Wanting to work 3-4 days a week after residency, is this feasible? Which job markets should I be paying attention to?

[Episome]

Hi, I'm a current physiatry resident, PGY1. haven't seen this come up so it might be a somewhat foolish question. I'm wanting to spend time with my children and spouse, we are pretty frugal and prefer family time and quality experiences outside of work to an increase in revenue. The ideal situation would be one in which I could find a 3-4 day a week job after residency. Does this exist, and if so, would there be specific areas of physiatry that I should be paying more attention to?

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[runfastnow]

Off the top of my head -- weekend coverage for inpatient or working part time in an ortho practice doing EMG or seeing patients.

It won't meet your goal immediately, but if you work hard for 5-10 years in outpatient and build a patient base you will be able to pretty easily cut down to 4 days per week while still being productive and financially stable.

You can make medicine any career you want, but being a specialist can limit your options in terms of time flexibility. FM/IM would be easier to do shift work via urgent care.

 

[sloh]

1099 SAR. 4 days/week, 4-6 hr workdays, 300-350k/yr. No fellowship required. No pager, no weekends, no call, no nights.

 

[Bostonspine]

Off the top of my head -- weekend coverage for inpatient or working part time in an ortho practice doing EMG or seeing patients.

It won't meet your goal immediately, but if you work hard for 5-10 years in outpatient and build a patient base you will be able to pretty easily cut down to 4 days per week while still being productive and financially stable.

You can make medicine any career you want, but being a specialist can limit your options in terms of time flexibility. FM/IM would be easier to do shift work via urgent care.

One of the Pain doctors in the ortho Practice I joined works 3 days(recent graduated fellow) the other 12yrs out works 4days... I work 5 days because I do more evaluation and management stuff and fewer direct book injections but I can’t speak to there contract or overhead responsibilities. Some of these job you just get a percentage of collection if you not full time.

 

[sloh]

I'm new here, what's 1099 SAR?

It's subacute rehab

For more info, this is a good summary:

The physiatrist's role in post-acute rehabilitation - McKnight's Long Term Care News

In the IRF environment, it is mandated by federal regulation that the rehabilitation physician performs several key functions. It is not specified that this doctor necessarily be a physiatrist, but only a physician with training and experience in rehabilitation. In the SNF environment, there is...

www.mcknights.com

 

[PMR2008]

Happy to answer any questions about subacute here or private

 

[PMR2008]

Hi, I'm a current physiatry resident, PGY1. haven't seen this come up so it might be a somewhat foolish question. I'm wanting to spend time with my children and spouse, we are pretty frugal and prefer family time and quality experiences outside of work to an increase in revenue. The ideal situation would be one in which I could find a 3-4 day a week job after residency. Does this exist, and if so, would there be specific areas of physiatry that I should be paying more attention to?

Plenty of opportunities to work 3-4 days a week. Depends on what you want to do and if you prefer remote versus in person. I am happy to discuss each in detail if needed and I am listing approximate salary for each
1) Subacute full time 4 days a week(30-35 hrs) 350-400k
2) Part time outpatient doing EMGs, injections 3-4 days a week 200k
3) Part time inpatient consults 3-4 days a week 150k-200k
4) Intraoperative neuromonitoring 150k-200k
5) Medlegal - IME, disability exams, life care plans 200k+ but can take time to build up
6) part time academic - 100k-150k
7) Disability Management, Utilization Review 100k-150k
8) Telemed - 125-150k
9) part time VA - 100k-125k
10) Tech-startup industry
11) Medical director of home health
12) Part time working as medical director of Chiro clinic

 

[Iamnew2]

Plenty of opportunities to work 3-4 days a week. Depends on what you want to do and if you prefer remote versus in person. I am happy to discuss each in detail if needed and I am listing approximate salary for each
1) Subacute full time 4 days a week(30-35 hrs) 350-400k
2) Part time outpatient doing EMGs, injections 3-4 days a week 200k
3) Part time inpatient consults 3-4 days a week 150k-200k
4) Intraoperative neuromonitoring 150k-200k
5) Medlegal - IME, disability exams, life care plans 200k+ but can take time to build up
6) part time academic - 100k-150k
7) Disability Management, Utilization Review 100k-150k
8) Telemed - 125-150k
9) part time VA - 100k-125k
10) Tech-startup industry
11) Medical director of home health
12) Part time working as medical director of Chiro clinic

Can you elaborate a bit on the telemed options?
How do you become a director of home health?

