Another 25 years?

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CHARLESTONMMM

CHARLESTONMMM

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5 years out of residency and a partner in a small town group and making great money and thinking to myself… How am I going to keep doing this for another 25 years?

I have a lot of call and I HATE call. I feel like the entire hospital only cares about my signature and nothing more. I see no future increase in income, only more downside. It’s difficult to recruit quality partners in a small town. I have no control over the efficiency of the surgery schedule or the surgeons. Patients are getting older and sicker and more obese.

The future seems so bleak.
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Take a trip to a nice sunny beachside town with tropical drinks and hot babes
 
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Call is just pure misery. Wasting the limited time given to you on this earth to earn a few sheckles just becomes harder and harder to do.
 
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AnesProfesso said:
5 years out of residency and a partner in a small town group and making great money and thinking to myself… How am I going to keep doing this for another 25 years?

I have a lot of call and I HATE call. I feel like the entire hospital only cares about my signature and nothing more. I see no future increase in income, only more downside. It’s difficult to recruit quality partners in a small town. I have no control over the efficiency of the surgery schedule or the surgeons. Patients are getting older and sicker and more obese.

The future seems so bleak.
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I feel the same way. Just starting my 3rd year as an attending.
 
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Work in a small town…make great money…why would you need to do this for anywhere near 30 years? I live in an expensive city, make below average in academics, and could quit after 10 if I didn’t have kids. With the kids probably 20.
 
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AnesProfesso said:
5 years out of residency and a partner in a small town group and making great money and thinking to myself… How am I going to keep doing this for another 25 years?

I have a lot of call and I HATE call. I feel like the entire hospital only cares about my signature and nothing more. I see no future increase in income, only more downside. It’s difficult to recruit quality partners in a small town. I have no control over the efficiency of the surgery schedule or the surgeons. Patients are getting older and sicker and more obese.

The future seems so bleak.
Click to expand...

Move to a big city and take one of many no call positions.
 
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ambiturner said:
Work in a small town…make great money…why would you need to do this for anywhere near 30 years? I live in an expensive city, make below average in academics, and could quit after 10 if I didn’t have kids. With the kids probably 20.
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I also have little kids that won’t leave the home for another 15+ years. The real question is how much money is enough money for my sanity. Maybe all adult jobs are misery and I’m no different than every other joe out there.
 
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AnesProfesso said:
The future seems so bleak.
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The future seems so bleak because IT IS bleak.
Once I accepted the perverse nature of this reality we face, things I am not so pissed off anymore. It actually is kind of amusing watching this whole system racing towards the cliff
 
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AnesProfesso said:
5 years out of residency and a partner in a small town group and making great money and thinking to myself… How am I going to keep doing this for another 25 years?

I have a lot of call and I HATE call. I feel like the entire hospital only cares about my signature and nothing more. I see no future increase in income, only more downside. It’s difficult to recruit quality partners in a small town. I have no control over the efficiency of the surgery schedule or the surgeons. Patients are getting older and sicker and more obese.

The future seems so bleak.
Click to expand...
Just curious...what's a lot of call ?
 
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AnesProfesso said:
I also have little kids that won’t leave the home for another 15+ years. The real question is how much money is enough money for my sanity. Maybe all adult jobs are misery and I’m no different than every other joe out there.
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I’ve noticed that dissatisfaction really notches up in years 3-5 when doctors realize that…this is it. Med school and residency are rough but at least things are exciting, new challenges every day, you’re learning, and have good camaraderie with the other residents. My surgeon friends actually got this malaise worse so it’s not just anesthesia.

If you’re geographically flexible you might like a bigger group where the call is split among more people. The benefits are usually better in academics which is a plus with a young family too.

And aheadbyacentury isn’t wrong, this job is way more fun if you reduce your personal investment in the job and watch with a sense of detached amusement. Probably not a great idea in a small partnership where reputation matters though.
 
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I mean if you’re making good money which I assume is at least >500 if taking a lot of call you’re really only 10-12 years away from FI if want to be
 
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The problem is most who get into medical school are achievement motivated people. Anesthesiology in many ways mirrors socialism (as you may notice by the number of "practitioners" of all pedigree from the far left of the bell curve).
Nobody is going to recognize or reward your achievements from here on, although some delude themselves to believe otherwise.
 
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gasdoc77 said:
The problem is most who get into medical school are achievement motivated people. Anesthesiology in many ways mirrors socialism (as you may notice by the number of "practitioners" of all pedigree from the far left of the bell curve).
Nobody is going to recognize or reward your achievements from here on, although some delude themselves to believe otherwise.
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Yes. And academics/AMCs resemble socialist kleptocracies.
 
