Hospitalist x critical care x pulm/cc lifestyle

[Polacko]

Hey guys, whats up?
Id like to ask how overall general lifestyle of critical care in private practice compares to hospitalist and pulm+critical care.
Cheers

---

Members don't see this ad.

 

[jdh71]

What do mean by "lifestyle"?

 

[bashwell]

I'm guessing this means regular and well defined hours, 8-5, M-F, no weekends, no holidays, no call, no paperwork at all, every procedure is perfectly prepped for you beforehand, minimum $500k/year (starting salary), and basically everyone kisses your feet as you walk into the unit.

 

[Raryn]

I'm guessing this means regular and well defined hours, 8-5, M-F, no weekends, no holidays, no call, no paperwork at all, every procedure is perfectly prepped for you beforehand, minimum $500k/year (starting salary), and basically everyone kisses your feet as you walk into the unit.

I believe he would be better served by a different forum then.

 

[Polacko]

Well, thats obviously not what i mean, but im sure a lot of people have wrong ideas about medicine. Im currently doing a surgery rotation... 04:45 am till 7pm most days(ofc it is not in the US). So I'm not delusional about reality as a physician. Im asking between these three possibilites of practice (hospitalist x pulm/cc x pure ccm), which one possibly leads to a better life x work balance and which one would, in general, be less stressful, given the reality that all of those options will be hard stuff and that im not looking to derm/rads/plastic.
I know it sucks to hear stupidity from medical students who are blind to reality as it is and think it will all be a walk in the park. But i'm actually not one of those...
Any input is kindly appreciated

 

[shiftingmirage]

There are different models I have seen. I'm a resident and we have a teaching ICU service, but there are also different private services at the hospitals we rotate at that work differently.
For the teaching service, attendings are generally on 7 on/7 off. They are on call for 12 hrs. Depending on patient census and acuity, some are not physically in the hospital for their entire shift, but are available to come in if needed. The night call is divided up amongst all attendings, including ones that are not on service. Most of our people are pulm/ccm so they will bounce between pulm and ccm service, with some preferring one more than the other. So for the teaching service, even if you are not on service, you will likely be covering a night or two and may have to come in for those.
One private group works 7 on/7 off, 12 hour shifts. Someone is assigned to night coverage for the week, but it rotates.
Another private group is 7 on/7 off, generally present during the day and does morning admits. This allows the teaching service to round, and then the teaching service generally does most/all of the evening and night admissions. The private group continues to provide cross coverage for their patients, and would have to come in for emergent needs of current patients, but generally no admissions in the evening. Usually the same guy is on call 24 hrs during the 7 on, but like I said, teaching service generally covers later admissions.

Hospitalists
For academics I've seen 7 on/7 off, and 14 on/14 off. There is generally call Q4 or so. Generally evening and night admissions are staffed over the phone, or the following morning if patient is stable. Attendings rarely come in unless it is super busy.
With private groups, 7 on/7 off. I've seen a few different policies about signing out to the on call guy. Some places once you round, do notes and discharges, you can sign out to the call guy regardless of what time it is. Others its more a traditional 12 hr shift.

I'm sure there are several other variations.

 

[gutonc]

There are different models I have seen. I'm a resident and we have a teaching ICU service, but there are also different private services at the hospitals we rotate at that work differently.
For the teaching service, attendings are generally on 7 on/7 off. They are on call for 12 hrs. Depending on patient census and acuity, some are not physically in the hospital for their entire shift, but are available to come in if needed. The night call is divided up amongst all attendings, including ones that are not on service. Most of our people are pulm/ccm so they will bounce between pulm and ccm service, with some preferring one more than the other. So for the teaching service, even if you are not on service, you will likely be covering a night or two and may have to come in for those.
One private group works 7 on/7 off, 12 hour shifts. Someone is assigned to night coverage for the week, but it rotates.
Another private group is 7 on/7 off, generally present during the day and does morning admits. This allows the teaching service to round, and then the teaching service generally does most/all of the evening and night admissions. The private group continues to provide cross coverage for their patients, and would have to come in for emergent needs of current patients, but generally no admissions in the evening. Usually the same guy is on call 24 hrs during the 7 on, but like I said, teaching service generally covers later admissions.

