I quit, and it's awesome

[miacomet]

I quit and it's awesome. Yes, I wish I had more money, mainly because I'm not a huge fan of my house, but the lack of work stress, the regular hours, the freedom...intoxicating and relaxing.

Giving myself three to six months of R&R and then we will see if locums/new job appeals.

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[bravotwozero]

I am truly happy for you. Get lots of exercise, eat good food, and spend time with the ones you love.

Keep us informed!

 

[NYEMMED]

Congratulations! Hope you find some balance!

 

[Brigade4Radiant]

Congrats if you do locums how many more shifts are you going to do

 

[miacomet]

Thanks @bravotwozero (you are always one of my favorite posters). I'm skiing, snowshoeing a ton.

@Brigade4Radiant I'm not sure. Now that I've realized I *can* survive for a decent while without working, it's hard to convince myself to work. The hours credentialing, doing nightshifts again, dealing with admin and toxic colleagues (not EM colleagues!) makes it less and less appealing. It's such a thankless and high risk field that from my new vantage point makes me question the cost-benefit analysis of working.

 

[PikminOC]

Thanks @bravotwozero (you are always one of my favorite posters). I'm skiing, snowshoeing a ton.

@Brigade4Radiant I'm not sure. Now that I've realized I *can* survive for a decent while without working, it's hard to convince myself to work. The hours credentialing, doing nightshifts again, dealing with admin and toxic colleagues (not EM colleagues!) makes it less and less appealing. It's such a thankless and high risk field that from my new vantage point makes me question the cost-benefit analysis of working.

Your wife is rich?

 

[dchristismi]

Congratulations. Now take a deep breath and try to resist the wanderlust. It's going to take time to recover.

 

[bky3c]

Welcome to the other side. Once I stopped/didn't have to anymore, I was amazed by how much I used to talk myself into putting up with. We're programmed for that since the pre-med years, and at work, everyone thinks it's normal. Life is too short, and no fancy house is worth that. Glad you're out there having fun!

 

[NYEMMED]

How many years are you out of residency?

 

[miacomet]

How many years are you out of residency?

14, 12 at this job

 

[miacomet]

Welcome to the other side. Once I stopped/didn't have to anymore, I was amazed by how much I used to talk myself into putting up with. We're programmed for that since the pre-med years, and at work, everyone thinks it's normal. Life is too short, and no fancy house is worth that. Glad you're out there having fun!

Were you EM? What did you do...after?

 

[miacomet]

Your wife is rich?

No...

 

[forchinet121]

14 years out of residency one should easily be able to take 6 months off and probably should do it for their overall well-being, hell should probably just work part time at that point that’s a long career of grinding

 

[miacomet]

Here are the mistakes I made:

1. I should have bought more house instead of what seemed affordable
2. I should not have paid off my mortgage
3. I should have invested 90% plus in the stock market instead of diversifying to bonds
4. I should have kept my rental properties, but they were the same kind of stress as ER, and it was too much at the time

It still worked out, but it could have been even better!

Other learning points:

No job, or career is safe, so diversify your income streams. Try and pick a field where you can be your own boss (hard in EM unless you are in Texas). Develop a nonclinical income stream as early as you can. Buy the house you want.

 

[bky3c]

Were you EM? What did you do...after?

Yes.

Financially... living off my spouse's six-figure income. Not saving much for retirement anymore because I have a good nest egg stashed away/growing in the stock market, which will be for both of us if the spouse ever decides to retire.

Otherwise... finished fixing up our old house to sell it, moved across the country, got two puppies and got way into dog training, more time with friends and family, traveling, reading, cooking, exercising, etc. Plus the very basics that we forget humans are meant to do, like sleeping at night, all night, every night.

 

[Birdstrike]

Here’s one to being free!

And Happy New Year!

 

[Franzd'Epinay]

I quit and it's awesome. Yes, I wish I had more money, mainly because I'm not a huge fan of my house, but the lack of work stress, the regular hours, the freedom...intoxicating and relaxing.

Giving myself three to six months of R&R and then we will see if locums/new job appeals.

Congrats!

Honestly, if you can afford to step away for 6 months, you can use this time to pivot into something different for the rest of your working life.

