Doctors Need A Four Day Work Week

doctors need a four day work weekWorking in the healthcare industry is hard. Stress hits you in all levels. Burnout rates are high. Job satisfaction has slowly declined over the past 20 years due to a number of external factors beyond the practice of medicine.

Take, for instance, the daily work of an intensive care unit (ICU) nurse. Patients in the ICU are sick. Many of them die. The nurse is responsible for monitoring these patients for health changes. He is responsible for changing the bed sheets, cleaning ventilator tubing, cleaning the patient, and changing dressings. This job is physically demanding and tough on your feet, back, and arms. It is emotionally and psychologically draining due to the degree of illness you are surrounded by. It is demoralizing when you make mistakes or are yelled at. The fluorescent lights in the hospital are depressing. They do burnout. For the level of shit that nurses deal with, I am grateful that nurses are available to help us out. 

However, nurses are almost always contracted on a hourly rate. A standard work week is 40 hours, which can consist of four 10-hour shifts. I have seen options for three 12-hours shifts per week. Yes, shifts can last longer than you expect due to sign-outs and ten-hour shifts can become 11 or even 12 hours. That is the reality of medicine. You want to deliver good care. If you were the patient, you would be thankful that your healthcare worker stays longer to make sure appropriate care is handed off.

Doctors Are Likely To Burnout Even More

The one perk of being an hourly worker is that if you end up taking additional shifts beyond your designated time, you can potentially receive overtime pay. That’s right. Time and a half. You might argue that cleaning up an incontinent patient’s shit is worth more than time and a half, but at least there is additional compensation. Some doctors are paid according to shifts like Hospitalists and Emergency Room Physicians, but they are unlikely to receive a higher hourly rate for extra shifts.

Most doctors are compensated by the amount of care they deliver. That is stratified by the number of patients they care for, and the acuity of the diseases treated. It doesn’t matter how long it takes a doctor to care of the patient; they still get paid the same amount.*  With the evolution of the American healthcare system, doctors are compensated less while having to deal with ever increasing regulations that are often not even pertinent to healthcare. Sermo is a good reference forum for doctors to bitch about their problems. It is depressing to see what our profession now has to deal with.

In addition to decreasing compensation, doctors still have to deal with the usual stresses of the workplace. We deal with sick patients who sometimes die. We deal with family members and overbearing parents whose children are in the hospital. We deal with questionable lawyers who advertise on late night television who promise to sue doctors when modern medicine fails to prolong lives or cure all ailments.

Keeping a Sane Work Week May Be A Solution for Doctors 

While financial independence may be the ultimate solution to eliminate physician burnout, restricting the number of hours you spend with work may be a temporary solution. One of the best advice I’ve received from several retired doctors was that keeping a four day workweek was one of the best lifestyle decisions they’ve made. Yes, some employers don’t allow this. You might not make as much money. Sometimes working less will prevent you from advancing your career.

But it can make you much happier. I recently experimented with taking one day off a week at the expense of a slightly lower income. I am much happier now. The typical day in the hospital is stressful. Patients, no matter how informed, have questions. Patients are sick. Some misinformed patients are hostile. It is amazing how many personalities exist, and no matter how nice you are, you will be verbally abused by unreasonable patients.

Having a four-day week gives me a break from those stresses. I can actually take care of chores at home and run errands. I avoid losing an hour of my life commuting to and from work. Again, I do have a lower income than the majority of my peers and nearly all of my colleagues in the same field, but I still have enough to sustain a reasonable lifestyle. It will likely take me longer to achieve my F-You Money stash, but it is a sane balance.

Do you cut back on your hours at work to allow for more time with your family? What has your experience been at work? Sound out below!

 

 

*This is true for the most part, although some billing methods allow for doctors to bill for the amount of time spent to care for a patient to account for those complex cases that require additional discussion. I do find that time-based billing to be somewhat impractical since you end up having to spend a very long time before you can code for high level cases.

(Photo courtesy of Flickr)

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  • Hamster

    I definitely agree that doctors would be happier working less, and spending less, while enjoying life more. As a primary care doc, working full time, I make $200k a year. That is a stupidly high amount of money for anyone to earn, even if like me, you are paying off student loans and raising a family. It doesn’t seem like much when you compare to the radiologists and orthopedists I know, but seriously… 4 times the median US household income, with one working parent. That’s a lot of dough, in the grand scheme of things.

    I have been working full time (60 hours plus when you add it all up) since I finished residency 9 years ago, but burning out – billing, paperwork, EMRs, admin – the usual complaints. I am finishing a 6 month unpaid personal leave from work. which I requested – no mental health breakdown or anything, but I needed an extended vacation to reconnect with life. I am spending this month volunteering in a developing country. It has been wonderful.

    I think I have one or two more years of full time work in me, then I plan to go down to half-time or 60%.

    I have been saving pretty aggressively for the last several years, in a upper-mid cost of living area, and we easily live on less than half my salary at home. We paid off our mortgage last year using our relatively aggressive savings, so we need the income less and less. We buy used, decent cars – Honda and Kia, rather than Audi’s and BMWs, and live in a home that is about $150k above median for our area. Kids go to public school, and we do a fair amount of traveling – some funded by credit card sign up bonus miles and such. But, we cook good food at home instead of spending at restaurants, we hike, bike, and watch netflix instead of spending on movie theaters and cable TV subscriptions. We are still living pretty high on the hog, but not spending nearly as much as most Drs I know whose income mostly goes to lifestyle costs. Still, living a little more frugally lets us live on half what we earn, and we have saved up a stash so it will not hurt to cut way back on hours in the future.

    • Smart Money MD

      I actually know a few radiologists and orthopedists who don’t make much more than the $200k threshold! They are all in competitive markets. Yes, the MGMA reported data often states relatively high numbers, but I’ve wondered if there is a reporting bias. Combine a lowish doctor salary with a high cost of living area, and you’ve set yourself up for a long career. Most doctors and other professionals still do it. I would not.

      It’s great that your entire family is on board with the mindset. I’m only two years into full-time practice, and the non-medical side of practice has already become overwhelming. I think that experiencing this has helped motivate me to reach that level of F-You Money sooner and cut back. We don’t have kids yet, but when we get to that stage we’ve got to remind ourselves to spend on our kids intelligently as well.

      Kudos on the lifestyle. You’re on the right track to financial freedom. It has been challenging to see how our friends from school living high on the hog while resisting ourselves. But I keep reminding myself that everyone is in a different situation with different goals. It really doesn’t seem like much of any sacrifice if you are able to focus on low-cost activities that you enjoy.

  • Drsan1

    This post again raises the question to me. Work harder for a shorter period of time, or work easier for a longer period. I’m 9 years out and I’ve always worked as at least a 1.25 FTE….but getting tired. I’m a hospitalist and work 7on/off so it has been easy to work more with 7 days off. I made almost 400K with overtime/bonus/job change last year. No overtime will be around 300K. I’ve decided to try the no overtime this year, my kids are now middle/high school and want to be with them more before they’re gone. This year will feel like a pay cut…but I bet I’m gonna be much happier. We will see.

    • Smart Money MD

      That’s true. The sooner you can build up your investments, the sooner you will have the freedom to call it quits. Also depends on family obligations and just how tough your job is.

      It sounds like you have a good arrangement to have the ability to pick up extra shifts. I’ve heard that there may not necessarily be as many 7 on/7 off Hospitalist arrangements going forward.

      Keep me posted!