Hospitalists
For academics I've seen 7 on/7 off, and 14 on/14 off. There is generally call Q4 or so. Generally evening and night admissions are staffed over the phone, or the following morning if patient is stable. Attendings rarely come in unless it is super busy.
With private groups, 7 on/7 off. I've seen a few different policies about signing out to the on call guy. Some places once you round, do notes and discharges, you can sign out to the call guy regardless of what time it is. Others its more a traditional 12 hr shift.

I'm sure there are several other variations.

If by "several", you mean "a hojillion", then you're absolutely right.

 

[jdh71]

Well, thats obviously not what i mean, but im sure a lot of people have wrong ideas about medicine. Im currently doing a surgery rotation... 04:45 am till 7pm most days(ofc it is not in the US). So I'm not delusional about reality as a physician. Im asking between these three possibilites of practice (hospitalist x pulm/cc x pure ccm), which one possibly leads to a better life x work balance and which one would, in general, be less stressful, given the reality that all of those options will be hard stuff and that im not looking to derm/rads/plastic.
I know it sucks to hear stupidity from medical students who are blind to reality as it is and think it will all be a walk in the park. But i'm actually not one of those...
Any input is kindly appreciated

They all suck for hours. There is no "work life balance". What there is: work hard, play hard.

Want to be a marine? Be prepared to march and get muddy.

 

[jdh71]

"work life balance" is happy hippy horse**** nonsense cooked up by people that can't hang so they can complain and bitch and moan

you want a "sweet free time life," do another job

and stay way the **** away from my unit

 

[deleted547339]

"work life balance" is happy hippy horse**** nonsense cooked up by people that can't hang so they can complain and bitch and moan

you want a "sweet free time life," do another job

and stay way the **** away from my unit

I pray I never work with you.

 

[jdh71]

I pray I never work with you.

It has nothing to do with working with me.

This is the job. It's what you're signing up for. What do you think a week on, week off or the equivalent number of shifts looks like anyway? It's not a "lifestyle" specialty. It's long days, nights, weekends, holidays, anniversaries, and children's sports games. It's not chill. It hard work. The job dictates things not me.

Though since it is work hard play hard, I wouldn't wouldn't be very accommodating to any extra time off nonsense some people have. Covering the ICU is a zero sum game. Your more time off is my more time working the pit. And I take my time off serious. Work hard, play hard. I'll be up in them mountains. Don't even try and call. There won't be cell service.

 

[Polacko]

Dude, i don't get your point or your anger. I just asked between these 3 possibilities which one would led to a daily practice less stressful. It's comparative not absolute. I'm not asking for a cush job or am lazy (definetely im not).I'm asking it because these 3 possibilities are most probable for me and i have a family, so i want to have a glimpse about how day to day work life will look like and how much free time should i expect... for example,how does it look like daily in each option? You are on call everyday when you are on a 7on/7off? At what time do you leave hospital usually (assuming you are not jeopardizing pt care)? I never said im a lazy ass looking for a walk in the park... dont assume things you dont know

 

[Raryn]

Look, there's going to be a million variations for any one of these, so no one can really answer your question. In general terms:

The original hospitalist practice model (and my *guess* is still the most common, but thats truly a guess) was 7 on 7 off with admissions and rounding mixed in to your 7 days on. This is still done in some places. In other places, the "admitters" and the "rounders" are separate. There's some cities where 14 on 14 off is more common. There's some groups where they don't have 12 hour shifts, so you might do something like 7 on with 8-10 hour shifts and then during the week "off" pick up 2-3 shorter shifts. I even know of a few that allow flexible scheduling as long as you work your 14 shifts a month, so you could do 1 on 2 off 3 on 1 off whatever, which sounds like it's awful for patient continuity (but what do I know?). Regardless, it's always shift work, and when you're off, you're off. Pretty much every group I know of handles nights differently as well, with the model ranging from finding someone to just do straight nights (a nocturnist) so most of the rest don't do them that often, to making every 2nd, 3rd, or whatever week on just a week of full nights rather than days, to making you work a couple nights during your week "off".