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If you’re geographically constrained, with all the call and hopefully good income, get yourself something that brings you joy every time you see it, especially since traveling is limited currently. I know us high earners get made fun of for blowing money on “things” but honestly every once in a while you need to be able to enjoy the fruits of your labor.
 
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pgg said:
You know what the answer is -

Move to a better practice, spend less, save more, go part time sooner, retire early.
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Better practice..???!!. its slight variation of the same theme everywhere.. Generally speaking..
 
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ambiturner said:
Yes. And academics/AMCs resemble socialist kleptocracies.
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Your corporate, private equity overlord who works you hard and then profits off your labor is actually the very definition of capitalism.
 
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vector2 said:
Your corporate, private equity overlord who works you hard and then profits off your labor is actually the very definition of capitalism.
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It's actually CRONY CAPitalism, not real capitalism.. They paid off a lot of people to be able to be able to bully you.
 
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I’d like to be out of medicine by 45. Certainly not taking anymore call by then. Already planning an exit.
 
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Aheadbyacentury said:
It's actually CRONY CAPitalism, not real capitalism.. They paid off a lot of people to be able to be able to bully you.
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The history of capitalism in the US for the last 150 yrs *is* crony capitalism (see: the source of politicians’ campaign funds). The problem is people tend to complain about the “crony” part only after it has personally affected them.
 
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vector2 said:
The history of capitalism in the US for the last 150 yrs *is* crony capitalism (see: the source of politicians’ campaign funds). The problem is people tend to complain about the “crony” part only after it has personally affected them.
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The crony part is detrimental to everything except those who personally benefit. the crroked politician and the corporate beneficiary.
 
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Aheadbyacentury said:
The crony part is detrimental to everything except those who personally benefit. the crroked politician and the corporate beneficiary.
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No argument there. Just correcting the record that AMCs are capitalist in nature and that a comparison to a socialist kleptocracy is not nearly as accurate.
 
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Perhaps the AMC comparison was less accurate. I had in mind the big groups with the inner circle of ‘superpartners’ that are written about not infrequently here (everyone equal but some more equal than others). Agree that the private equity brand is the worst form of capitalism.

Academics in the wrong hands, which I know much about, resembles the Soviet Union at the height of its corruption.
 
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ambiturner said:
I’ve noticed that dissatisfaction really notches up in years 3-5 when doctors realize that…this is it.
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I think a lot of this is conditioned in us by our training.

High School-4 years
College-4 years
Med School-4 years
Residency-4 years

For me, the longest I had ever lived in a home/city was 5 years into practice. It led to a lot of restlessness, even though I liked the practice/city. Having become financially stable by that time also took away a lot of motivation.

Spend some time thinking about where you actually want to end up in life, rather than “the next step.”

Then find the way to adjust to get there.

It took me another 4 years after the “4 year itch” to adjust my job and life to be properly aimed at my target. Now it is just minor course corrections when I took too little or much time off or change my plan.
I get made fun of by my partners/surgeons for taking more time off or being super rich and not needing money.
The reality is I spend less and would prefer to work less hard for longer. Also, I dont give a **** what they say, unless they think I am declining clinically.
 
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Aheadbyacentury said:
Better practice..???!!. its slight variation of the same theme everywhere.. Generally speaking..
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Uh, no.

Drive 50 or 100 miles. Get out of the city. Try another state. Or keep telling yourself that you're "geographically" constrained by the quality of bagel shops within walking distance, or something.
 
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ambiturner said:
Perhaps the AMC comparison was less accurate. I had in mind the big groups with the inner circle of ‘superpartners’ that are written about not infrequently here (everyone equal but some more equal than others).
Click to expand...

That is also capitalism. Thankfully I work in a socialist practice where everybody is truly equal ;) I don’t have a Bezos taking the profits from my warehouse labor.
 
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pgg said:
Uh, no.

Drive 50 or 100 miles. Get out of the city. Try another state. Or keep telling yourself that you're "geographically" constrained by the quality of bagel shops within walking distance, or something.
Click to expand...
Bagels are important.
Taking the job far from them:
 
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AnesProfesso said:
Q4. Those 13 weekends and splitting holidays feels like prison.
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Vacations? Supervision? Was doing Q6, then dwindled down to Q4. When two physicians are on vacation (which we allowed). it can be very not fun. We also did 48 hr weekend. Just so you can get them over with…..
Smaller groups have its pros and cons. I liked my group, and seeing them all the time was not bad. Now I am in a much bigger group, call burdens are much less, but I may not see a partner for months at a time….
 
IMGASMD said:
Vacations? Supervision? Was doing Q6, then dwindled down to Q4. When two physicians are on vacation (which we allowed). it can be very not fun. We also did 48 hr weekend. Just so you can get them over with…..
Smaller groups have its pros and cons. I liked my group, and seeing them all the time was not bad. Now I am in a much bigger group, call burdens are much less, but I may not see a partner for months at a time….
Click to expand...