 

[Kryptocoin]

Congrats. Hope you get some time to relax and reflect on next steps. The only way I tolerate this job is by keeping my fees really high. If some doctor wants to see 2.5pt/hr for $200/hr, godspeed to them.

I haven't worked for less than $300 in years. When EM can no longer afford me, I will join the exodus.

 

[forchinet121]

Congrats. Hope you get some time to relax and reflect on next steps. The only way I tolerate this job is by keeping my fees really high. If some doctor wants to see 2.5pt/hr for $200/hr, godspeed to them.

I haven't worked for less than $300 in years. When EM can no longer afford me, I will join the exodus.

How many pt per hour do you see?

 

[Kryptocoin]

How many pt per hour do you see?

1.5-2

 

[Backpack234]

Congrats! And good to know how long you are out of residency. 10-12 years honestly seems like a good length for an ER doc. saying this as someone approaching year 5.

 

[miacomet]

Congrats!

Honestly, if you can afford to step away for 6 months, you can use this time to pivot into something different for the rest of your working life.

Open to new ideas! So far snowplow driver is the only thing that appeals.

 

[forchinet121]

1.5-2

So some are doing more work for less pay? Why would someone volunteer for more work for less pay than you? How are you finding these high paying jobs?

 

[miacomet]

Congrats. Hope you get some time to relax and reflect on next steps. The only way I tolerate this job is by keeping my fees really high. If some doctor wants to see 2.5pt/hr for $200/hr, godspeed to them.

I haven't worked for less than $300 in years. When EM can no longer afford me, I will join the exodus.

You know, I think I underestimated how much being underpaid really fed into this.

I worked at what was initially a unicorn job (1.5 pph, 60% of billing, no metrics) that morphed over 12 years into being paid less than the median EM wage with expectations of 99th%ile patient satisfaction and an increasingly toxic nursing and hospital culture. The perks were decent, and it's an area more exclusive than Denver (35 people applied for my position, minimum), but when the job became toxic and the salary went down, what was the point? It took more than it gave.

 

[miacomet]

Congrats! And good to know how long you are out of residency. 10-12 years honestly seems like a good length for an ER doc. saying this as someone approaching year 5.

I only worked 1200-1400 hours for the last couple of years, but it was a small group (15 or so docs) and covered two hospitals; the nights and weekends were therefore pretty heavy, which was an issue.

 

[WilcoWorld]

Here are the mistakes I made:

1. I should have bought more house instead of what seemed affordable
2. I should not have paid off my mortgage

Buy the house you want.

This is a theme...please build on it.

Are there numbers you've run? Or is this more of a "values" decision?

Inquiring minds want to know.

 

[WilcoWorld]

Congrats! And good to know how long you are out of residency. 10-12 years honestly seems like a good length for an ER doc. saying this as someone approaching year 5.

I don't disagree. Seems like a shame though, right? To expend all this work and talent then quit with decades of productive time left?

Stated otherwise - how does someone with the drive and aptitude required for becoming a BCEP just stop working after 10 years and not go crazy?

Don't tell me you put all that energy into making sourdough starter.

Yes.

Financially... living off my spouse's six-figure income. Not saving much for retirement anymore because I have a good nest egg stashed away/growing in the stock market, which will be for both of us if the spouse ever decides to retire.

Otherwise... finished fixing up our old house to sell it, moved across the country, got two puppies and got way into dog training, more time with friends and family, traveling, reading, cooking, exercising, etc. Plus the very basics that we forget humans are meant to do, like sleeping at night, all night, every night.

One shouldn't have to retire in order to sleep

Thanks @bravotwozero (you are always one of my favorite posters). I'm skiing, snowshoeing a ton.

@Brigade4Radiant I'm not sure. Now that I've realized I *can* survive for a decent while without working, it's hard to convince myself to work. The hours credentialing, doing nightshifts again, dealing with admin and toxic colleagues (not EM colleagues!) makes it less and less appealing. It's such a thankless and high risk field that from my new vantage point makes me question the cost-benefit analysis of working.

Great time for snowshoeing. May your ability to enjoy sporting in such weather put you in auspicous circumstances to find a good life going forward!

 

[miacomet]

This is a theme...please build on it.

Are there numbers you've run? Or is this more of a "values" decision?

Inquiring minds want to know.