Critical Care is similar shift work (when JDH is off, he's off). Probably has as many variations as the above, but with less complexity to the schedule (because the divisions are usually smaller). Total hours worked is generally comparable to the hospitalists, but you usually have fewer, significantly more complex patients. You don't have to worry about disposition/placement as much (because the patient can always go to the floor), but you do have to worry about having a LOT of discussions regarding goals of care. Oh, and outside some large academic medical centers, the work is pretty much exclusively days. I don't know of any community hospitals where the intensivists stay in house at night, though of course they are on call. So from that aspect (never working nights) I suppose you can say it's more "lifestyle friendly" than a lot of the hospitalist jobs.

Pulmonary/Critical Care gets a bit more complicated, but basically you can anticipate less time inpatient with more clinic built into your schedule. Whether that's weeks of clinic or some other model, there's so many ways to do it... It's probably more lifestyle friendly in that you have fewer 12 hour shifts built in... but less lifestyle friendly in that you have fewer days "off".

 

[Mad Jack]

Dude, i don't get your point or your anger. I just asked between these 3 possibilities which one would led to a daily practice less stressful. It's comparative not absolute. I'm not asking for a cush job or am lazy (definetely im not).I'm asking it because these 3 possibilities are most probable for me and i have a family, so i want to have a glimpse about how day to day work life will look like and how much free time should i expect... for example,how does it look like daily in each option? You are on call everyday when you are on a 7on/7off? At what time do you leave hospital usually (assuming you are not jeopardizing pt care)? I never said im a lazy ass looking for a walk in the park... dont assume things you dont know

The lifestyle sucks for all three, just in different ways. Critical care has the highest burnout rate of any specialty for a reason, which is probably a big part of why he's laying things down the way he is- critical care is not, in any way, a lifestyle specialty. Hospitalists end up feeling pretty burned out by the 7 on/7 off lifestyle as well. Can't say in regard to pulm/CC, as I've heard clinic can help ease burnout, but practice models vary so widely it's hard to make generalizations.

Regardless, if you want lifestyle, you should run far, far away from the ICU.

 

[Polacko]

Thanks for the answers guys. I think you got me wrong when i talked about lifestyle. When I asked about lifestyle i was not talking about a specific very balanced work and free time stuff. I actually meant, and im sorry if i made not myself clear, how was life regarding working hours and free time in each practice. Burn out is kinda taboo where i live, and,believe me, ive a very keen cardiology teacher that advised me to run away from cards and consider icu because life was a lot better. Guess he likes a lot being off, since he hardly could do that while a cardiologist...
So, in the ICU, one should expect 12 hours shifts on the days on and some of these days to be on call during night, correct? Usually 14/15 shifts a month.
Pulm/cc usually ccm 1 week on , 1 week off and other weeks on pulmonary? Ive seen ppl talking about doing both in one shift (some hours icu, some inpatient,some clinic)- does that work shiftwise as well ?(7on7off or something related?).
Thanks

 

[Mad Jack]

Thanks for the answers guys. I think you got me wrong when i talked about lifestyle. When I asked about lifestyle i was not talking about a specific very balanced work and free time stuff. I actually meant, and im sorry if i made not myself clear, how was life regarding working hours and free time in each practice. Burn out is kinda taboo where i live, and,believe me, ive a very keen cardiology teacher that advised me to run away from cards and consider icu because life was a lot better. Guess he likes a lot being off, since he hardly could do that while a cardiologist...
So, in the ICU, one should expect 12 hours shifts on the days on and some of these days to be on call during night, correct? Usually 14/15 shifts a month.
Pulm/cc usually ccm 1 week on , 1 week off and other weeks on pulmonary? Ive seen ppl talking about doing both in one shift (some hours icu, some inpatient,some clinic)- does that work shiftwise as well ?(7on7off or something related?).
Thanks

