An emergency doc's budget

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dchristismi said:
1.6% baby! (And I feel really bad for you guys at those painfully high interest rates.)

And I come home to dogs who are thrilled to see me, cats who don't give a damn, my own space, and peace and quiet. It's certainly not cold unless I forget to turn the AC up, and empty is a state of mind.

My residency buddies were my best friends, and understand me like no other. While I have some very close friends from my pre-residency days, I sort of dropped off the map during it. Of course, once I finished, those friendships were rekindled as if I'd never disappeared once I was done. But being halfway across the country, well... (this was also pre-Facebook, which changes a lot.)
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You see, at 1.6 and 2.5, I understand why it would be possible to ease the debt off into the sunset and it would be no problem. Investing would be much better. But at our rates, we need to get these shackles off fast. It's almost like an investment in itself.

Before the internet, moving just a city or two away meant all friendship ties were lost except in rare occasions. Now, my younger cousins, who move quite often across the state, have Facebook, Skype, MSN/AIM, etc. to keep in touch. It's not exactly the same, but it is way better than the days of letter writing and Juno email that took 24+ hours to send.

My old friends are far off and away from my school, but I still manage to get in a few rounds of computer games a week just to catch up with them and relax. I don't really have many close friends in med school.

In the future, when we all have money and are free to move about the country, I do hope we're in close vicinity of each other, but the internet can keep us all connected until that day comes. Along with this, many of the fellas also have little intention to get married or have kids in the near future because of the costs.

Of course, like ccfccp says, anything can happen, but at the same time, things have changed dramatically for this generation, not just in communication, but in what is expected of us socially. My older cousins (28+) are still bugged by their respective parents to get married, but they're still living their lives with their jobs and relationships. I don't see this commonality of having these landmarks reached by 30 anymore and that's a good thing to me; the more options, the better.



Sorry for potentially derailing this thread with this horrendous rant. I thank anyone for reading it.
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ccfccp said:
Whoah! Holy blown out of proportion! I didn't say that marriage is for everybody, and I certainly didn't say run out and get married because you may be lonely. Both of those would be ridiculous statements. Get married if you find someone you love and it's something the two of you want to do. Do it for no other reason.

All I said is that stuff can happen quicker than you think, and it's hard to plan 5-10 years down the road at this stage in your life without things constantly changing. Plans like that tend to be ephemeral and priorities change... Will they change for you? Maybe or maybe not. I'm not you. I, personally, got tired of coming home to an empty apartment, and fortunately enough found a girl I really liked who apparently really liked me. All I can share are my own experiences as someone who was happily single at 26 with no prospects of being otherwise and am now happily married at 29.

I will say, however, that unless you make a HUGE conscious effort during residency, it will be difficult (again, not impossible) to have lots of friends outside of the residency program (due to your hours, flipping nights, call, etc.) You can do it, and some do, but it's hard. Most of my friends outside our program are through my wife, and I can't do a lot of the things they do together because of my schedule. From what I've seen (again this could be different at different programs) it's also hard to "get everybody together" as a residency program. Factor in that someone always has to be manning the department(s), (around) half of the residents are on off-service rotations with a completely different schedules, etc. Also, as you yourself said, lots of people this age are busy with their own new families and have their own commitments outside of the residency. It's certainly not the only option, but it's naive to say that just because the option isn't right for you, it's not what other people want. I always wanted a family, and hopefully that will work out for us when we're ready.

Just a quick little aside to finish up this novella: When I was a first year medical student (on our first day actually), our dean of student life told us something that has always stuck with me. He said, "No one ever looks back from their death-bed and thinks, 'You know, I wish I would have spent more time at work...'" Having seen a lot of people die over this crazy ride through medicine, I have to agree.

If you made it through all that I'm impressed. Sorry if it sounded a little preachy.

[/soapbox]
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Well said, sir.
 
ccfccp said:
... He said, "No one ever looks back from their death-bed and thinks, 'You know, I wish I would have spent more time at work...'" Having seen a lot of people die over this crazy ride through medicine, I have to agree.
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Agreed here. Work hard, do well, and make time for family. Done and done.
 
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Can Emergency Medicine be considered a lifestyle specialty?

