would rather do this any day than have a desk job like the hubs. But super jealous that the hubs gets to sleep every night and never takes weekend call.

                      We are kidding ourselves if we expect the perfect job. There is good and bad to everything.

                      Retired OB here. If I could have a do-over I would of picked something more lifestyle friendly. The call bothered me a lot more as I aged. Certainly you save lives in OB/GYN as a regular occurence. You will likely have some unexpected unexplained fetal deaths along the way. It happens. It makes OB/GYN take an emotional toll. I got sued and even went to trial. This is horrible beyond words. I found the biggest plus of OB was the long term patient relationships. You start seeing a patient as a teenager for contraception, you do several deliveries, and finally a hysterectomy. The complete female life cycle so to speak.

                      Comment


                      • #56
                        Originally posted by Panscan View Post

                        It’s funny because it seems everyone says they are recruiting yet the job market is overall pretty neutral. Personally I think many PP rads are out of touch with what perspective job candidates desire(said as someone who recently accepted a PP position). Hence why tele is proliferating. PP has failed to innovate and respond to the market as a whole, hence they’re losing the battle.
                        I think there are more candidates that want a narrow focus in private practice. This is very difficult in PP where “general call” encompasses almost every body part. Our call is broken into subspecialty imaging modalities somewhat. But, there’s no MSK only call or body only call.

                        Weekday shifts have more room for subspecialty reading. But, if you can only staff one specialty, that’s undesirable and it will make coverage tricky when planning off days.

                        Mammo has morphed into another specialty basically. In the last 5+ years, I have been the only rad that reads almost everything +mammo. Almost all mammo rads interested in our practice have not wanted to read other specialties. Rads without mammo fellowship and saying no to mammo. And they can in this climate. Mammo is relatively easy compared to other rad specialties. Plus you interact with patients and perform low risk procedures!

                        In summary, staffing a medium sized PP (20-30 rads) can be very difficult. For long term viability of the practice, the rad hired has to read out of their fellowship subspecialty, with the exception of mammo these days.

                        Comment


                        • #57
                          Originally posted by Hatton View Post

                          Retired OB here. If I could have a do-over I would of picked something more lifestyle friendly. The call bothered me a lot more as I aged. Certainly you save lives in OB/GYN as a regular occurence. You will likely have some unexpected unexplained fetal deaths along the way. It happens. It makes OB/GYN take an emotional toll. I got sued and even went to trial. This is horrible beyond words. I found the biggest plus of OB was the long term patient relationships. You start seeing a patient as a teenager for contraception, you do several deliveries, and finally a hysterectomy. The complete female life cycle so to speak.
                          I am fearful of the almost unavoidable poor outcomes and high risk of litigation. If/when I get sued, that might be a decision point to see if I want to continue doing OB. Sad but true. One of the reasons I am so thankful for the WCI and this forum- to have an out before age 65yo if needed.

                          Any advice about how to weather this storm (poor outcome and/or litigation) and still want to keep practicing? Is it possible?

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                          • #58
                            Originally posted by Hatton View Post

                            Retired OB here. If I could have a do-over I would of picked something more lifestyle friendly. The call bothered me a lot more as I aged. Certainly you save lives in OB/GYN as a regular occurence. You will likely have some unexpected unexplained fetal deaths along the way. It happens. It makes OB/GYN take an emotional toll. I got sued and even went to trial. This is horrible beyond words. I found the biggest plus of OB was the long term patient relationships. You start seeing a patient as a teenager for contraception, you do several deliveries, and finally a hysterectomy. The complete female life cycle so to speak.
                            Hatton You underestimate the "trust factor" on the husband and the relationship that is created. Many fathers are grateful for your care and attention to the people most important to them. You forgot one additional factor. How did you feel when the child you brought into this world became a patient? Not common, but anecdotally I can say this happens (he practiced 42 years). Of course my daughter ended up needed to find a new OB/GYN. I am sure you have a legion of fans that greatly miss you, not just patients, the fathers and the children.

                            Comment


                            • #59
                              I’ve always thought I wouldn’t want to be in medicine if I weren’t a psychiatrist, but I guess I could have made it work. I prioritize the independence, autonomy, control of schedule, control of which patients I choose to work with, lack of EMR, no insurance to deal with in private practice. But more than all that, the work is just interesting and satisfying. I talk to people about their deepest concerns. I am called upon to be my best self. Then again, there is a risk of romanticizing work.
                              My Youtube channel: https://www.youtube.com/channel/UCFF...MwBiAAKd5N8qPg

                              Comment


                              • #60
                                Originally posted by Panscan View Post

                                Volume/person is related to the desire to make money of the individual rads. Could easily read less and make less. Most rads don't want to do that.

                                The amount of vacation in PP rads is frankly ridiculous compared to essentially all other specialties and employment situations. There are people literally getting 12-18 weeks off. I have never heard of a job where you get 1/3 of the year off with no call and reading an extremely narrow modality such as mammography in another specialty besides rads. It would be like if you were a general surgeon who only did appys all day and literally nothing else.

                                I love rads subject matter and the job FWIW just the employment paradigms especially in private practice make no sense to me and I don't really see them repeated anywhere else in any other field of medicine. Would rather have a little less time off and not have calls be absolutely miserable where you are doing 3x FTE work. Again this is something I haven't really heard of in any other field and am not sure why it's a thing in radiology, I guess because PACS enables it? Not sure how it's legally defensible, it seems pretty clear to me you could look at normal business hours volumes and establish that as a normal volume and then if you have a mistake during a time where you are literally doing an integer multiple of that, it would look pretty bad.
                                as for the volume. I think in PP and in small community hospitals, you can read pretty quick without making mistakes (too often).

                                most of the studies are not necessary and you have a high chance of being negative. as long as you do your search pattern and stick to it, I think you can read fast and be accurate.

                                CTs of the heads are ordered ALOT and they are the easiest study to read. DVT studies are another thing. Many out patient orthopedic follow up studies are straight forward. For the complicated ones, you take your time and dictate a good report. But on the stone cold normal ones, use a template. I mean how many ways is there say 'the lungs are clear, the heart is normal. there is no ptx."? if normal, just say, "powerscribe negative chest 2 views' and move on.

                                And if the patients come in multiple times how many times do you have to describe the multiple levels of disk space narrowing or the multiple diverticula they have? It was already mentioned before.

                                So yes it can be done.

                                If you work at a large hospital with complicated cases, ah, then dictations can go on. But you get the name recognition of working for a 'top hospital' as opposed to being called a 'small time radiologist'.

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