There's a lot of different models out there for pulm/CC, it's really hard to generalize how they divvy up clinic time. Every group is different. Some groups might do a blended model where you cover during the day if it's all in one building, while others might have you do clinic every third working week, some might have mixed schedules where you can trade days with people for clinic and ICU so long as you meet your minimum number of shifts for each in a month, etc. It's really highly variable.

 

[jdh71]

Dude, i don't get your point or your anger. I just asked between these 3 possibilities which one would led to a daily practice less stressful. It's comparative not absolute. I'm not asking for a cush job or am lazy (definetely im not).I'm asking it because these 3 possibilities are most probable for me and i have a family, so i want to have a glimpse about how day to day work life will look like and how much free time should i expect... for example,how does it look like daily in each option? You are on call everyday when you are on a 7on/7off? At what time do you leave hospital usually (assuming you are not jeopardizing pt care)? I never said im a lazy ass looking for a walk in the park... dont assume things you dont know

I'm not mad kid. My point should have been clear.

Hard not to make assumptions given your generation's reputation.

 

[jdh71]

There's a lot of different models out there for pulm/CC, it's really hard to generalize how they divvy up clinic time. Every group is different. Some groups might do a blended model where you cover during the day if it's all in one building, while others might have you do clinic every third working week, some might have mixed schedules where you can trade days with people for clinic and ICU so long as you meet your minimum number of shifts for each in a month, etc. It's really highly variable.

Your day shifts will usually be split between clinic or the icu. Icu night coverage is what varies so much. Taking call is for the most miserable of bastards. Nights shifts are more manageable long term. But then someone has to work . . . Nights.

And pulm clinic isn't for the feint of heart. It's largely thankless and depressing a lot of the time. You need to be ok with diseases you can't fix but manage chronically and sometimes only minimally. In some ways it's more exhausting.

 

[Polacko]

Thanks for the input, jdh. I get your feelings towards my gen, but its not my fault as you know. How would it be an ordinary day in private practice on a shift doing both pulm and ccm?
Thanks in advance

 

[gutonc]

Dude, i don't get your point or your anger. I just asked between these 3 possibilities which one would led to a daily practice less stressful.

Rheumatology.

 

[jdh71]

Thanks for the input, jdh. I get your feelings towards my gen, but its not my fault as you know. How would it be an ordinary day in private practice on a shift doing both pulm and ccm?
Thanks in advance

Doing shift work in the ICU it would be show up around 7am. Take sign out on overnight patients. Then round. Admit new patients and or see consults (if you are pulm trained you'll likely be set up to get called to see pulm consults too)

Doing a shift from n clinic is probably first patient at 8 and last patient at 4 to 4:30. You'll probably leave a hole in your schedule for an hour lunch. But seeing 12 to 20 patients in a day.

You'll have to arrange bronchs around this schedule. It will for highly unlikely whoever is paying you will let you collect money to have s big hole open just in case you have a bronch. I do my bronchs either on ICU days - just fit it in somewhere - or on "days off".

 

[Hernandez]

Dude, i don't get your point or your anger. I just asked between these 3 possibilities which one would led to a daily practice less stressful.

Want less stress, do out patient pulm only.

 

[VA Hopeful Dr]

Rheumatology.

I'm convinced that fibromyalgia will be the death of rheum.

Easiest, least chance of dying patients? Allergy.

 

[Hernandez]

Easiest, least chance of dying patients? Allergy.

Come on Big money, big money, big money, no whammy, no whammy STOP!

