Specialities for lazy people wanting relaxed 8-5 job (serious)

[colbgw02]

Can anyone else confirm if the above depiction of FM/Psych is true? Do FM docs really spend 2-3 hours after work every evenings on paperwork and other followup work? And is it true that their days are not very leisurely, and that they're constantly in a rush?

I'm married to a family practitioner. The EMR she is forced to use, in a word, sucks. As in, it is historically bad. Even then, she probably spends less than an hour per weeknight catching up on charting. I am confident that a decent EMR could substantially reduce that number. She works 45 hours per week, with no nights, no weekends, and no inpatients. We'll be moving soon, so she'll be changing jobs and has had multiple job offers. Our experience is that her current experience is emblematic. She makes just under $200K, and her job offers essentially match that amount.

I'm not so sure the job you described in your OP exists, mostly because very few physicians have a leisurely work day. Lifestyle in medicine is mostly defined as an overall small number of hours worked with a predominance of those hours coming during bankers' hours. The expectation, regardless of specialty, is that time on the clock will be maximized because the bottom line demands it. The only exceptions I've seen to this is in academia or with federal service (e.g. VA), both of which come with their own baggage.

So, what we're really talking about are degrees of likelihood. Almost all specialties can be lifestyle fields if you are willing to sacrifice certain things like salary or location, so it's really a question of what percentage of a field's positions fit your criteria. Neurosurgery? Yeah, good luck finding a job that fits your description. But I think FM has a relatively high percentage of jobs that meet most of your criteria.

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[Mass Effect]

Psych will be the same or a little better lifestyle wise but will usually require night/weekend call responsibilities if you're affiliated with a hospital system.

What are you going to do if your patient attempts suicide on a Saturday night?

"Sorry bro I'm not coming in to the ED, its after normal business hours..."

You could go private practice, but then you'll have to deal with all the paperwork and administrative issues involved with running your own business.

Basically you're SOL.

Not sure where you work, but at any of the places I rotated in med school and where I work now, no psych attending ever comes into the ED on a Saturday night because a patient attempted suicide. That's like saying if you're an IM doc and your patient has a COPD exacerbation on a Saturday night, you have to come in. Uh, no.

 

[Cinclus]

Right on. I'm starting to think Psych is my best bet too. What's the job market like for private-practice Psychiatrists? Also, what might be some pros/cons of being a private-practice Psychiatrist vs. a hospital employee?

It's wide open. Even most major cities (which seem to be "desirable" to lots of people) are still wanting for psychiatrists. It's one of those specialties where you can pretty much just throw a dart at a map and be able to work at that location, no problems. One con for some people with PP vs. employed may be that you have to manage the business aspects of the practice, buy your own insurance, etc. Pros are that you make your own hours, have the opportunity for significantly higher earnings, can have a cash-only practice, etc. Check out the psych forum for more info. The practice settings for psychiatrists are so varied.

 

[Stagg737]

I think numbers 2 and 4 will be the toughest ones to find. While you can definitely minimize your work at home/the end of the day, having absolutely none seems nearly impossible from the people I've talked to and shadowed. Maybe EM would fit that, but you'd also have hours that definitely aren't 8-5. I would also add that while I wouldn't consider almost any field to have a 'leisurely' work pace, I think there are plenty of fields where you don't have to work like a chicken with its head cut off.

I'm also surprised to hear people saying that an easier residency is possible. Honestly, I would just suck it up for 3ish years and do what you need to in residency to be set for the rest of your career.

I
As to family med, these are some of the busiest and hardest-working docs I know, with the amount of patients they're required to see. Maybe check out AtlasMD on the FM forums for more information on direct primary care; without a model like that you have little time to catch your breath during the day, let alone take your time.

Keep in mind the AtlasMD guys are also ballers that have some pretty strong business knowledge that many doctors just don't have. They came and spoke at our school and they've got a cool setup with a great model, but they also said it won't work everywhere and that you have to know the business end of medicine to pull it off.

 

[Siggy]

Radiology has some call and weekend shifts. Using RadiHoliday to describe radiology isn't applicable these days.

I prefer "radiation vacation" because it rhymes. Also, it's fun seeing all of the really stupid studies that get ordered. "Pelvic ultrasound RE: S/P total hysterectomy, unable to visualize cervix." ::

 

[Postictal Raiden]

Not sure if you're being tongue-in-cheek, but definitely yes lol. More so than any other speciality mentioned in this thread so far (with the exception of Rads, perhaps).