I mean, I thought it was. But then on this forum everyone says the changing of night shifts to day shifts is awful, that they don't have time for friends outside of residency, that they can't be social because work gets in the way. Also that the 10 or 12 hour shift is so exhausting that you can't or don't want to do anything after.

Is it really that bad? What if we compared it to a general surgery residency or an orthopedic residency? Would the "drain" be equivalent or less? I can't tell if EM is incredibly difficult or if there is just a bit more complaining on internet forums...
 
MCAT guy said:
Can Emergency Medicine be considered a lifestyle specialty?

I mean, I thought it was. But then on this forum everyone says the changing of night shifts to day shifts is awful, that they don't have time for friends outside of residency, that they can't be social because work gets in the way. Also that the 10 or 12 hour shift is so exhausting that you can't or don't want to do anything after.

Is it really that bad? What if we compared it to a general surgery residency or an orthopedic residency? Would the "drain" be equivalent or less? I can't tell if EM is incredibly difficult or if there is just a bit more complaining on internet forums...
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Whoa, whoa, whoa. - EM is totally a 'lifestyle' specialty. No call. Working where you want, when you want (mostly), and not being 'married' to a practice or a pager is awesome.

10 and 12 hour shifts are NOT draining. Period. Especially when you generally have a day or two off between strings of 3 shifts.

Yeah, switching from days to nights can get sucky at times, but you get the hang of it.

"Drain" is infinitely greater in surgery/medicine. Period.
 
MCAT guy said:
Can Emergency Medicine be considered a lifestyle specialty?

I mean, I thought it was. But then on this forum everyone says the changing of night shifts to day shifts is awful, that they don't have time for friends outside of residency, that they can't be social because work gets in the way. Also that the 10 or 12 hour shift is so exhausting that you can't or don't want to do anything after.

Is it really that bad? What if we compared it to a general surgery residency or an orthopedic residency? Would the "drain" be equivalent or less? I can't tell if EM is incredibly difficult or if there is just a bit more complaining on internet forums...
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I'm sure it's different for different types of people. If your like me and constant change is something that you enjoy and it energizes you then it's not as big of a deal. If you're like my wife however, and routine is what males you feel at peace then it will probably suck you dry.
 
RustedFox said:
10 and 12 hour shifts are NOT draining. Period.
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I can understand wanting to defend EM as a good career choice, but there's no reason to lie to the lad. Unless you're getting substandard training or have an energy level several standard deviations above the mean, 12 hour shifts are draining. You may find some place as an attending where it's cush and you shoot the breeze for a majority of your shift, but that's the exception rather than the rule. Even if you get past the actual circadian shifts, it's difficult to deal with the psych patients, chronic pain patients, and demanding families without it taking something out of you. I love what I do, but to pretend that it's not draining is disingenuous. Otherwise, most EPs would be working (5 days/wk x 4 weeks/month x 12 hrs/day) 240 hrs/month.
 
agree w/ arcan... most places you see AT LEAST 1.5 pph - if you're doing good medicine AND customer svc AND charting appropriately... you might not be beat after 12. usually though you're doing more than that, the 1.5+ are sick and/or needy in a variety of ways, and you don't get to take care of your own physical needs (see previous thread referencing bladder habits). you go home exhausted, hungry, and dehydrated. i'm a huge extrovert but even i don't want to be around others when i come home from a double digit hrs shift.

i will also note that i am a good bit more fatigued after community practice attending shifts than training/county hospital resident shifts. and i'm a young un... 33.
 
MCAT guy said:
Can Emergency Medicine be considered a lifestyle specialty?

I mean, I thought it was. But then on this forum everyone says the changing of night shifts to day shifts is awful, that they don't have time for friends outside of residency, that they can't be social because work gets in the way. Also that the 10 or 12 hour shift is so exhausting that you can't or don't want to do anything after.

Is it really that bad? What if we compared it to a general surgery residency or an orthopedic residency? Would the "drain" be equivalent or less? I can't tell if EM is incredibly difficult or if there is just a bit more complaining on internet forums...
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It's not about being social or not, or having time or not. I have plenty of time to do what I want. I walk into a cold apartment because I do not want to get myself into a relationship just for the sake of having one. I have too many friends who get into marriages/relationships just because of that and they are absolutely miserable. No wonder divorce rate is so high. I'm in a city where most of my closest friends and family are far away and the people I work with are wonderful people but they like staying home with their family. Which is totally understandable.