 

[gutonc]

I'm convinced that fibromyalgia will be the death of rheum.

Easiest, least chance of dying patients? Allergy.

The 2 biggest hospitals where I have privileges now have NP run Fibro clinics. Keeps the Pain, rheum and Gen Med docs happy, gives the crazies a place to go.

 

[RememberWhen]

So I don't mean to high jack the thread, but I'm at the end of intern year and seriously trying to figure out my next steps in residency as I steer my career towards fellowship. I'm very seriously considering pulm/crit and the one aspect that gives me pause is lifestyle. I loved general medicine and considered hospitalist, but after intern year I found that many hospitalists have such a high patient volume they consult specialists quite a lot and sometimes seem to be more involved with coordination than medical management. I really enjoyed the physiology & medicine found in the unit and think I could definitely see myself enjoying pulm. This thread certainly highlights the lifestyle concerns, but I went in to medicine because I loved it even though I knew the hours would be bad and I'm considering continuing that same logic on to fellowship



And so, I ask you, knowing what you know now about lifestyle, would you still choose pulm/crit?

 

[VA Hopeful Dr]

The 2 biggest hospitals where I have privileges now have NP run Fibro clinics. Keeps the Pain, rheum and Gen Med docs happy, gives the crazies a place to go.

The part of me that still cares thinks that's a bad idea and I'd bet that Fibro clinic has more opioid prescribing compared to MD run clinics. The part of me that wants to not burn out wants to find an NP to open a clinic like that here...

 

[Hernandez]

So I don't mean to high jack the thread, but I'm at the end of intern year and seriously trying to figure out my next steps in residency as I steer my career towards fellowship. I'm very seriously considering pulm/crit and the one aspect that gives me pause is lifestyle. I loved general medicine and considered hospitalist, but after intern year I found that many hospitalists have such a high patient volume they consult specialists quite a lot and sometimes seem to be more involved with coordination than medical management. I really enjoyed the physiology & medicine found in the unit and think I could definitely see myself enjoying pulm. This thread certainly highlights the lifestyle concerns, but I went in to medicine because I loved it even though I knew the hours would be bad and I'm considering continuing that same logic on to fellowship



And so, I ask you, knowing what you know now about lifestyle, would you still choose pulm/crit?

Life style is what you make it, my philosophy is if I love what I do then that is my life style. Don't get me wrong, some of the bull**** grinds my gears but for me, my ego is that I am the badass that can handle the downpour when the **** has the fan and everyone else is pissing their pants.

The nice thing about pulm/cc is there such a void in what's needed that you're almost given carte Blanche to set up your practice how you want, for me, I have a harder time backing off of clinic, I can't say no to sick pts needing worked in, stat consults for lung masses, and that's where my lifestyle goes to crap, I know how to say no, that isn't urgent at the hospital.

 

[jdh71]

So I don't mean to high jack the thread, but I'm at the end of intern year and seriously trying to figure out my next steps in residency as I steer my career towards fellowship. I'm very seriously considering pulm/crit and the one aspect that gives me pause is lifestyle. I loved general medicine and considered hospitalist, but after intern year I found that many hospitalists have such a high patient volume they consult specialists quite a lot and sometimes seem to be more involved with coordination than medical management. I really enjoyed the physiology & medicine found in the unit and think I could definitely see myself enjoying pulm. This thread certainly highlights the lifestyle concerns, but I went in to medicine because I loved it even though I knew the hours would be bad and I'm considering continuing that same logic on to fellowship



And so, I ask you, knowing what you know now about lifestyle, would you still choose pulm/crit?

Yep. I like my job. (Most of the time)

 

[group_theory]

And pulm clinic isn't for the feint of heart. It's largely thankless and depressing a lot of the time. You need to be ok with diseases you can't fix but manage chronically and sometimes only minimally. In some ways it's more exhausting.