Sometimes that's a blessing
 
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It is not easy to wake up and show up to ANY job everyday for 25 years... especially one with variable hours.

I agree with the sentiments above, if you want longevity the keys are to find a job that provides you a good work/life balance even at the cost of some compensation.
 
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AnesProfesso said:
5 years out of residency and a partner in a small town group and making great money and thinking to myself… How am I going to keep doing this for another 25 years?

I have a lot of call and I HATE call. I feel like the entire hospital only cares about my signature and nothing more. I see no future increase in income, only more downside. It’s difficult to recruit quality partners in a small town. I have no control over the efficiency of the surgery schedule or the surgeons. Patients are getting older and sicker and more obese.

The future seems so bleak.
Click to expand...
This has has always been the situation out there. You are just waking up to the reality. Now, you need to develop goals and strategy for the next 25 years. Start thinking of Anesthesiology as a job where you go to work and bring home a paycheck. This means you control those things you can and ignore those you can't.

1. Are you maximizing your take home income?
2. Are you saving as much as possible both pre-tax and after tax?
3. Can your group switch from W-2 to a sole proprietorship model?
4. Can you group make investments as a whole which will appreciate?
5. Are you taking enough time off for mental health? For some this is 3 weeks while others it is 10 weeks
6. Do you have a decent lunch at work? This helps boost morale.
7. Offer a recruitment sign on bonus to obtain good talent
8. Become involved with limiting OR rooms after 500 PM or 600 PM
9. Flex your schedule so you get some later days and more pre/post call time
10. Marry the right spouse who can help or stay single
 
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BLADEMDA said:
This has has always been the situation out there. You are just waking up to the reality. Now, you need to develop goals and strategy for the next 25 years. Start thinking of Anesthesiology as a job where you go to work and bring home a paycheck. This means you control those things you can and ignore those you can't.

1. Are you maximizing your take home income?
2. Are you saving as much as possible both pre-tax and after tax?
3. Can your group switch from W-2 to a sole proprietorship model?
4. Can you group make investments as a whole which will appreciate?
5. Are you taking enough time off for mental health? For some this is 3 weeks while others it is 10 weeks
6. Do you have a decent lunch at work? This helps boost morale.
7. Offer a recruitment sign on bonus to obtain good talent
8. Become involved with limiting OR rooms after 500 PM or 600 PM
9. Flex your schedule so you get some later days and more pre/post call time
10. Marry the right spouse who can help or stay single
Click to expand...
Blade, the hospital is a machine nowadays ,,,,, its a factory.. you cant be limiting rooms at 5 0r 6.. The hospital needs to stay afloat. We dont care about your vision of work/life balance. marrying the right spouse is key.. Cant have a spouse spending money while you are slaving away in the sweatshop called general hospital .
 
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I’ve been out long enough to have several jobs. My first was a gig like yours - awesome for a new grad to fly on their own. We did every kid of case solo. Took q4-5 call. Worked post call, covered ob from home. Vascular hearts regional etc. busy practice - It was a fine first job but if I had it to do over I wouldn’t have taken it. The small town life isn’t for me. I don’t have that much in common with people there. Q4 is too much- you just work and try to catch up on sleep. Find a different gig.
I really like my current gig- small city, decent cost of living… there are days I genuinely like going to work. Yea some of its level one trauma call but the other days I’m at a nice community hospital solo w good surgeons or the surgery center or the plastics suite. My group also builds in no call at 60, prn at 65….. so I know I won’t work like this forever. And now if I want to give up a call there are people who want them.
like my old horse trainer said “not every butt fits in every saddle.” Figure out what you don’t like and change it…
 
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AnesProfesso said:
5 years out of residency and a partner in a small town group and making great money and thinking to myself… How am I going to keep doing this for another 25 years?

I have a lot of call and I HATE call. I feel like the entire hospital only cares about my signature and nothing more. I see no future increase in income, only more downside. It’s difficult to recruit quality partners in a small town. I have no control over the efficiency of the surgery schedule or the surgeons. Patients are getting older and sicker and more obese.

The future seems so bleak.
Click to expand...

just compare yourself to others in same boat, making way less money and hopefully you'll feel better.
call is what gets me too. these overnight calls are brutal (cause im old)
 
POW16 said:
Ouch. That is a lot of call. Lots of good advice in this thread. Hopefully you find something that fits you better. Life is too short to spend so much time in the hospital.
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Is q4 call like 7-8 overnight in hospital calls a month? if so that's terrible. shortening your life span with every call you take..
 
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Here yet again working at 7 pm. Wasted another day of life. Forget 25 years, don't know how I can do this another 2.5 yrs
 
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