Walking out of a 12 hr shift is physically demanding... no kidding about that. But what out there isn't? I feel like alot of the complaints come from seeing others complain. If we look past the people around us, we can see how good we have it, especially at the rate per hour we have. To me it's nothing new and it's not bad. I would much rather work in a busy setting than sit around all day waiting. I am also one of the fastest resident in my program, even as a first yr. I do not look at who sees what and how many pts my colleagues see, I just scoop them up as they come in and move on.
 
Eh, I'll give a touch. I was specifically thinking about residency shifts.

Think about it: we do 10s or 12s for 2-3 days (maybe 4) at a stretch, then have a day or two off. Those poor suckers in surgery or IM plug away for ten a day every day, then have overnight call, or just get tugged around even more (surgery) and have to lie about their hours. THOSE fellas feel drained. By comparison. Several 10s/12s in a row seems easy. I'd hate to be IM/Surgery.

Yeah, there are downsides (narc seekers, chronic pain guys, etc) - but the bigtime upshot for me is that when I hit hour eight or nine, I think to myself - "Going home, real soon." Then hours 10-12 aren't bad, and I usually leave feeling like - "Yeah, time to do something fun." I average between 1.5 and 2 patients an hour at my place, starting my third year. I expect to pick up more as I go on.

To me, it seems like those IM/Surg residents NEVER get to go home.
 
RustedFox said:
Eh, I'll give a touch. I was specifically thinking about residency shifts.

Think about it: we do 10s or 12s for 2-3 days (maybe 4) at a stretch, then have a day or two off. Those poor suckers in surgery or IM plug away for ten a day every day, then have overnight call, or just get tugged around even more (surgery) and have to lie about their hours. THOSE fellas feel drained. By comparison. Several 10s/12s in a row seems easy. I'd hate to be IM/Surgery.

Yeah, there are downsides (narc seekers, chronic pain guys, etc) - but the bigtime upshot for me is that when I hit hour eight or nine, I think to myself - "Going home, real soon." Then hours 10-12 aren't bad, and I usually leave feeling like - "Yeah, time to do something fun." I average between 1.5 and 2 patients an hour at my place, starting my third year. I expect to pick up more as I go on.

To me, it seems like those IM/Surg residents NEVER get to go home.
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Nice coping mechanism. :sleep:
 
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Flushot said:
I'm not sure what you mean by this conscious effort to make and maintain friends outside of residency or work, but I'll be the judge of how hard it is when I get there. Friends mean a lot to me, in the sense that they're chosen family as opposed to blood ties. If something means that much to you, you can make it work.
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I fail to understand your warped & perverted view of what truly constitutes family.

On one hand: you 'warn' others of marriage & family life bc of the commitment to another person.

On the other hand: you try to qualify your lack of commitment to the most intimate of personal relationships by saying that your friends are 'chosen family'.

Correct me if i'm wrong, but isn't marriage the true act of making someone you love true family since you LOVE them enough to legally obligate yourself to them? And isn't the choice to not marry bc of a fear of legal obligations toward them a sign of not wanting to be family?

As long as you go around fooling yourself that you're playing it smart by 'making your own choices' and eschewing marriage bc of the commitment, then you are not really choosing a family member to the same level as those of us who do.

And lastly, you talk as if there's this huge movement to make people get married. I've never been exposed to that. But I do notice how you are pretty active here and on other threads in your preaching of anti-marriage dogma. Better watch out, you're looking pretty close to what you claim to be against.

I could care less if people want to stay single or not. I nor anyone else is here trying to get anyone hitched. YOU on the other hand are pretty loud with your pressurings. I'm asking you to please, let people make their own decisions, we don't need your divine wisdom on marriage vs single life.
 
sarcoid said:
I fail to understand your warped & perverted view of what truly constitutes family.

On one hand: you 'warn' others of marriage & family life bc of the commitment to another person.

On the other hand: you try to qualify your lack of commitment to the most intimate of personal relationships by saying that your friends are 'chosen family'.

Correct me if i'm wrong, but isn't marriage the true act of making someone you love true family since you LOVE them enough to legally obligate yourself to them? And isn't the choice to not marry bc of a fear of legal obligations toward them a sign of not wanting to be family?