You mean you don't like the "chronic cough for 50 years" stat consult while inpatient for cellulitis, or the office patient who says "I stop breathing during the day for hours at a time, then realize I stop breathing and panic and then I start to breath again" 15 minute appointment?

 

[Hernandez]

I could find a pulm only job within a week. Pay will likely suck without in pt coverage unless it's with a strong onc program and a very well run endo suite

 

[Hernandez]

Yes. No.

 

[PlutoBoy]

Well, thats obviously not what i mean, but im sure a lot of people have wrong ideas about medicine. Im currently doing a surgery rotation... 04:45 am till 7pm most days(ofc it is not in the US). So I'm not delusional about reality as a physician. Im asking between these three possibilites of practice (hospitalist x pulm/cc x pure ccm), which one possibly leads to a better life x work balance and which one would, in general, be less stressful, given the reality that all of those options will be hard stuff and that im not looking to derm/rads/plastic.
I know it sucks to hear stupidity from medical students who are blind to reality as it is and think it will all be a walk in the park. But i'm actually not one of those...
Any input is kindly appreciated

All three suck. Stay out of the hospital.

 

[PlutoBoy]

Dude, i don't get your point or your anger. I just asked between these 3 possibilities which one would led to a daily practice less stressful. It's comparative not absolute. I'm not asking for a cush job or am lazy (definetely im not).I'm asking it because these 3 possibilities are most probable for me and i have a family, so i want to have a glimpse about how day to day work life will look like and how much free time should i expect... for example,how does it look like daily in each option? You are on call everyday when you are on a 7on/7off? At what time do you leave hospital usually (assuming you are not jeopardizing pt care)? I never said im a lazy ass looking for a walk in the park... dont assume things you dont know

As a hospitalist sometimes you leave early, sometimes you leave late. It is NOT a cushy specialty and it is not the best lifestyle out there, especially if you have a family.

The latest I left the hospital? 12:30 AM. That's right. From 7:00 A.M. to 12:30 A.M. Of course this is not common but people in the hospital are sick and a lot of the time you are the last man standing, at least if you want to be responsible.

jdh is right I guess. These jobs are not cush. If you go for them expect to work your ass off.

I'd suggest you do rheumatology or endo. Way better

 

[PlutoBoy]

I came across this link and thought about this thread.

ICU Burnout at 45%, Medical Societies Call for Action
Marcia Frellick

July 07, 2016

A new report issued jointly by four critical care organizations says up to 45% of the nation's 10,000 critical care physicians and nearly a third (25% - 33%) of the 500,000 critical care nurses are reporting severe burnout.

For physicians who specialize in pediatric critical care, that proportion was 71%, which is twice the rate of that for general pediatricians. In addition, nearly 86% of critical care nurses reported at least one of the three classic symptoms of burnout syndrome (BOS): exhaustion, depersonalization (a distant or indifferent attitude toward work), and feelings of diminished personal accomplishment.

The syndrome, measured by the 22-item Maslach Burnout Inventory, is highest among those on the front lines, according to the report.

Click the link for the full report.

http://www.medscape.com/viewarticle/865814?nlid=108008_2822

 

[Vigileo]

On a somewhat related note, what kind of salaries are academicians getting these days? And by academics, I mean both clinician-educator and the 70/30 research types? Regional variation? Just curious


Sent from my iPhone using SDN mobile

 

[sunny123]

On a somewhat related note, what kind of salaries are academicians getting these days? And by academics, I mean both clinician-educator and the 70/30 research types? Regional variation? Just curious


Sent from my iPhone using SDN mobile

Curious about this as well. Any ideas?

 

[tartesos]

On a somewhat related note, what kind of salaries are academicians getting these days? And by academics, I mean both clinician-educator and the 70/30 research types? Regional variation? Just curious


Sent from my iPhone using SDN mobile

If you like academics then you should not inquire much about money or don't find out how much your private practice counterparts make.... it's a big difference.

