Anyone regret doing Cards because of lifestyle?

[FunnyDocMan1234]

I am a med student and really enjoy cardiology, but I also really enjoy golfing, vacationing, and other recreational activities. So, can anyone share if they have at some point during the 6+ years of training followed by busy practice regretted their decision due to lack of time for fun activities/seeing kids too rarely. It also seems like it is very hard to scale back your hours to 40 or less per week as a cardiologist until you are old; is this true? If anyone has any insight other than the usual sdn 'work your butt off forever or don't go into medicine' spiel please share.

---

Members don't see this ad.

 

[IMDoc607]

I am only a fellow and I am guessing you question is directed more towards attendings but I definitely do not regret my choice. I LOVE cardiology and wouldn't do anything in the world else. My only pet peeve is how scrutinized it is but I'll take the good with the bad.

 

[nstemi]

do you work harder? yes. could you imagine doing anything else in internal medicine? f*ck no. cardiology is king

 

[dcwm]

king of what exactly...
cardiologists are overworked in a high acuity setting, bound by so many protocols, their pay is going down, limited in terms of job location options, sacrificed their youth making themselves competitive for a specialty with a future that's not looking too bright.

I love cardiology, but let's face it... it just isn't what it used to be.
If you are not 1000% set on cardiology and absolutely can't see yourself doing anything else (i.e. have no "back-up 2nd option"), then don't do it ...there are other specialties with similar mindset and type of work with similar pay but with better lifestyle.

 

[nymed16]

what are the other specialties that are similar but are better lifestyle in your opinion?

 

[GoodmanBrown]

I would guess he's (she's?) maybe thinking about pulm/ccm? The thought process being you're still thinking lots of physiology and procedures, but they may tend to have more shift work that gives them a lifestyle advantage. Just my 2 cents.

 

[Handsome88]

what are the other specialties that are similar but are better lifestyle in your opinion?

I'd say Pulm/CC and GI.

But not even that, what about Hospitalist? I see figures of hospitalists making around $300k these days working half the year with no call. Taking every other WEEK off is amazing. Sure you work 12 hours a day for a week, but cardiologists work 8-5 at least if you're lucky (9+ hours) when not on call, what's a difference of 3 hours a day when you can have a full week off. Take a one week vacation and now you got 3 full weeks off. And you start making attending salary after THREE years of residency (you could have at least $200,000 saved in the bank by the time the cardiology fellows go into practice with zero in their savings). Jobs are easier to come by too. This is as good as EM these days.

My friend's dad works hospitalist locums and does only 9-12 WEEKS A YEAR and has a salary of 110-150k. I think that's enough to live more than comfortably and enjoy life.

 

[go lakers]

I'd say Pulm/CC and GI.

But not even that, what about Hospitalist? I see figures of hospitalists making around $300k these days working half the year with no call. Taking every other WEEK off is amazing. Sure you work 12 hours a day for a week, but cardiologists work 8-5 at least if you're lucky (9+ hours) when not on call, what's a difference of 3 hours a day when you can have a full week off. Take a one week vacation and now you got 3 full weeks off. And you start making attending salary after THREE years of residency (you could have at least $200,000 saved in the bank by the time the cardiology fellows go into practice with zero in their savings). Jobs are easier to come by too. This is as good as EM these days.

My friend's dad works hospitalist locums and does only 9-12 WEEKS A YEAR and has a salary of 110-150k. I think that's enough to live more than comfortably and enjoy life.

you're also essentially a coordinator of care for the rest of your career.
there's more to picking a career path than salary and time away from work.

 

[bronx43]

you're also essentially a coordinator of care for the rest of your career.
there's more to picking a career path than salary and time away from work.

At what point are you NOT a coordinator of care? Are general cardiologists just coordinators of care for EP and interventional guys? Are heart failure docs just coordinators of care for the CT surgeons?

 

[dcwm]

you're also essentially a coordinator of care for the rest of your career.
there's more to picking a career path than salary and time away from work.

you say it like its a bad thing. Being a manager and coordinator of care is what makes a lot of people join the field.
At the end of the day it is YOUR patient and you have the final word. which what actually makes the intensivist "king" (to repeat what the above poster said)

 

[FunnyDocMan1234]

what are the other specialties that are similar but are better lifestyle in your opinion?

What about EM? Still do medicine but with the bonus of shift work and the associated flexibility, easy to scale back to work as many shifts as you want per month. Whereas in cards, I feel you only option is 50-60+ hours per week.

 

[royalmedicus]

of course its not BAD to be a coordinator, but at some point of life you get tired of the fact that you are not expert of anything and somebody else is always gonna have a better opinion and a conclusion about any disease. i think this is the reason why USMGs dont choose IM. personally i respect IM docs because they play a very important role in health care.

 

[bronx43]

of course its not BAD to be a coordinator, but at some point of life you get tired of the fact that you are not expert of anything and somebody else is always gonna have a better opinion and a conclusion about any disease. i think this is the reason why USMGs dont choose IM. personally i respect IM docs because they play a very important role in health care.