My bad. I meant point #8, the one about the future outlook of the field.

 

[IlDestriero]

My bad. I meant point #8, the one about the future outlook of the field.

Yes, the bottom can only go so low. And the reality of the situation is that the majority of CRNAs can't and don't want to try to practice independently. The flood gates aren't opening on actual competition that would put you out of work.
The days of the 600k+ private practices with million+ dollar hospital subsidies may be coming to an end, but they haven't yet. A bad job pays more than 1/2 of that now. A 8-4 surgicenter type job will easily exceed his minimum income target as would a mommy track job working for another group. Those jobs already don't get the call subsidies, etc. that other groups are losing. It's fee for service and eat what you kill or a salary. I wouldn't want salary in that situation, but that's a whole other topic.
If he/she could suck up an anesthesia residency, anesthesia to pain is also an option to consider, if they like procedures.
They've been saying the sky is falling for 25 years. And it has, if you were making the equivalent of $1m/yr.

 

[Law2Doc]

Right on. I'm starting to think Psych is my best bet too. What's the job market like for private-practice Psychiatrists? Also, what might be some pros/cons of being a private-practice Psychiatrist vs. a hospital employee?

Job market is irrelevant to you because if you expect these stringent hours and no weekend work you really are going to need to be self employed. No employer is going to tolerate much of what you wrote and certainly not gonna pay you 200 large with these demands. If you are working for a hospital group you'll have call obligations, so that's out. Can you set up shop and generate $200k without working nights or weekends? Sure, eventually, although starting a Practice isn't easy and you'll be working very hard initially just to get the business going.

 

[username456789]

Job market is irrelevant to you because if you expect these stringent hours and no weekend work you really are going to need to be self employed. No employer is going to tolerate much of what you wrote and certainly not gonna pay you 200 large with these demands. If you are working for a hospital group you'll have call obligations, so that's out. Can you set up shop and generate $200k without working nights or weekends? Sure, eventually, although starting a Practice isn't easy and you'll be working very hard initially just to get the business going.

I'm perpetually amazed at how many medical students/premedical students (and even residents) have this notion that they will all be able to completely set their own schedule and rules in an outpatient setting other than solo self-owned private practice. The number of times I see someone comment to that effect is a bit alarming.

 

[PL198]

Not sure where you work, but at any of the places I rotated in med school and where I work now, no psych attending ever comes into the ED on a Saturday night because a patient attempted suicide. That's like saying if you're an IM doc and your patient has a COPD exacerbation on a Saturday night, you have to come in. Uh, no.

yeah I didn't understand that either. it's not like you can do anything different for them than someone else can at that moment.

 

[ACSurgeon]

Job market is irrelevant to you because if you expect these stringent hours and no weekend work you really are going to need to be self employed. No employer is going to tolerate much of what you wrote and certainly not gonna pay you 200 large with these demands. If you are working for a hospital group you'll have call obligations, so that's out. Can you set up shop and generate $200k without working nights or weekends? Sure, eventually, although starting a Practice isn't easy and you'll be working very hard initially just to get the business going.

I think it's fair to outline your dream job, as long as you realize that not all features will be met. For example, no night/weekend call and very minimal night/weekend call becomes an acceptable change.

 

[Law2Doc]

I think it's fair to outline your dream job, as long as you realize that not all features will be met. For example, no night/weekend call and very minimal night/weekend call becomes an acceptable change.

The OP said he was lazy and wanted a relaxed job with no weekend or evening work and a decent salary. He indicated that he wanted to do nothing work related after 5pm. He didn't express the flexibility you are ascribing. That means he has to be self employed, in an outpatient setting in a field without emergencies. No employer would put up with that and nobody is going to hire someone with rigid hour demands and a resistance to paying his dues in the call pool. Just won't happen.

What he's written is a far cry from merely asking what fields are "lifestyle friendly." But if instead he saying what job can I work no more than 60 hours a week with about one weekend of call a month, then sure, there might be a few more options.

 

[jakeislove]

I'm biased towards psych but it's hard to believe someone who wasn't passionate about helping people with mental illness could be any good.

 

[ACSurgeon]

The OP said he was lazy and wanted a relaxed job with no weekend or evening work and a decent salary. He indicated that he wanted to do nothing work related after 5pm. He didn't express the flexibility you are ascribing. That means he has to be self employed, in an outpatient setting in a field without emergencies. No employer would put up with that and nobody is going to hire someone with rigid hour demands and a resistance to paying his dues in the call pool. Just won't happen.