Will you starve in academics? No you will still have a good salary.

It's all about how much you like it and if you can't live without it.


Sent from my iPhone using SDN mobile app

 

[heretics]

Endo?

So you can spend 2 years making 40 k and then make LESS than a PMD?

I'd suggest you do rheumatology or endo. Way better [/QUOTE]

 

[Raryn]

Endo?

So you can spend 2 years making 40 k and then make LESS than a PMD?

I'd suggest you do rheumatology or endo. Way better

You know some people actually are motivated by things other than money, right? Many of us want to enjoy our jobs as well and find certain fields more intellectually stimulating relative to others.

Hell, endo and rheum aren't anywhere near the worst from this standpoint... ID, nephro, and geriatrics all still have a fair number of applicants (though obviously proportionally less than the high earning specialties) and they all have a negative ROI compared to just working in general medicine. Hell, so do almost all peds fellowships, and they still typically fill.

 

[agranulocytosis]

1st year fellow here. Is it just me, or do I feel busier on inpatient Pulmonary than I do in the unit? From clinic, consults, and bronchs - to talks, lectures and grand rounds, I'm often stretched pretty thin.

At least when I'm in the Unit, I'm in the Unit. Bronchs aren't as much fun there, though...snot spelunking isn't really my thing.

Does this seem to be the case for those in PP?

 

[Hernandez]

Does this seem to be the case for those in PP?

Yes

 

[tartesos]

1st year fellow here. Is it just me, or do I feel busier on inpatient Pulmonary than I do in the unit? From clinic, consults, and bronchs - to talks, lectures and grand rounds, I'm often stretched pretty thin.

At least when I'm in the Unit, I'm in the Unit. Bronchs aren't as much fun there, though...snot spelunking isn't really my thing.

Does this seem to be the case for those in PP?

I just got 9 consults as soon as I walked in.
"Can be Called in the morning".
On top of my 19, and usually 3-5 from the floor all over the place.
In the icu, there are 24 beds all in the same place, makes life easier.

Makes the day go by quickly though.


Sent from my iPhone using SDN mobile app

 

[jdh71]

1st year fellow here. Is it just me, or do I feel busier on inpatient Pulmonary than I do in the unit? From clinic, consults, and bronchs - to talks, lectures and grand rounds, I'm often stretched pretty thin.

At least when I'm in the Unit, I'm in the Unit. Bronchs aren't as much fun there, though...snot spelunking isn't really my thing.

Does this seem to be the case for those in PP?

I remember it being like that in fellowship too.

Where I work now in patient pulmonary consults aren't too bad. Probably just the culture but our hospitalists try and handle straight forward pulm. And they should. And the surgeons consult hospitalists first too. Hospitalists get us involved if things stall out (which usually means I won't know what to do either. Lol) or there is a chest tube involved. I can't seem to get out of dealing with pneumos and pleural stuff.

 

[DetectiveAlonzo]

"work life balance" is happy hippy horse**** nonsense cooked up by people that can't hang so they can complain and bitch and moan

you want a "sweet free time life," do another job

and stay way the **** away from my unit

This. I love this attitude. **** I hope I end up with a badass doc like you to work with. You seem like the type to shoot the **** and get some beers after a badass shift.

 

[jdh71]

This. I love this attitude. **** I hope I end up with a badass doc like you to work with. You seem like the type to shoot the **** and get some beers after a badass shift.

I just get cranky sometimes and I do need to try to be a bit nicer. But. I mean it would be like a navy seal complaining about their job being "dangerous". That's the job. Critical care is long days, nights, weekends, holidays, anniversaries, and kid's soccer games. It's what we do. It's the sacrifice for doing the job. You can't do this job outside of that paradigm anymore than a navy seal can do his job outside of a carrying a rifle and hanging out on large boats. I don't hate you if you want to have a more chill life from a work/life balance, but I don't want you anywhere near my patients with that attitude if you are also trying to be a critical care physician. It's nor personal, but that level of self-centeredness can't exist in the context of what needs to be done. Don't get me wrong when I'm off I'm very happy to be off. Workd hard, play hard, but don't do the job half-assed, patient's and their loved ones are counting on us to do it right.