Except more and more "USMGs" are going into hospitalist compared to 10 years ago...

What do you mean "expert of anything?" Can a cardiologist who is 10 years out of fellowship do the job of a hospitalist as well as a hospitalist?

 

[wire]

Except more and more "USMGs" are going into hospitalist compared to 10 years ago...

What do you mean "expert of anything?" Can a cardiologist who is 10 years out of fellowship do the job of a hospitalist as well as a hospitalist?

yes

 

[royalmedicus]

What do you mean "expert of anything?" Can a cardiologist who is 10 years out of fellowship do the job of a hospitalist as well as a hospitalist?

what are you even saying?

 

[royalmedicus]

Except more and more "USMGs" are going into hospitalist compared to 10 years ago...

praise the lord, my ultimate goal of interventional cardiology will be so easy now.

 

[bronx43]

yes

Cool story bro.

 

[bronx43]

what are you even saying?

I'm saying the nature of specialization has made it so each specialty is maximally effective/efficient at performing the duties of that specialty. You state that a hospitalist is not an "expert," which I'm rebutting. I would argue that a hospitalist is an "expert" on performing the duties of hospital medicine. A primary care physician is an expert on primary care and acting as a triage for the specialists. A cardiologist cannot be as effective as a general internist in this role, so is the PCP any less an "expert" compared to the cardiologist?

 

[bronx43]

praise the lord, my ultimate goal of interventional cardiology will be so easy now.

Your ultimate goal is to move to South Dakota and/or be unemployed?

 

[royalmedicus]

Your ultimate goal is to move to South Dakota and/or be unemployed?

i sense troll, sir.
moving to south Dakota and being unemployed simultaneously would be a bad bad idea.

 

[bronx43]

i sense troll, sir.
moving to south Dakota and being unemployed simultaneously would be a bad bad idea.

Not really trolling... and that's the sad part. My IC fellow buddy was just lamenting the other day about this. I was actually shocked he brought up SD and not even ND. I guess the Bakken fields are a buttress for the health care market up there and they're fully staffed.

 

[Brigade4Radiant]

of course its not BAD to be a coordinator, but at some point of life you get tired of the fact that you are not expert of anything and somebody else is always gonna have a better opinion and a conclusion about any disease. i think this is the reason why USMGs dont choose IM. personally i respect IM docs because they play a very important role in health care.

One you are not an expert unless you are in an academic center making numerous publications. You are just in a field that is specialized like anesthesiology. I wouldn't say better opinion. If your smart you are smart also you have the whole picture of the patient's health in mind. I really doubt the cardiology team at WashU can do a better job working up a patient than the Gen Med team at WashU who has a lot of issues on board. Also it's just that an opinion you may be an expert but the primary team doesn't have to do what you want to do and it isn't about having a conclusion most of the time you just get a test done that helps with the diagnosis. The generalist is the one that forms the differential.

 

[royalmedicus]

One you are not an expert unless you are in an academic center making numerous publications. You are just in a field that is specialized like anesthesiology. I wouldn't say better opinion. If your smart you are smart also you have the whole picture of the patient's health in mind. I really doubt the cardiology team at WashU can do a better job working up a patient than the Gen Med team at WashU who has a lot of issues on board. Also it's just that an opinion you may be an expert but the primary team doesn't have to do what you want to do and it isn't about having a conclusion most of the time you just get a test done that helps with the diagnosis. The generalist is the one that forms the differential.

ok, i agree with what you said. but many [not all] internists i have met had the frustration of not being able to actually do something about a particular disease. may be i just met the wrong kind of internists or may be i didnt met enough docs to form a solid conclusion, but i did hear this 'not being an expert' opinion.

 

[bronx43]

ok, i agree with what you said. but many [not all] internists i have met had the frustration of not being able to actually do something about a particular disease. may be i just met the wrong kind of internists or may be i didnt met enough docs to form a solid conclusion, but i did hear this 'not being an expert' opinion.

Define "do something." If an internist puts someone who has pneumonia on an antibiotic, is that not "doing something?"

As a cardiologist, if you have a patient that needs a heart transplant, is the cardiologist NOT "doing something?" If the CT surgeon has a patient that needs a cath or pacemaker post transplant, is he/she "doing something" or not "doing something."

 

[royalmedicus]

Define "do something." If an internist puts someone who has pneumonia on an antibiotic, is that not "doing something?"

you know exactly what i am saying, these things have no definition.
and this is not something i am creating out of thin air, i have got this from actual docs.

 

[bronx43]

you know exactly what i am saying, these things have no definition.
and this is not something i am creating out of thin air, i have got this from actual docs.

Actually, I have no idea what you are saying. If you can't even define what you mean, then you have no point and there is no discussion.

The only thing I am gathering from you is that a bunch of malcontent attendings or residents are telling you things without actually thinking through their argument. If they are going to use "do something" to mean specialization, then obviously I cannot refute that, since it is their own definition. They also have made no point at all since all they're saying is "specialists specialize." If they use the actual definition of those words, which means "performance of an act" to assist patients, then obviously I have to call BS on their claim.