As long as you go around fooling yourself that you're playing it smart by 'making your own choices' and eschewing marriage bc of the commitment, then you are not really choosing a family member to the same level as those of us who do.

And lastly, you talk as if there's this huge movement to make people get married. I've never been exposed to that. But I do notice how you are pretty active here and on other threads in your preaching of anti-marriage dogma. Better watch out, you're looking pretty close to what you claim to be against.

I could care less if people want to stay single or not. I nor anyone else is here trying to get anyone hitched. YOU on the other hand are pretty loud with your pressurings. I'm asking you to please, let people make their own decisions, we don't need your divine wisdom on marriage vs single life.
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My definition of family involves a group of people that look out for each other and care for each other because they want to, not because they're legally bound. It's fine if you disagree, but I don't see what is so warped or perverted about this.

I'm making my decision to commit to friends over a singular relationship that involves a financial contract, which marriage is. You define marriage as this idealistic union that must be enforced. I do not find government/state approval or involvement of who I care about all that appealing, especially if I have to pony up if it doesn't work out.

The irony in your criticism of how I view marriage and relationships while laying down your own 'dogma' confuses me. I support options and choices while you make your own opinion painfully clear. Just because I don't like marriage at this moment doesn't it make it invalid. It is an option, as is the option to stay single.

So, yes, I want people to have more choice. To have this expectation or assumption that sooner or later, everyone is going to be hitched, have two kids and a house is stifling; life is much more varied than this. It's not to say this path is bad, but I have elaborated on another way that is not as terrible as you make it out.
 
MCAT guy said:
Really far off topic...
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It kind of is, and I apologize. I'll end it with that, but a lot of it also has to do with planning for the huge costs down the line. I mean, I did ask ActiveDuty how much things would change if he didn't have kids and he said his budget would be dramatically different.

CestaVie said:
It's not about being social or not, or having time or not. I have plenty of time to do what I want. I walk into a cold apartment because I do not want to get myself into a relationship just for the sake of having one. I have too many friends who get into marriages/relationships just because of that and they are absolutely miserable. No wonder divorce rate is so high. I'm in a city where most of my closest friends and family are far away and the people I work with are wonderful people but they like staying home with their family. Which is totally understandable.

Walking out of a 12 hr shift is physically demanding... no kidding about that. But what out there isn't? I feel like alot of the complaints come from seeing others complain. If we look past the people around us, we can see how good we have it, especially at the rate per hour we have. To me it's nothing new and it's not bad. I would much rather work in a busy setting than sit around all day waiting. I am also one of the fastest resident in my program, even as a first yr. I do not look at who sees what and how many pts my colleagues see, I just scoop them up as they come in and move on.
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I'm glad someone else feels the same way, and I wish I had seen this sooner. Like other posters such as the OP, this is just another perspective, with its own benefits and whatever downfalls you can perceive.
 
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Flushot said:
My definition of family involves a group of people that look out for each other and care for each other because they want to, not because they're legally bound. It's fine if you disagree, but I don't see what is so warped or perverted about this.

I'm making my decision to commit to friends over a singular relationship that involves a financial contract, which marriage is. You define marriage as this idealistic union that must be enforced. I do not find government/state approval or involvement of who I care about all that appealing, especially if I have to pony up if it doesn't work out.

The irony in your criticism of how I view marriage and relationships while laying down your own 'dogma' confuses me. I support options and choices while you make your own opinion painfully clear. Just because I don't like marriage at this moment doesn't it make it invalid. It is an option, as is the option to stay single.

So, yes, I want people to have more choice. To have this expectation or assumption that sooner or later, everyone is going to be hitched, have two kids and a house is stifling; life is much more varied than this. It's not to say this path is bad, but I have elaborated on another way that is not as terrible as you make it out.
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:thumbup::thumbup:
and this coming from a married woman!
 
Flushot said:
My definition of family involves a group of people that look out for each other and care for each other because they want to, not because they're legally bound. It's fine if you disagree, but I don't see what is so warped or perverted about this.

I'm making my decision to commit to friends over a singular relationship that involves a financial contract, which marriage is. You define marriage as this idealistic union that must be enforced. I do not find government/state approval or involvement of who I care about all that appealing, especially if I have to pony up if it doesn't work out.