 

[drak405]

This thread is a classic - perfect example of toxic people in both forums and medicine. I've got to agree with TimesNewRoman... jdh71 seems like a miserable sod. "I'm not mad kid", he says condescendingly, while ironically complaining about other people complaining, swearing, and calling out "hippies" for some reason - as if we are still in the 80s under good ol' Reagan. An absolute caricature of a grumpy old man who complains about "this generation" and millennials, as if an entire generation of people spanning race, geography, and class are somehow generalizable with a few harsh words. To go out on a limb, probably the type of person who thinks he's the ubermensch because he's proficient at cardioverting and believes that taxes are stealing from the strong.

And don't even get me started on this absurd gung-ho mentality and military references. You should probably watch fewer Clint Eastwood movies and fill your statin. Yes, everyone knows being a CC doctor is hard work that requires dedication, but you really want to compare a profession that is based on killing people with one whose mantra is do no harm? But I guess I've probably just forgotten that being a marine or a navy seal is the manliest thing a man can do and 'going hard' all the time is the gold standard for lifetime achievement...

It's not even only him, all these other people giving snarky replies to the OP's clearly stated question.... seriously, what's with all the snide remarks when someone dares to ask about 'lifestyle' *gasp*, as if being human is a sign of weakness. We're supposed to be a learned profession and yet we act like a bunch of hopped up muscle heads. I guess I should get on a couple more "badass shifts" with DetectiveAlonso, because clearly delivering atropine to a tachycardic father of three is a real testosterone booster.

 

[PlutoBoy]

2018 Burnout report

Medscape: Medscape Access

 

[CCM-MD]

2018 Burnout report
View attachment 228231
Medscape: Medscape Access

These medacape reports have poor methodology and small sample size. They surveyed 15,543 physicians, out of which 1% were critical care physicians - so only 155. Doubt there is statistical significance between any of those numbers you posted above.

 

[appalachian_man]

This thread is a classic - perfect example of toxic people in both forums and medicine. I've got to agree with TimesNewRoman... jdh71 seems like a miserable sod. "I'm not mad kid", he says condescendingly, while ironically complaining about other people complaining, swearing, and calling out "hippies" for some reason - as if we are still in the 80s under good ol' Reagan. An absolute caricature of a grumpy old man who complains about "this generation" and millennials, as if an entire generation of people spanning race, geography, and class are somehow generalizable with a few harsh words. To go out on a limb, probably the type of person who thinks he's the ubermensch because he's proficient at cardioverting and believes that taxes are stealing from the strong.

And don't even get me started on this absurd gung-ho mentality and military references. You should probably watch fewer Clint Eastwood movies and fill your statin. Yes, everyone knows being a CC doctor is hard work that requires dedication, but you really want to compare a profession that is based on killing people with one whose mantra is do no harm? But I guess I've probably just forgotten that being a marine or a navy seal is the manliest thing a man can do and 'going hard' all the time is the gold standard for lifetime achievement...

It's not even only him, all these other people giving snarky replies to the OP's clearly stated question.... seriously, what's with all the snide remarks when someone dares to ask about 'lifestyle' *gasp*, as if being human is a sign of weakness. We're supposed to be a learned profession and yet we act like a bunch of hopped up muscle heads. I guess I should get on a couple more "badass shifts" with DetectiveAlonso, because clearly delivering atropine to a tachycardic father of three is a real testosterone booster.

Somebody call the cops because I just witnessed a verbal murder. Didn't even get a response from @jdh71 or @DetectiveAlonzo ...Couldn't agree more with this sentiment.

OP, I'm sorry everyone was such a dick to you. I hope you got better career advice from somebody more helpful.