So I ran the numbers and it should be OK, if not...stellar, but EM isn't terribly well paid for most folks, so it's not usually stellar, I guess. That is, if I can ever figure out how to cash out my pension. Except for the house. That I can't fix unless I go back to work, which I may at some point, I don't know.

As to values, my system became more and more corporate and the department more and more toxic and the pay worse and worse and it just led to some level of burnout.

 

[xaelia]

2.5 years into the New Zealand semi-retirement, I find it still does a nice job of checking the boxes of decent pay for the time/effort invested, and dramatically lower stress levels during shifts – except when clinically engaging and challenging cases show up! (which is the fun part of what we do, isn't it?)

I'd highly recommend entertaining the idea of doing some locums in NZ or AUS as a way to get a break while still remaining connected to EM scope and skills.

 

[RustedFox]

So I ran the numbers and it should be OK, if not...stellar, but EM isn't terribly well paid for most folks, so it's not usually stellar, I guess. That is, if I can ever figure out how to cash out my pension. Except for the house. That I can't fix unless I go back to work, which I may at some point, I don't know.

As to values, my system became more and more corporate and the department more and more toxic and the pay worse and worse and it just led to some level of burnout.

You had a "unicorn" gig, too (if I remember correctly).

Just goes to show, kids... that "dream job" of yours can go from perfect to dog$hit really quickly in EM.

 

[BoardingDoc]

You had a "unicorn" gig, too (if I remember correctly).

Just goes to show, kids... that "dream job" of yours can go from perfect to dog$hit really quickly in EM.

Agree with that sentiment. That said, I think there's a lot of "thinking that what we have is perfectly fine" that EM docs do when in reality it isn't. I remember some old posts from mia where they kept posting about how they had a unicorn gig and then posted some details about it and my immediate thought was: "ummm, that actually sounds pretty mediocre at best." I think that @miacomet fell victim to the idea that if you aren't actively being whipped during a shift, it must be a pretty good gig.

The fact that this is a common mentality among EM docs certainly says something about the state of our profession.

 

[Mbekweni]

Sabbatical for a few months to a few years with some amazing life adventures and experiences sounds great. So much easier to achieve than financial independence retire early 5-10 years out from residency. Even some alternative strategies like working 2-4 shifts in a row then flying off to a lower COL area for a month or two could work if you don’t have an expensive stateside lifestyle to maintain. Doesn’t mean you can’t work again- just time to reset. I’m in the middle of a 7 day time off stretch and that alone feels amazing. Can’t even imagine what a longer time would do.

 

[RustedFox]

FWIW: after this week, I'm about to quit as well. Again.

 

[emergentmd]

For all of EMs warts, the flexibility is amazing not seen in many specialties.

I have been off for the past 3 wks when my kids were out of school. Currently doing 6or5x24hr shifts a month. Thinking about dropping to 4 a month but I get bored when I even work 5.

I coach my kids basketball team so just take off when they have practice/game.

Congrats to Op for getting out with the option to pick up a few if he needs it.

 

[forchinet121]

For all of EMs warts, the flexibility is amazing not seen in many specialties.

I have been off for the past 3 wks when my kids were out of school. Currently doing 6or5x24hr shifts a month. Thinking about dropping to 4 a month but I get bored when I even work 5.

I coach my kids basketball team so just take off when they have practice/game.

Congrats to Op for getting out with the option to pick up a few if he needs it.

Aren’t you like worth 10M+? Not really applicable to the rest of us

 

[BoardingDoc]

Aren’t you like worth 10M+? Not really applicable to the rest of us

Yeah and he works 24s in the FSED he owns. Emergent has a great gig but seems to think that his situation is generalizable (which it isn't) or that everyone else can have the same gig as he does (insert pulling oneself up by their bootstraps argument here)

 

[WorkNoteEmergency]

I am meeting with a financial advisor next week to go over my numbers. I‘ve decided to quit in June. Likely I won’t be able to quit entirely but want to get an idea from the FA how much income loss I can withstand. Based on that I will likely do PRN at the current job or more likely 3-4 shifts/month locums.

