Ideal Weekly Schedule

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Saw some discussion on another post about how working consecutive 10 hour shifts a week is more exhausting than taking call with post-call days. That begs the question, what would be your ideal route to 40 hours a week? To 50? 4 x 10's sounds pretty good to me over 5 x 8's. Now does MD only vs supervision change this equation?

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Seems hard to answer but in residency and even now as an attending, getting out at 3 is in a different world compared to 5. I’d be okay with 7-3 everyday if it paid enough. I’d be fine taking a weekly call as long as the other days I’m out by 3 or earlier
 
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I’m out by 3 90% of the time. Compared to my previous job where it was 5-530 it is glorious.
 
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I like my own bed too much. The goal is to never sleep in a hospital ever again (eventually).
 
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Seems hard to answer but in residency and even now as an attending, getting out at 3 is in a different world compared to 5. I’d be okay with 7-3 everyday if it paid enough. I’d be fine taking a weekly call as long as the other days I’m out by 3 or earlier

Agree my ideal would be four 10s
 
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Worked in a few settings

Partnership taking q2-3 call and working pre and postcall 80-90% of the time. Mostly own cases.

40 hours a week, 10 hour shifts. No calls. Mostly own cases.

55 hours a week plus call with guaranteed pre and post off. All own cases.

I found you are equally tired at the end of each day. Not really tired if supervising that day but get way more steps in. No call just means less time recovering postcall.
 
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The ideal schedule is 35 hours a week if working 5 days a week.

If working 45 hours a week. Need post call day mid week and early our day (before 12pm another day).
 
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The ideal schedule is 35 hours a week if working 5 days a week.

If working 45 hours a week. Need post call day mid week and early our day (before 12pm another day).
I appreciate your posts on the business aspects of Anesthesiology.

Q: Private practice democratic group. All partners rotating call schedule, equal burdens, usual post call day off and peel off schedule divided evenly. Some carve out for admin time, the usual cardiac/non-cardiac grumbling but nothing terrible. 55 hours/week rotating call nights, weekends, holidays. Call is bad.
One longstanding respected member of the group wants to work 40 hours M-F. Same number of vacation weeks.

what is your opinion of the "fair" ratio of the hourly rate for call partner to this new proposed position. Assume same cost for benefits.
 
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Saw some discussion on another post about how working consecutive 10 hour shifts a week is more exhausting than taking call with post-call days. That begs the question, what would be your ideal route to 40 hours a week? To 50? 4 x 10's sounds pretty good to me over 5 x 8's. Now does MD only vs supervision change this equation?

4 x 10s is better than 5 x 8s because you save on commute and sign-out time.

My ideal schedule is home call with taking call once per week and guaranteed post-call day off. Call back rate would be 50% or less…enough that you can hope to win and have a full night of sleep. There would also be enough early days per week that weekly workload would be in the 40-45 range including the at-home-on-call hours. Of course there would have to be no OB to make it truly ideal.
 
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Coffee in the morning with steamed milk, overlooking a beautiful field with a mountainous forest and a lake in the background. OR starts at 8 am. Finish at 4. Turnovers are 5 minutes long. Cash pay patients only. Drive home with no traffic. Have a nice homecooked meal with a different menu every day. Clean, efficient international airport nearby.
 
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It’s amazing to me how much of a difference it makes to have at least one day a week where you’re walking out of the hospital before 3pm (not postcall).

I will never work post 1st call again, money isn’t worth it to me.

So my ideal is 1 1st call/week with a guaranteed postcall off, a pre-call day that is <8hrs, the other two days can be 10+, and no more than 1 weekend/mo call.
 
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I appreciate your posts on the business aspects of Anesthesiology.

Q: Private practice democratic group. All partners rotating call schedule, equal burdens, usual post call day off and peel off schedule divided evenly. Some carve out for admin time, the usual cardiac/non-cardiac grumbling but nothing terrible. 55 hours/week rotating call nights, weekends, holidays. Call is bad.
One longstanding respected member of the group wants to work 40 hours M-F. Same number of vacation weeks.

what is your opinion of the "fair" ratio of the hourly rate for call partner to this new proposed position. Assume same cost for benefits.
~65%
 
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I really like having a mix of longer and shorter days in a week. It’s nice only working a couple hours and then using the entire afternoon to run a few errands or squeeze in a workout before dinner.

For the most part, I try to create this type of weekly schedule when I can:

- Two regular days (out by 4-5pm)
- One late call day (out around 9pm)
- Two short days (out before 1pm) or one day off

That’s my ideal 40-45 hour work week.
 