The irony in your criticism of how I view marriage and relationships while laying down your own 'dogma' confuses me. I support options and choices while you make your own opinion painfully clear. Just because I don't like marriage at this moment doesn't it make it invalid. It is an option, as is the option to stay single.

So, yes, I want people to have more choice. To have this expectation or assumption that sooner or later, everyone is going to be hitched, have two kids and a house is stifling; life is much more varied than this. It's not to say this path is bad, but I have elaborated on another way that is not as terrible as you make it out.
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:thumbup::thumbup:

If there's one thing I dread more than anything, it's a house in the suburbs with 2.5 kids and a family dog. :barf:
 
Simply, to each their own. I know married people who are unhappy and those who are happy. I know singles who are happy and unhappy. There is no recipe for happiness or success.

There is also no doubt that kids and to a lesser degree marriage effect your life and your expenditures.
 
MCAT guy said:
Can Emergency Medicine be considered a lifestyle specialty?

I mean, I thought it was. But then on this forum everyone says the changing of night shifts to day shifts is awful, that they don't have time for friends outside of residency, that they can't be social because work gets in the way. Also that the 10 or 12 hour shift is so exhausting that you can't or don't want to do anything after.

Is it really that bad? What if we compared it to a general surgery residency or an orthopedic residency? Would the "drain" be equivalent or less? I can't tell if EM is incredibly difficult or if there is just a bit more complaining on internet forums...
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EM residency is very cush compared to gen surg or ortho!
 
gman33 said:
The interest rates are a lot higher for grads now.
Pretty sure mine are at 6.8% and there is no longer a way to consolidate them at a lower rate.

That being said, there still isn't a real advantage to paying them off at a super fast rate. If I can earn 6.8% or more, I'd rather have $200k invested that I can access, than $0 student loans and minimal savings.
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Bringing the thread back on track, this (old) link was emailed to many of us, but some probably deleted it as they do all ACEP emails.
Why You Should Pay [Student] Loans Off SLOWLY
More importantly, this was also in the same email.
http://services.aamc.org/fed_loan_pub/index.cfm?fuseaction=public.welcome&CFID=91145&CFTOKEN=23676707
It behooves all of us to take advantage of these programs. I happen to work in an HSPA in TX, and as such, am eligible for $160K in student loan repayment simply for working there for 4 years. The catch is that I have to take Medicaid/Medicare patients, but since I'm already required to by law, I will do that anyway.
My wife is applying for $140K in student loan repayment for accepting children with Medicaid for the next 4 years. Once again, the group she joined already does this, so it makes no difference to her at all. All told, we stand to get almost all of our student debt wiped off for doing jobs we were already going to do.
Barring budget shortfalls, that is.


Other useful links from a well written email from the college:
Financial Planning for Graduating Residents
Financial Security
Financial Planning and Management for the Emergency Physician
Financial Planning at Every Life Stage
The Layman's Guide to Education Debt Management
How To Manage Debt and Have a Life, Too
Disability insurance for emergency physicians: What you need to know, now!
Review disability clauses now, not later
Playing the Mortgage Game
Four Easy Ways to Lose Money in the Stock Market
Investing Made Easy: Exchange Traded Funds!
Why You Must Open a Roth IRA Now!
The last one is better for medical students/early residents, as the rest of us cannot put money in a Roth anymore.
 
It behooves all of us to take advantage of these programs. I happen to work in an HSPA in TX, and as such, am eligible for $160K in student loan repayment simply for working there for 4 years. The catch is that I have to take Medicaid/Medicare patients, but since I'm already required to by law, I will do that anyway.
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Don't most of these loan repayment programs for underserved areas require primary care specialties? I took a look at that list and that seems to be a primary requirement for eligibility.
 
Groove said:
Don't most of these loan repayment programs for underserved areas require primary care specialties? I took a look at that list and that seems to be a primary requirement for eligibility.
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Most at least prefer, but I contacted the Texas PELRP and was told if the area is underserved, I am still eligible.
 
Thanks for all of the links McNinja. I haven't looked through all of the links, but I have to comment on the "pay student loans off slowly" article.