All the little indiginities and annoyances of our job have become intolerable for me. The sleep disruption, the apathy, and often outright hostility, of corporate “leadership”, the ****ty work conditions, the never ending flood of patients who are more and more complex have broken through my resolve. It was all okay when the money was good, I was younger, and I seemed to have the respect of colleagues and leadership. Now, even though I really should work another 2-3 years for a more worry free retirement, I will gladly trade the stress of all this crap for having to worry a little bit more about money. OP I’m glad it has worked out well for you and really hope my experience will be the same!

 

[forchinet121]

I am meeting with a financial advisor next week to go over my numbers. I‘ve decided to quit in June. Likely I won’t be able to quit entirely but want to get an idea from the FA how much income loss I can withstand. Based on that I will likely do PRN at the current job or more likely 3-4 shifts/month locums.

All the little indiginities and annoyances of our job have become intolerable for me. The sleep disruption, the apathy, and often outright hostility, of corporate “leadership”, the ****ty work conditions, the never ending flood of patients who are more and more complex have broken through my resolve. It was all okay when the money was good, I was younger, and I seemed to have the respect of colleagues and leadership. Now, even though I really should work another 2-3 years for a more worry free retirement, I will gladly trade the stress of all this crap for having to worry a little bit more about money. OP I’m glad it has worked out well for you and really hope my experience will be the same!

You have a financial advisor managing your finances? Has that been good I’m your experience?

 

[emergentmd]

Aren’t you like worth 10M+? Not really applicable to the rest of us

You must have missed the point. It has nothing to do with net worth. Just pointing out EM can easily dial it down once they are financially secure.

If I were single, I could work half time and still be financially set.

 

[miacomet]

You must have missed the point. It has nothing to do with net worth. Just pointing out EM can easily dial it down once they are financially secure.

If I were single, I could work half time and still be financially set.

Yeah, I should pick up a few shifts in a few months, but I will likely have to travel (I'm pretty sure I'll get a great reference from my job, but I didn't offer prn there and they didn't ask). Not sure if I'm up for learning a new system and for new headaches.

 

[Fox800]

I'm only a few years out of training and I'm already stepping away from EM. In the past 2-3 years, I've accumulated more gray hairs than ever. We were sold a sh#t sandwich. When I graduated, everyone was pulling $250-300/hr in Texas and the midwest. No issues with nursing, boarding, etc. Resources aplenty, transferring wasn't a problem.

Now it simply is. Not. Worth it.

High $100s-low $200s/hr to deal with full waiting rooms, sh&t patient attitudes, slow nursing, apathy from the public/admin (who give negative F's about solving problems). Skyrocketing volumes, and increasingly meaner patients, on top of inflation. Inflation with stagnant wages equals a pay cut, lest we forget.

Every shift, it's do more with less. Keep the status quo but less rooms. Less nurses. Fewer supplies. More difficult transfers. More patients in the waiting room. More PCP's "out of town", "on vacation" or unable/unwilling to see their patients for minor stuff. So now I have to play PCP on top of everything else. Urgent cares sending in ridiculous things like simple lac repairs, perforated TMs, "fever of 103" in a well-appearing child with a URI, etc.

This is not what we signed up for.

EDs in my area are paying crap wages that they are saying have bonuses, and they don't take my word for it that telemedicine jobs are paying the same or more per hour. Yeah, no thanks. I'll chill in my sweatpants and see patients on my laptop while I drink my Nespresso gingerbread coffee, thankyouverymuch.

I've dialed down to five shifts a month. I only give day shift availability. No nights. No holidays. No weekends. (Unless it suits me for some reason).

Not sure if I'm going to make the move overseas (Australia, NZ, Canada), go 100% telemedicine/remote, try to find a VA/IHS job with good benefits, lower volume, and sovereign immunity, or do a fellowship in something else.

I'm outtie.

 

[miacomet]

Agree with that sentiment. That said, I think there's a lot of "thinking that what we have is perfectly fine" that EM docs do when in reality it isn't. I remember some old posts from mia where they kept posting about how they had a unicorn gig and then posted some details about it and my immediate thought was: "ummm, that actually sounds pretty mediocre at best." I think that @miacomet fell victim to the idea that if you aren't actively being whipped during a shift, it must be a pretty good gig.

The fact that this is a common mentality among EM docs certainly says something about the state of our profession.

My job was total unicorn for the first three years, decent for the next three, OK for four more, then the pandemic AND a change in leadership came. Its main unicorn-ness now is location- literally everyone wants to live here, it's a very exclusive and popular area, although weirdly it's becoming an issue hiring people because it's so insanely expensive- they mostly get 50+ hobbyists applying these days.