What he's written is a far cry from merely asking what fields are "lifestyle friendly." But if instead he saying what job can I work no more than 60 hours a week with about one weekend of call a month, then sure, there might be a few more options.

You said it- since what he describes doesn't exist, he'll have to compromise some aspects. Maybe I'm not as literal on my reading of the original post.

 

[alpinism]

Not sure where you work, but at any of the places I rotated in med school and where I work now, no psych attending ever comes into the ED on a Saturday night because a patient attempted suicide. That's like saying if you're an IM doc and your patient has a COPD exacerbation on a Saturday night, you have to come in. Uh, no.

In the community, yes.

If the patient is still an active danger to themselves or others we'd call psych for an inpatient admission. Since there aren't any residents, the attending on call has to come in to evaluate and possibly admit the patient. Maybe its different where you work but thats how it worked at multiple private hospitals where I rotated.

 

[Mass Effect]

In the community, yes.

There aren't any residents so the attending on call has to come in to evaluate and possibly admit the patient.

You're talking about a community hospital psychiatrist? Because even "in the community," a psych attending wouldn't have to come in to admit the patient on a Saturday night unless they joined a practice with that stipulation. Most private practice psychiatrists in the community don't do this. Again, it's like saying if you're an internal medicine attending in the community and your patient has a COPD exacerbation, you have to come in to admit the patient. That's not how it works.

 

[alpinism]

You're talking about a community hospital psychiatrist? Because even "in the community," a psych attending wouldn't have to come in to admit the patient on a Saturday night unless they joined a practice with that stipulation. Most private practice psychiatrists in the community don't do this. Again, it's like saying if you're an internal medicine attending in the community and your patient has a COPD exacerbation, you have to come in to admit the patient. That's not how it works.

Yep. Their practice required everyone with hospital privileges to take call. Wasn't too frequent though so most weekends they were free.

True but in IM there are hospitalists to do the admitting. Even then I know of a few practices that still require outpatient IM docs to do hospitalist shifts on weekends.

 

[Mass Effect]

Yep. Their practice required everyone with hospital privileges to take call. Wasn't too frequent though so most weekends they were free

Take call as in actually go in to the hospital to do admissions? I'd say that's unusual. Taking call is usually over the phone in private practice. The hospital does admissions and whoever is on call has to round on the patient the next morning.

True but in IM there are hospitalists to do the admitting. Even then I know of a few practices that still require outpatient IM docs to do hospitalist shifts on weekends.

In most cases, hospital shift means you round on the patients, not that you get up and go to the hospital at 11 p.m. on a Saturday night to do an admission.

 

[zennythz]

...No employer would put up with that and nobody is going to hire someone with rigid hour demands and a resistance to paying his dues in the call pool. Just won't happen.

What he's written is a far cry from merely asking what fields are "lifestyle friendly." But if instead he saying what job can I work no more than 60 hours a week with about one weekend of call a month, then sure, there might be a few more options.

Just from my experiences speaking with other doctors, I think this is untrue. I think there are definitely employers out there who would be OK with you saying that you're looking for an inflexible 8-5 commitment with no call. Granted, you would have to be in one of the specialities mentioned earlier in this thread--Psychiatry, PM&R, etc., and your income might be slightly lower.

 

[zennythz]

Also, FWIW, here's a useful graph I came across recently from the JAMA Network:

 

[PL198]

wtf is occupational medicine

 

[zennythz]

wtf is occupational medicine

http://en.wikipedia.org/wiki/Occupational_medicine

 

[Law2Doc]

Just from my experiences speaking with other doctors, I think this is untrue. I think there are definitely employers out there who would be OK with you saying that you're looking for an inflexible 8-5 commitment with no call. Granted, you would have to be in one of the specialities mentioned earlier in this thread--Psychiatry, PM&R, etc., and your income might be slightly lower.

I call BS. No employee is going to be "OK" with someone looking for "an inflexible 8-5 commitment with no call". And certainly wouldn't pay you $200k plus for that. Those that believe in this also believe in unicorns, sorry.
As mentioned you can get some of what you want. Unless you work for yourself you won't get most of what you want. Saying "from my experiences speaking with other doctors" is the same as the people who say " I know a guy". I know a guy who won the state lottery -- BFD-- that doesn't make it realistic to think I can too.