This was written in 2004 and even the author says to adjust when loans get about 6%. Well, now they are well above that mark with tuition being higher as well. Unfortunately, much of what is recommended here is no longer useful.
 
Dr.McNinja said:
Most at least prefer, but I contacted the Texas PELRP and was told if the area is underserved, I am still eligible.
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Wow, very nice. I just emailed the state where I'm interested in moving to after residency to see if eligibility applies to me as well. I would have never thought to pursue that avenue as I always thought it was off limits to EM. Informative post.

The primary article they need to revamp would be the paying loans off slowly. I was lucky enough to lock in my loans for the first year of med school at 2.5%, right before the Grad Plus loans took effect, so my subsequent loans, even after consolidation are 7%. The 2.5% loans I can sit on for awhile, but definitely not the 7%. Any med students since 2005 would be stuck in the same situation. Uncle Sam apparently wants us to pay these things off sooner rather than later. I'm aiming for a 12 year plan.
 
RustedFox said:
Not sure what that means.

Go ahead and job me if you want; but we put in way less total hours than many of our medicine/surgery colleagues.
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There are two issues here: how hard you work when you're at work and how many hours you work.

I don't know about most places, but where I work the hardest hours BY FAR are in the ED. The benefit is that we get more days off, but that doesn't change the fact that 12 hours of ED is far more draining than IM or even surgery. True, the call does get tiring for surgery, but hour for hour the ED is more tiring than any other.
 
KYTNOH said:
There are two issues here: how hard you work when you're at work and how many hours you work.

I don't know about most places, but where I work the hardest hours BY FAR are in the ED. The benefit is that we get more days off, but that doesn't change the fact that 12 hours of ED is far more draining than IM or even surgery. True, the call does get tiring for surgery, but hour for hour the ED is more tiring than any other.
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Yep for Surgery or IM it isnt as draining on a per hour basis. At one of the hospitals I work at the hospitalist can hang and relax for hours while I am busy in the ED. All I am saying is 1 EM hour is WAY WAY harder than 1 Surgery hour.
 
EctopicFetus said:
Yep for Surgery or IM it isnt as draining on a per hour basis. At one of the hospitals I work at the hospitalist can hang and relax for hours while I am busy in the ED. All I am saying is 1 EM hour is WAY WAY harder than 1 Surgery hour.
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I definitely believe it after being in the ER. I guess that is reflected in the hourly wage for the ER though. I would argue that pre-rounding on some surgery days can be as busy as it gets :p
 
KYTNOH said:
There are two issues here: how hard you work when you're at work and how many hours you work.

I don't know about most places, but where I work the hardest hours BY FAR are in the ED. The benefit is that we get more days off, but that doesn't change the fact that 12 hours of ED is far more draining than IM or even surgery. True, the call does get tiring for surgery, but hour for hour the ED is more tiring than any other.
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Word. I have a surgeon father and father-in-law who love to talk about their "medical NAM days" with the 50hr call, appy's with lantern light and ether drips, flame sterilized scalpels used for back to back surgeries, cauterization by pieces of coal, (ok, so I'm exaggerating) etc..

I can't help but think about some of my call days from intern year and how they were ALWAYS less stressful by far than a single hard 12 hour shift in the ED. The pay:hrs worked ratio might be higher but I'd say we definitely work harder for it. I'd say most of the other specialties aren't used to going 15hrs without food or bathroom breaks like I've done on more than a few occasions.

However, you know what's even more stressful to me? and this is just a personal thing... Carrying around a little black object that could "page-detonate" at any moment's notice. It's like carrying around a thermonuclear device while I'm out enjoying my day...able to wreak mass casualty on my plans with a single beep. I'll take the ED.
 
The pager is like satan. My experience seriously gave me some ptsd type stuff. When I hear the hospitalist pager go off I get this sinking feeling. Ive been out for 2 years and I think in another 2-3 ill be better.
 
Good stuff all. I think this post should be stickied. I'm three years out and still putting away 25% for savings/investments in addition to the 10% charitable givings. I still feel like I can do anything that I want with the money that I have earned.
 
EctopicFetus said:
The pager is like satan. My experience seriously gave me some ptsd type stuff. When I hear the hospitalist pager go off I get this sinking feeling. Ive been out for 2 years and I think in another 2-3 ill be better.
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I've heard it called "pager PTSD" or "beeper-lepsy".
 