Pandemic itself was not a huge deal- tourism dropped off, so our numbers shrank, too, and it was more than manageable until last summer; it's an integrated health system, so transfers were almost never an issue. Community is highly vaccinated and very healthy. I wanted to quit after the leadership change, but that was winter 2020, and when the pandemic hit, there just wasn't anything else out there, there was nothing else to do aside from work, and they pretty much kept us whole financially, so I stuck it out until last month.

Like every other job, it's now all patient satisfaction; administration expects no complaints, 99%ile pt satisfaction, and there is a very toxic nursing culture at one site, and the pay is awful, which they try and ameliorate with fancy parties, endless free food, and an awesome pension. So no longer a unicorn except for the location, which is extremely desirable.

 

[HemorrhagicShock]

Yeah, I should pick up a few shifts in a few months, but I will likely have to travel (I'm pretty sure I'll get a great reference from my job, but I didn't offer prn there and they didn't ask). Not sure if I'm up for learning a new system and for new headaches.

Congrats! I was wondering if you could expound a little bit more on the quitting process. How far in advance did you let your group know? It seems like this was amicable in some senses, but in a small group, the loss of one full-time partner can be pretty darn devastating to the schedule. I assume being in a desirable location made it easy to "replace" you?

How did your director and/or partners take the news? I can imagine immediate hostility and/or subtle coldness in interactions after dropping the news until you actually leave. Maybe getting the weekend/overnights by the scheduler "accidentally." Granted I wonder if these are just me projecting my own experiences with my group if I were to choose your path!

Thank you for your OP and for posting your experience in general because I don't know how much more I can take of working in this "specialty" and routinely fantasize about doing what you did this weekend!

 

[GonnaBeADoc2222]

FWIW: after this week, I'm about to quit as well. Again.

Storytime???

 

[miacomet]

Congrats! I was wondering if you could expound a little bit more on the quitting process. How far in advance did you let your group know? It seems like this was amicable in some senses, but in a small group, the loss of one full-time partner can be pretty darn devastating to the schedule. I assume being in a desirable location made it easy to "replace" you?

How did your director and/or partners take the news? I can imagine immediate hostility and/or subtle coldness in interactions after dropping the news until you actually leave. Maybe getting the weekend/overnights by the scheduler "accidentally." Granted I wonder if these are just me projecting my own experiences with my group if I were to choose your path!

Thank you for your OP and for posting your experience in general because I don't know how much more I can take of working in this "specialty" and routinely fantasize about doing what you did this weekend!

I tried to keep it really amicable. I mean, they threw me a huge, fancy party at a resort so I hope so. Filling my shifts wasn't an issue, but they might have taken it personally, I don't know. There were over 35 applicants for my position, so that was not an issue at all.

I called my director and let him know. He was SHOCKED as I'd been there 12 years, which is...a lifetime in EM. I basically said it's me, not you, and asked him what would work for the group regarding with my last day, and he said whenever you want, so I just kept all my shifts so as not to leave them in the lurch for Thanksgiving. I would have stayed a few more weeks but I decided it was safer just to work my assigned shifts due to the concerns you listed re: nights and weekends. It was about 120 days notice. There was no notable hostility, although some jealousy and confusion.

The sad thing is there just isn't much of a market for burnt out ER doctors. I'd like to work in something, but we aren't NPs, retraining is hard.

This weekend? Snowshoeing, maybe skiing, we will see. Sleeping for sure. I think I will be OK financially, but wow not getting free food, health insurance, and gift certificates is cutting into the bottom line, and well winter activities are pricey, as is the equipment. We'll see.

 

[CoolDoc1729]

I tried to keep it really amicable. I mean, they threw me a huge, fancy party at a resort so I hope so. Filling my shifts wasn't an issue, but they might have taken it personally, I don't know. There were over 35 applicants for my position, so that was not an issue at all.

I called my director and let him know. He was SHOCKED as I'd been there 12 years, which is...a lifetime in EM. I basically said it's me, not you, and asked him what would work for the group regarding with my last day, and he said whenever you want, so I just kept all my shifts so as not to leave them in the lurch for Thanksgiving. I would have stayed a few more weeks but I decided it was safer just to work my assigned shifts due to the concerns you listed re: nights and weekends. It was about 120 days notice. There was no notable hostility, although some jealousy and confusion.