 

[PMR2008]

Lots of telemed companies out there that are looking for virtual disability exams, consults, expert opinions etc.
You have to reach out to local home health agencies and see if they are looking for a director. New home health companies open up all the time.
You can also use recruiters that specialize in that space. Also look at glassdoor, ziprecruiter etc
I am not a fan of either personally but just wanted you to be aware.

 

[Iamnew2]

Lots of telemed companies out there that are looking for virtual disability exams, consults, expert opinions etc.
You have to reach out to local home health agencies and see if they are looking for a director. New home health companies open up all the time.
You can also use recruiters that specialize in that space. Also look at glassdoor, ziprecruiter etc
I am not a fan of either personally but just wanted you to be aware.

Those are excellent suggestions. Do home health agencies require physicians to be medical directors? And what is a reasonable fee for a home health med director?

 

[PMR2008]

Yes they do require physicians to be the medical director. The fees are all over the place. Depends on location, size of the agency and your experience. Can be 2500-7500 or more a month. Not a big money maker unless you are the medical director of a few. I know a physiatrist trained in palliative Med who is the Med director of a hospice. He rounds with a nurse and loves his work life balance.

 

[sloh]

Plenty of opportunities to work 3-4 days a week. Depends on what you want to do and if you prefer remote versus in person. I am happy to discuss each in detail if needed and I am listing approximate salary for each
1) Subacute full time 4 days a week(30-35 hrs) 350-400k
2) Part time outpatient doing EMGs, injections 3-4 days a week 200k
3) Part time inpatient consults 3-4 days a week 150k-200k
4) Intraoperative neuromonitoring 150k-200k
5) Medlegal - IME, disability exams, life care plans 200k+ but can take time to build up
6) part time academic - 100k-150k
7) Disability Management, Utilization Review 100k-150k
8) Telemed - 125-150k
9) part time VA - 100k-125k
10) Tech-startup industry
11) Medical director of home health
12) Part time working as medical director of Chiro clinic

Should be stickied! Thanks for taking the time to write this. It's informative even for me as an attending

 

[sloh]

Lots of telemed companies out there that are looking for virtual disability exams, consults, expert opinions etc.
You have to reach out to local home health agencies and see if they are looking for a director. New home health companies open up all the time.
You can also use recruiters that specialize in that space. Also look at glassdoor, ziprecruiter etc
I am not a fan of either personally but just wanted you to be aware.

Can you elaborate on why you aren't a fan of these?

 

[PMR2008]

Liability for home health. I would be a lot more comfortable being a Med director if I was primary care. Also lots of fraud in the home health space.
I am “old school” I guess regarding telemed. I don’t like make clinical decisions based just on imaging and symptoms. Need to put my hands on patients. But if I had no other choice I would do telemed. I would rather do chart review on a beach while making $500/hour.

 

[sloh]

What kind of fraud do you see in the home health space? Thanks!

 

[PMR2008]

Certifying patients that are not home bound, extending care, kick backs, over billing etc. long list. All you have to do is google home health fraud

10 popular health care provider fraud schemes

www.fraud-magazine.com

 

[9732doc]

Any telemed options open during training (residency/fellowship)? Like disability eval exams.

 

[PMR2008]

Any telemed options open during training (residency/fellowship)? Like disability eval exams.

No idea. You will have to reach out to local recruiters or look on the job boards. Typically they will give preference to board certified and experienced physicians.

 

[runfastnow]

Four year PM&R vs three year IM/FM residency
Typically IM going to be more comfortable with all the comorbidities that come with end of life care - but may be alleviated during fellowship.

Salary in academic setting - lowish 200s (based on a few friends who did academic palliative)
Palliative can be extremely emotionally taxing and can come with 24/7 call - so doing it as an "easy" subspecialty would not be my first choice.