 

[The kitchen sink]

Can anyone in general cardiology (+\- imaging) comment on their current lifestyle?

Thanks

 

[desdinova]

The only thing I am gathering from you is that a bunch of malcontent attendings or residents are telling you things without actually thinking through their argument. If they are going to use "do something" to mean specialization, then obviously I cannot refute that, since it is their own definition. They also have made no point at all since all they're saying is "specialists specialize." If they use the actual definition of those words, which means "performance of an act" to assist patients, then obviously I have to call BS on their claim.

Actually after doing internal medicine/hospitalist in both large academic center and smaller community hospital in New England I can tell you that frustration and burn out is real. Hospitalist is considered a PGY4 floor b**ch by majority of staff and management. They own you and your opinion is equally important as RNs. Specialists dictate course of action, due to Hospitalist patient volume in big places and because of being familiar with the patient from the office. You can also chose not to consult but that's not an option in academic center which has to train fellows and even less so in smaller place where patients will ask "where is my doctor". Personal experience over the last two years and can't wait to get on with my fellowship in July.

 

[royalmedicus]

Actually after doing internal medicine/hospitalist in both large academic center and smaller community hospital in New England I can tell you that frustration and burn out is real. Hospitalist is considered a PGY4 floor b**ch by majority of staff and management. They own you and your opinion is equally important as RNs. Specialists dictate course of action, due to Hospitalist patient volume in big places and because of being familiar with the patient from the office. You can also chose not to consult but that's not an option in academic center which has to train fellows and even less so in smaller place where patients will ask "where is my doctor". Personal experience over the last two years and can't wait to get on with my fellowship in July.

super +1

 

[bronx43]

Actually after doing internal medicine/hospitalist in both large academic center and smaller community hospital in New England I can tell you that frustration and burn out is real. Hospitalist is considered a PGY4 floor b**ch by majority of staff and management. They own you and your opinion is equally important as RNs. Specialists dictate course of action, due to Hospitalist patient volume in big places and because of being familiar with the patient from the office. You can also chose not to consult but that's not an option in academic center which has to train fellows and even less so in smaller place where patients will ask "where is my doctor". Personal experience over the last two years and can't wait to get on with my fellowship in July.

So, basically you're saying that you feel frustrated when you consult, and feel the need to do as the consultant says, am I right? Ok. That's fine. What's your argument against what I said?

You people are conflating multiple arguments all of which are derived from emotions related to fear of belittlement. These are all subjective arguments, which are stated as such - subjectively. Therefore, I am arguing against the supposed "objective" claim that hospitalists don't "do anything." Or that only hospitalists are "coordinators of care." Both are which are vapid statements, devoid of any real thought.

 

[desdinova]

So, basically you're saying that you feel frustrated when you consult, and feel the need to do as the consultant says, am I right? Ok. That's fine. What's your argument against what I said?

You people are conflating multiple arguments all of which are derived from emotions related to fear of belittlement. These are all subjective arguments, which are stated as such - subjectively. Therefore, I am arguing against the supposed "objective" claim that hospitalists don't "do anything." Or that only hospitalists are "coordinators of care." Both are which are vapid statements, devoid of any real thought.

Physicians are mostly independent , driven individuals and, yes, I find it annoying that in healthcare these days and in this medico legal climate you need a blessing from a specialist treating conditions which are taken care of by internal medicine anywhere else. This compromises internal medicine attending authority at times (depends on setting and local culture naturally) and reduces IM to bureaucrats and "providers" which obviously takes away from Joy of practicing medicine. That's all. Either way IM is a cornerstone of medical care and good internist is more difficult to find than any specialist because ambitious individuals don't want to be errand boys and PGY4 for life.

 

[FunnyDocMan1234]

Can anyone speak toward the original question instead of this hospitalist vs specialist squabble...

 

[Fab5Hill33]

To answer the OP's question: Yes. It is very hard to scale back your hours to 40 or less per week as a cardiologist (or any type of proceduralist) until you are older. Even then it may not be possible.

Once you finish training, your future private practice group will not want to hire a part time guy (or gal). The partners have spent years building up their practice by working very hard. They are going to want to hire someone who's equally hard working if not more. In fact, some older partners in some groups will put more work on the fresh hire to make them earn their keep and prove their worth. Now imagine you've made partner. Do you think your other partners are going to be ok with you saying "I'd like to work 4 days a week, I'll take Friday's off and no weekends, so I can work 40 hours a week"? Who's going to cover the time you're not going to be there? They're probably already working hard, and they're not going to want to pick up the extra clinic days or call. How likely is it you'll find a new hire who wants to only work ~2 days a week and make 1/3 of a full cardiology salary to fill the gap you're creating by cutting back?

The one thing that may change in the future is all physicians becoming employees of hospitals. This is slowly happening, and may lead to all physicians working in shifts or based on hourly pay. But, IMHO, this will take a few decades to happen.

You can't half-ass medicine. If you want lifestyle, go for shift work jobs like hospitalist or ER.