;)Always find interesting 411 on this thread.
 
ActiveDutyMD said:
You think that's on the low end you should have seen when I was making half that much in the military! I think my average pay is about average for a pre-partner job (perhaps even a bit more than average) but I definitely work fewer hours than most pre-partners, thus the lower salary. Also, I see fewer patients (though more than average in my group) than most EPs due to a bit lower volume in our ED- maybe 1.5 an hour.



Sure, I could go work for a contract management group for $200/hour, but once I make partner I'll be doing better than that every month, so the pre-partner years are a bit of an investment.

Annual salaries don't mean much to me when it comes to emergency medicine. You could make $400-500K pretty easy in EM if you just work a ton of shifts. Taking one of these jobs in a crappy ED in a crappy place that are advertised in the throw-aways could pay you $300 an hour. If you work twenty 12-hour shifts (let's say you get 13 hours a piece) =$300/hour*13*20*12 months= $936,000. But how long are you going to last doing that?
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So I'd like to get this straight. I've got two friends who are both EM doctors. One of them works part time and gets around 150-200k a year. Another EM doctor receives around 500-700k a year. The second doctor works 4-5 days a week, 12 hour shifts. Are these two salaries really possible amongst EM doctors?
 
CaliGirl14 said:
So I'd like to get this straight. I've got two friends who are both EM doctors. One of them works part time and gets around 150-200k a year. Another EM doctor receives around 500-700k a year. The second doctor works 4-5 days a week, 12 hour shifts. Are these two salaries really possible amongst EM doctors?
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Depends on where in the country and what "part time" is considered.

For the full time doc working 50x4x$200 is $400k, working 50x5x$200 is $500k. That's working between 48-60 hours per week, which is probably not sustainable in most practice situations/lifestyles. From a purely monetary standpoint, I'd say none of these figures sound unreasonable.
 
Arcan57 said:
Depends on where in the country and what "part time" is considered.

For the full time doc working 50x4x$200 is $400k, working 50x5x$200 is $500k. That's working between 48-60 hours per week, which is probably not sustainable in most practice situations/lifestyles. From a purely monetary standpoint, I'd say none of these figures sound unreasonable.
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Well the full time doc is a huge work-a-holic, although he seriously enjoys it. He works, sleeps, dictates,and then works. I think he works even more than 60 hours per week. 10 years and he's still going. No kids, no gf.
 
CaliGirl14 said:
Well the full time doc is a huge work-a-holic, although he seriously enjoys it. He works, sleeps, dictates,and then works. I think he works even more than 60 hours per week. 10 years and he's still going. No kids, no gf.
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Making $500-700k for consistently working 60hrs per week in the ED seems like reasonable compensation. Most people would quit or eat a gun under that workload.
 
Arcan57 said:
Making $500-700k for consistently working 60hrs per week in the ED seems like reasonable compensation. Most people would quit or eat a gun under that workload.
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Really? Is it that bad? :confused:
 
CaliGirl14 said:
Really? Is it that bad? :confused:
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Yes. Even assuming that you get to work only day-time weekday shifts, 12 hour shifts in most locations render it almost impossible to do anything else besides eat and sleep. If you factor in the requirement to work at least some nights then freakishly painful becomes homicidal/suicidal inducing after a couple of months.
 
arcan57 said:
yes. Even assuming that you get to work only day-time weekday shifts, 12 hour shifts in most locations render it almost impossible to do anything else besides eat and sleep. If you factor in the requirement to work at least some nights then freakishly painful becomes homicidal/suicidal inducing after a couple of months.
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+1
 
EctopicFetus said:
Yep for Surgery or IM it isnt as draining on a per hour basis. At one of the hospitals I work at the hospitalist can hang and relax for hours while I am busy in the ED. All I am saying is 1 EM hour is WAY WAY harder than 1 Surgery hour.
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that is not accurate, it depends where you are. A super busy level I trauma center is probably what you are referring to. One ER hour is significantly more comfortable than one hospitalist hour (in my experience personally). This is my experience. ER is more fun, more procedures, and faster pace. Hospitalist has its perks as well however. You are correct, down time means sleep time, unless your pager is going off incessantly.
 
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