 

[Law2Doc]

...That said, I've heard that there actually are some psych VA jobs that offer no weekend/night call. My friend's father used to work one of these jobs.

VA jobs are tough to get because they are regarded as a lifestyle friendly gig. Most definitely have the weekly hours the OP described. but at some facilities they do require call and weekend work - they are full service hospitals and someone has to be available to see patients outside of business hours. And may not guaranty the salary OP said he requires. So again, a close option but OP would need to make some compromises and get a bit lucky.

 

[jakeislove]

If a parent subsidizes the education it might be doable.

 

[Jabbed]

Also, FWIW, here's a useful graph I came across recently from the JAMA Network:

View attachment 190015

Look at that spread on neurosurgery

 

[colbgw02]

wtf is occupational medicine

you probably know it by its more popular name - unemployment.

 

[Kaustikos]

Walgreen's/CVS minute clinic. BOOM. You're welcome

 

[Psai]

Walgreen's/CVS minute clinic. BOOM. You're welcome

if you sell out like that, you deserve to have your license revoked

 

[PL198]

you probably know it by its more popular name - unemployment.

are those the private consultants that don't do residencies? if not, what is that called?

 

[colbgw02]

are those the private consultants that don't do residencies? if not, what is that called?

not sure what you're referring to, but it's not occ med.

 

[IlDestriero]

I call BS. No employee is going to be "OK" with someone looking for "an inflexible 8-5 commitment with no call". And certainly wouldn't pay you $200k plus for that. Those that believe in this also believe in unicorns, sorry.
As mentioned you can get some of what you want. Unless you work for yourself you won't get most of what you want. Saying "from my experiences speaking with other doctors" is the same as the people who say " I know a guy". I know a guy who won the state lottery -- BFD-- that doesn't make it realistic to think I can too.

If you substitute 7:00-3:00, that's the definition of the mommy track in anesthesia and our ambulatory centers are always done by 4, usually last patient out by 4. And you'd make considerably more than 200k.

 

[IlDestriero]

if you sell out like that, you deserve to have your license revoked

We have a few urgent cares in the area staffed by actual physicians, I assume most are moonlighting from other gigs.

 

[Law2Doc]

If you substitute 7:00-3:00, that's the definition of the mommy track in anesthesia and our ambulatory centers are always done by 4, usually last patient out by 4. And you'd make considerably more than 200k.

The so called "mommy track"s are not very numerous, and highly fought over by actual mommies. I doubt OP could get one, certainly wouldn't pick a specialty with that goal. This is another unicorn.

 

[Law2Doc]

Walgreen's/CVS minute clinic. BOOM. You're welcome

Around here these are exclusively staffed by NPs. And they don't earn anything close to $200k. And they take turns staffing the weekend shifts. Doesn't fit what OP described at all.

 

[Psai]

We have a few urgent cares in the area staffed by actual physicians, I assume most are moonlighting from other gigs.

there's a huge difference between running an urgent care and being a conveniently located pill pusher for cvs/walgreens

 

[rodmichael82]

PM&R and Psych. Both have pretty laid back work to get into residency and laid back work when out of residency compared to other specialties.

 

[Slack3r]

What is that JAMA chart referring to? Hours per what? I'm assuming it's per year since I don't believe vascular surgery works an extra 800+ hours per month than FM?

 

[Mad Jack]

There are plenty of things about Dermatology that make it a great specialty, but a "leisurely pace" is absolutely not one of them.

Derm can be as cush as you want it to be, if you're willing to take a cut in pay. OP wants to be in the 200k range, which you can easily do in derm pulling a 9-5 that isn't too hectic.

 

[username456789]

Derm can be as cush as you want it to be, if you're willing to take a cut in pay. OP wants to be in the 200k range, which you can easily do in derm pulling a 9-5 that isn't too hectic.

Are you intentionally ignoring what I wrote above, or do you actually not understand how outpatient medicine (and Dermatology specifically) works?

 

[Mad Jack]

I call BS. No employee is going to be "OK" with someone looking for "an inflexible 8-5 commitment with no call". And certainly wouldn't pay you $200k plus for that. Those that believe in this also believe in unicorns, sorry.
As mentioned you can get some of what you want. Unless you work for yourself you won't get most of what you want. Saying "from my experiences speaking with other doctors" is the same as the people who say " I know a guy". I know a guy who won the state lottery -- BFD-- that doesn't make it realistic to think I can too.