The sad thing is there just isn't much of a market for burnt out ER doctors. I'd like to work in something, but we aren't NPs, retraining is hard.

This weekend? Snowshoeing, maybe skiing, we will see. Sleeping for sure. I think I will be OK financially, but wow not getting free food, health insurance, and gift certificates is cutting into the bottom line, and well winter activities are pricey, as is the equipment. We'll see.

I work mostly weekends and all but one weekend each month, so every month I have a 8-10 day gap in shifts - by the end of my gap I am fairly keen to go back to work even though work kind of sucks - I have a lot of hobbies and four kids and I like my husband, so I don’t think it’s just boredom per se , but I wonder if you feel anything like that? Or just glad to be out of the situation? Do you miss any part of your job?

 

[RustedFox]

Storytime???

All the stuff we already know.
We're stuck in the middle between patients who are totally ostriched, admins who are endlessly greedy, and attorneys who are looking to take advantage of anything.

My shop literally drowns every shift these days.

People are laying down in the waiting room. A patient called the unit coordinator and asked: "Is you guys real busy now, or should I come by ambulance?"

An IM subspecialist said to me: "We can't keep doing this you know; you're admitting too many patients." I shot back with: "Then stop sending them here for admission and take care of them in the outpatient world." I stopped just short of adding " - you dumb fugging (ostrich)."

The nurses at the hospital just across the way all walked out in the middle of their shift the other day. I was hit with an unstemmable tidal wave of patients as a result.

I need to go to a patient safety committee meeting because a patient accused me of assault by putting her in an armlock. She filed a police report. The police came, found the security camera footage. Nothing even close. Nothing inappropriate. Diagnosis? Crazy woman wanted attention, and narcotics... which I would not give.

I drove north on the highway home and passed the ambulances transporting MY patients to hospitals 5+ counties away.

Meanwhile, the goblins at Gringott's just tell us to work faster and harder, so the stock price stays up.

 

[emergentmd]

I tried to keep it really amicable. I mean, they threw me a huge, fancy party at a resort so I hope so. Filling my shifts wasn't an issue, but they might have taken it personally, I don't know. There were over 35 applicants for my position, so that was not an issue at all.

I called my director and let him know. He was SHOCKED as I'd been there 12 years, which is...a lifetime in EM. I basically said it's me, not you, and asked him what would work for the group regarding with my last day, and he said whenever you want, so I just kept all my shifts so as not to leave them in the lurch for Thanksgiving. I would have stayed a few more weeks but I decided it was safer just to work my assigned shifts due to the concerns you listed re: nights and weekends. It was about 120 days notice. There was no notable hostility, although some jealousy and confusion.

The sad thing is there just isn't much of a market for burnt out ER doctors. I'd like to work in something, but we aren't NPs, retraining is hard.

This weekend? Snowshoeing, maybe skiing, we will see. Sleeping for sure. I think I will be OK financially, but wow not getting free food, health insurance, and gift certificates is cutting into the bottom line, and well winter activities are pricey, as is the equipment. We'll see.

Have you thought about just doing telehealth? There are PRN, full time, and part time jobs avail I believe. If money was not a big issue, and just need 100K spending money and something to do, that would be like working 20 hrs/wk in your pajamas at a low end $100/hr.

I know tele med can suck and a script mill but they typically are low risk pts who just want a script or work note.

Lifestyle would be fantastic. Work as much as you need/want to pay for travels.

Also, If I were single, I would do Cruise medicine and get free traveling.

 

[forchinet121]

Have you thought about just doing telehealth? There are PRN, full time, and part time jobs avail I believe. If money was not a big issue, and just need 100K spending money and something to do, that would be like working 20 hrs/wk in your pajamas at a low end $100/hr.

I know tele med can suck and a script mill but they typically are low risk pts who just want a script or work note.

Lifestyle would be fantastic. Work as much as you need/want to pay for travels.

Also, If I were single, I would do Cruise medicine and get free traveling.

How do you do a physical exam on telehealth?

 

[RustedFox]

How do you do a physical exam on telehealth?

That's the neat part; you don't.