The match is complete and now the 4th year
medical students are preparing to make their move to residency and chief residents
are preparing to start their new career as an attending. The next phase of their
lives are about to begin.
The match got me thinking about a comment I read recently
from a doctor who decided to not become a general surgeon, which she had always
wanted to be, and switched instead to a specialty that had a “better home
It is a misconception that general surgery doesn’t have a
good home life. There is no specialty that has or does not have a good home
life. The home life you have is determined by you and how you organize your
life, not by the specialty you choose. Yes, some specialties have more call,
but that alone will not ruin your home life.
I was a general surgeon in private practice for 20 years.
Then I became a locums surgeon for three years. Both afforded me a good home
life because I wanted to have a good home life and made it so.
When I first came to town, my partners made rounds and took
care of their own patients on the weekends if they were in town, and they expected
me to do the same. That was not what I wanted. I wanted to have the weekends
off if I was not on call. I knew this was a battle I could not win. So I took a
different tact. I bought a motor home.
With the motor home, I was able to check out to whoever was
on call and take my family away for the weekend. When I bought the rig my kids
were nearly three and one. We often went camping at a campground just outside
of town. We purchased an inexpensive, used motor home, with 47,000 miles. But
it gave me my weekends off with my family, which was my goal. Four years later,
after hiring another surgeon, we changed the weekend coverage. Whoever was on
call for the weekend would cover for all surgical patients.
When my kids needed a soccer coach on the U-8 soccer league,
I volunteered. Games were on weekends and I could set the weekday practice
days. Tuesday was my day out of the office and on Thursday, my operating day, I
was done by three. So practices were Tuesday and Thursday at 4pm. I asked to
not be on call on Thursdays during soccer season. I had a parent who could be
my backup if there was ever an emergency that kept me away. I really enjoyed
being a youth soccer coach.
We chose to buy a house that was close to my office and
close to the kids’ school. It was a choice we made for a better home life. When
my kids had a school event, I could duck out of the office, see their part of
the program, and get back to the office before anyone missed me. Many doctors
choose to buy their house out in the country, which meant their kids went to the
county schools which are a long way from their offices in town. Having my house
close to work also gave me a short commute, enabling me to spend more time with
my family. I was even able to make it home for lunch several times a week.
Weekend call was Friday at 7am to Monday at 7am. After my 72
hour call weekends I was usually very tired and had lots of clean up to do on
Monday. Other doctors with the same schedule had their Monday fully booked and
had to work their weekend add on cases into an already full day. I took that Monday
off, which cost me some income, but it gave me some breathing room. If the
weekend was light, I spent the day off with my family. If it was a tough
weekend, I could finish the work from the weekend and go home to sleep.
We chose to pay off all our debt and become debt free. Which
meant I could take a lot more time off, as I didn’t need money to make payments
on the house, cars, credit cards, etc. Others chose to run up debt by
purchasing toys they just had to have. Without the debt I was able to take 12
weeks of vacation a year. I chose a lower income for a better home life.
I had always wanted to be in a play. I auditioned and was
cast in On Golden Pond at our local theater. I made a deal with one of my
partners to trade call. He took all of my call for 12 weeks so I could be at
all rehearsals and every performance. After the show closed, I took all his
call for 12 weeks. I came up with a way to do both my job and something I
really wanted to do for fun.
As you can see, I could have missed out on many things and
claimed that general surgery was bad for my home life. But I found ways that
made my profession work well with my home life. You can too.
When you become an attending it is you who chooses where you
will live. You can live close to the hospital, or the office, and have more
time with your family, or you can live out in the country and not see them as
much. If you have a long commute, is that the specialty’s fault or yours? You
can’t believe how many times someone has told me they “had to” buy a house out
in the suburbs and have a one hour commute because of some special circumstance.
Then they complain about their work hours keeping them from their family.
You choose the size and expense of your house, how much you
spend and how often you buy a car, and which toys you acquire. Your debt burden
is completely within your control. Now is the time to decide what kind of life
you want. A big house, expensive cars, and lots of toys equal many hours
working to finance these luxuries. A modest home, reliable cars and toy
purchases, only after becoming debt free, will grant you more time with your
family and a less stressful life.
I have seen many doctors who have made poor choices blame their
lack of family time on their job. They spend their free time working extra
shifts to earn more money to spend on new toys, a bigger house, or a special
vacation. While their family is at home wishing they could spend more time with
them. It’s time we took control of our lives and do the right thing. Create a
working environment in which we and our families can thrive.
In the recent Medscape burnout report, general surgery had a
burnout rate of 46%. Pathology had a burnout rate of 33%. If it was the specialty driving the issue,
pathology should have a very low burnout rate. Pathologists have little to no
call, they never deal with dying patients, and they have extremely low stress.
Yet 1 in 3 pathologists are burning out.
It is not the specialty that is the biggest detriment to
becoming burnt out or to a poor home life. Make your family a priority. Make
your home life a priority. If you make them important, and not just say they
are important, then you will have a great life as a physician no matter what
specialty you choose.
So choose the specialty that you like the best, with no
regard to its perceived home life or income. Make your home life what you want
and take control. Even employed physicians can have a very nice home life with
a little negotiating.
Take control of your
don’t let your job
If debt is causing you to work extra hours, then get a copy of The Doctors Guide to Eliminating Debt and take control today. You deserve it.
How about you? What have you done to take control of
something in your life or practice?