Plenty of 9-5 outpatient psych jobs in my area with no call.

 

[Darth Doc]

FM residency then prison physician

Prison physicians take a lot of call... Inmates wait until the docs are gone to shank each other, so there's a lot of "can we send this guy to the ER" from the nurses. There's also a lot of malingering in the evening, because only nurses are there to assess patients and since the inmates know nurses can't diagnose they keep trying to get a hospital vacation.

 

[Slack3r]

Derm can be as cush as you want it to be, if you're willing to take a cut in pay. OP wants to be in the 200k range, which you can easily do in derm pulling a 9-5 that isn't too hectic.

Derm clinic is very fast paced. On my rotation, we would frequently see 25-30 pts before lunch, and this was an academic practice.

 

[zennythz]

PM&R and Psych. Both have pretty laid back work to get into residency and laid back work when out of residency compared to other specialties.

Ha, this is exactly what I was thinking...easy to get in, easy to stay in, easy once you get out . And they both seem to fit my working style and personal preferences pretty well.

 

[username456789]

You could potentially get hired by a practice as a non-partner and work fewer hours. But they are going to expect you to be maximally productive with that time.

This gets to the main issue that MadJack and just about any medical student I've ever talk to about the issue seems to fail to understand. When you join a group practice (and the vast majority of graduating dermatology residents do) to a large extent you're at the mercy of what the group expects of you. Even if you are fortunate enough to get a contract that only requires you to work four days or even less, you will be working at anything but a "leisurely pace" (which is precisely what the OP is looking for). Seeing 5-10 patients an hour is not uncommon in many Derm practices. This is in no way compatible with what the OP says he is looking for.

 

[IlDestriero]

The so called "mommy track"s are not very numerous, and highly fought over by actual mommies. I doubt OP could get one, certainly wouldn't pick a specialty with that goal. This is another unicorn.

Every ambulatory only job is by definition mommy track, every fee for service office based job is as well. Many larger groups are comfortable with some mommy track because they will never be partners and will likely bill more then they cost. They also offer coverage when the majority of the work is done before the late and/or call team takes over. My academic job, and others I've had and interviewed at offer a no 1st 2nd or 3rd call option, often taken by elder statesmen and those with sugar mamas/daddies at home. They may be late a few times a month, but they're always out by 6, usually before 4. Of course you make less than the full partners/faculty.
It is not a unicorn.

 

[zennythz]

What is that JAMA chart referring to? Hours per what? I'm assuming it's per year since I don't believe vascular surgery works an extra 800+ hours per month than FM?

Correct. "Annual Work Hours Across Physician Specialities". Here's a link to the full, free article online:
http://archinte.jamanetwork.com/article.aspx?articleid=1105820

 

[Mad Jack]

Derm clinic is very fast paced. On my rotation, we would frequently see 25-30 pts before lunch, and this was an academic practice.

There's certainly a good number of dermatologists that see far fewer patients though. 42% of dermatologists see less than 100 patients a week., and a quarter of dermatologists see 75 or fewer. Not that any of this matters- a slacker like OP won't get into derm to begin with.

 

[Law2Doc]

...
You could potentially get hired by a practice as a non-partner and work fewer hours. But they are going to expect you to be maximally productive with that time.

Agree with this post. And even more, why would any practice hire OP to work fewer hours if there are people out there who could work more? Overhead is largely the same if someone works 30 hours a week or 60, so you save money with full timers. And obviously you generate more net income seeing more patients. I get that some places sometimes offer mommy tracks to retain amazing people who can't work full time for family reasons but I doubt OP can make that same pitch.

Still think OP needs to do something like psych, hang up his own shingle and schedule a bunch of regular standing weekly appointments, an hour a session, to get the light hours and $ he wants. I think his requirements, if non-negotiable, will make him unemployable.

 

[zennythz]

Still think OP needs to do something like psych, hang up his own shingle and schedule a bunch of regular standing weekly appointments, an hour a session, to get the light hours and $ he wants.

This would be ideal.

I think his requirements, if non-negotiable, will make him unemployable.

That's harsh. I'm sure such jobs are out there, and that they're not as uncommon as the "unicorns" to which you allude. But I do agree with you that I might not find a job that 100%, EXACTLY meets my criteria...and this is OK with me. 180K instead of 200k? No problem. Most days 8-5, but occasionally stay till 6 to wrap things up? No worries. As long as things don't deviate TOO MUCH from my original criteria.