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I appreciate your posts on the business aspects of Anesthesiology.

Q: Private practice democratic group. All partners rotating call schedule, equal burdens, usual post call day off and peel off schedule divided evenly. Some carve out for admin time, the usual cardiac/non-cardiac grumbling but nothing terrible. 55 hours/week rotating call nights, weekends, holidays. Call is bad.
One longstanding respected member of the group wants to work 40 hours M-F. Same number of vacation weeks.

what is your opinion of the "fair" ratio of the hourly rate for call partner to this new proposed position. Assume same cost for benefits.
A daytime 1099 CRNA will cost the group 400k (with agency). Or 300k if u are lucky for regularly staffed hours 7-3pm 40 hours a week with 8 weeks of vacation.

Those are numbers you have to configure pay for day doc. Having someone available most weeks every day 7-3 is worth a lot. That’s what crna’s have figured out. So the shift their hours to 7-7, 7-11pm and create daily staffing shortage
 
I appreciate your posts on the business aspects of Anesthesiology.

Q: Private practice democratic group. All partners rotating call schedule, equal burdens, usual post call day off and peel off schedule divided evenly. Some carve out for admin time, the usual cardiac/non-cardiac grumbling but nothing terrible. 55 hours/week rotating call nights, weekends, holidays. Call is bad.
One longstanding respected member of the group wants to work 40 hours M-F. Same number of vacation weeks.

what is your opinion of the "fair" ratio of the hourly rate for call partner to this new proposed position. Assume same cost for benefits.
About 2/3 of full call taking partner. The hours are roughly 3/4 but working on nights and weekends are much more stressful so there should be a penalty. The other option is an hourly rate for day docs and per diems. Group members are well paid for their work so a longstanding and respected group member should not be paid more to contribute less currently. An anesthesia group isn't a law firm where rainmakers bring work for the young associates based on goodwill. Having opted for per diem work after dumping full time work, I will say that 5 ten hour shifts is worse than working later and getting out earlier.
 
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I appreciate your posts on the business aspects of Anesthesiology.

Q: Private practice democratic group. All partners rotating call schedule, equal burdens, usual post call day off and peel off schedule divided evenly. Some carve out for admin time, the usual cardiac/non-cardiac grumbling but nothing terrible. 55 hours/week rotating call nights, weekends, holidays. Call is bad.
One longstanding respected member of the group wants to work 40 hours M-F. Same number of vacation weeks.

what is your opinion of the "fair" ratio of the hourly rate for call partner to this new proposed position. Assume same cost for benefits.
All of our partners take call, once you stop taking call you become an employee of the group. Our daytime employees make about 40% of a 24hr weekday shift, and it’s probably close to 25% of a 24hr weekend shift. But we heavily subsidize call within our group. Our call is home-call and it’s not bad so you may even consider paying your daytime employees less if your call is “bad.”
Ideal schedule for me is one weekday call per week and one 24hr weekend, roughly q5-6. I think that’s the sweet spot if you’re getting out early precall with postcall day off and call isn’t that bad. If call is terrible then q7 is where I’d want to be.
 
Honestly, I'd be happy with 4 10hr shifts, and one day off per week. Working until 5pm does suck a little, but having a full day off for myself beats working until 3pm five days a week. I have young kids, and getting home right when they get out of school every day just means that I'll get tasked out with doing more work. A day off during which they're all in school means I actually get time to myself, and I still have evenings to spend time with them.
 
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A daytime 1099 CRNA will cost the group 400k (with agency). Or 300k if u are lucky for regularly staffed hours 7-3pm 40 hours a week with 8 weeks of vacation.

Those are numbers you have to configure pay for day doc. Having someone available most weeks every day 7-3 is worth a lot. That’s what crna’s have figured out. So the shift their hours to 7-7, 7-11pm and create daily staffing shortage

What?

I made less than that on 40 hours a week with less vacation to boot.

Where are these practices?
 
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What?

I made less than that on 40 hours a week with less vacation to boot.

Where are these practices?
What I’m saying is crna’s are so fickle with their schedules. You will be hard press to find a 5 day a week CRNA to work 45 weeks out of a year 5 days a week.

The key word is consistent 7-3 staffing. That’s what day time doc offers. Consistency.

Daytime docs less likely to call out sick. Less demanding than 7-3 CRNA

It’s very hard to find a daytime CRNA for 200k/7 weeks off these days. U end up with a patch up of scrambling for staffing. It really ends up costing u 300k work overtime paying CRNA. That’s what I mean
 
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