¶ Work-Life Balance in Medicine
That's a big complaint from a lot of doctors nowadays is there's always work that's causing you either to be get home late or you get home and you're still doing this work .
There are people who are like they just don't like the on-call sporadic nature . Anything can happen the middle of the night . It's not for everybody . So if people listening are like , oh yeah , you know , I want to just be off , and then this , that and the other , I'm like , that's fine . But you got to remember when you are on .
The heat is on , hit it Alfred . The heat is on , burn it .
This is Docs Outside the Box and this is what y'all say . Yo , we are both tired . I'm recording this when I am finishing a 12-hour shift and Renee basically has a continuous shift with these boys right now . So we both are tired .
If anybody sees me on YouTube right now , I look a hot higgity mess .
Your camera looks off . Your camera looks really off . It's like crooked or something .
Is it ? Maybe I'm not sitting directly in front of it .
What about now ? I don't know . I don't know . Either way , someone was messing with the camera while I was gone , alfred , fix me , fix me . So listen , since we're talking about me finishing a 12-hour shift . We got a good question from Jamar again . Long time listener . Jamar , keeping us in business yo yeah , he straight up be listening .
So , guys , Jamar is one of our long time listeners . He writes in all the time . We love listening to what he has to say because he has really really good questions .
So he's got a question .
He's got a question that says hey , Dr Darko's , it's Jamar again . Been a while since we talked and I just recently listened to episode four , 33 . I was wondering what specialties are most like you mentioned . Quote , unquote . When I'm on , I'm on . When I'm off , I'm off . End quote .
What surgical specialties specifically get you as close to this where I can leave my work at work ? I understand there are many different ways to approach this lifestyle , but just looking in general for how you rank specialties with a low possibility
¶ Docs Outside the Box Introduction
to high possibility , Good to hear from you all again . So that is from Jamar .
That's a good question hear from you all again so that is from Jamar .
That's a good question . So basically , it looks as though he's interested in specialties where , like listen , it's shift work , he gets in , he does his job and it doesn't follow him at . You know , follow him to home .
Which is a major complaint , that's a big complaint from a lot of doctors nowadays , is wherever you go , whether you are in clinic , whether you're in the hospital , there's always work that's causing you either to be get home late or you get home and you're still doing this work , whatever it may be , and that's that's a fear that a lot of people have ,
particularly the generation . That's two generations or you know , I don't know how to explain it , but maybe 10 years . Yeah , gen Z , they're more into lifestyle . We're just catching up . We're Gen X .
But they're really big into lifestyle . Yeah , they're thinking about it much earlier . Do you want to go first or do you want me to go first ? I mean I can go . I mean , ob certainly is one of those specialties where
¶ Jamar's Question About Specialties
you traditional way of practicing some of these specialties does not allow for when you're on , you're on . When you're off , you're off .
So you know , in OB that's carved out right , because the traditional way of practicing OB is full scope , where you go to office , you go to the delivery room , you go to the operating room , you're in the ER seeing patients there , you're doing consults on the floor , you're doing procedures in the office as well , you're ordering labs , you know more exam testing
and that's kind of the thing that keeps you right . All of that is what keeps the work at home right . It keeps the work going even at home , and that's what you know essentially . I experienced , and I know a lot of other doctors .
Experience is like listen , you know if you have a full day of office and you're seeing patients who are now double booked or triple booked because , let's face it , some of these hospital systems don't really care whether or not you're seeing ,
¶ OB Practice and Hospital Work
you know , one patient every 15 minutes or if you're seeing three patients every 15 minutes , they will double and triple book you . That is what keeps you at the office longer . That is what keeps you busier in terms of the tests that you've ordered , that now you have to , you have to follow up on .
So these are the things that keep your day just perpetuating . So when I work now because I've carved out a space for myself where I'm an OB hospitalist now I'm not doing all of that office work . I'm not doing planned surgeries anymore , I'm not doing office procedures . I only cover the labor floor and I cover the ER and I cover consults .
So I'm only in the hospital . So that's what's carved out for me , where I can say this is my shift , this is what I do on my shift , and when my shift is over , in large part I'm actually done and the hospital work stays at the hospital .
I was going to start off by saying there's tradition and then there's reality . at this point , I think the more traditional your specialty is , the more likely it's going to follow you home .
The more likely it's going to follow you home , and I think the easiest way to describe it is if you , if the majority of your patients you are , excuse me , if the majority of patients that you see are new patients that you have to work up and evaluate in a elective fashion .
That means you see them in clinic , you evaluate them in clinic , you diagnose them in clinic . There's a higher chance that it's going to follow you right , like it's going to follow you , not
¶ Emergency vs Elective Specialties
only inpatient wise , but are you going to take it home ? also , if the majority of your patients show up in an emergency fashion , I think that tends to be more shift-based type of work , right , because the majority of your stuff is someone came in for an emergency , you handle an emergency , they go home and then that's it , right .
So specialties that really focus on taking care of people in an emergent fashion , I think those are the specialties that you're really gonna see hey , you do your work and you go home . So examples ER , obviously . Trauma surgery , right . Hospitalist right , here's what OB , hospitalist , right . Anything that is a specialty and hospitalist is attached to it .
Orthopedic surgeon who's a hospital like , is a surgical list . They call them surgical list , right . Even general surgeons who just take care of surgical list , they call them surgical lists , right . Even general surgeons who just take care of surgical emergencies , they call them surgical lists also . Or acute care surgeons .
Those are the specialties that you really are going to find it easier to say , hey , I want to do what I want to do in the hospital , I want to take care of people , and then when I'm out , I'm out and it works really well , right , and you have not only years of this , but you got probably have multiple decades of folks working in this fashion , where it's
not too much of a shock cardiothoracic surgery , even just elective general surgery right . Where the majority of your patients are coming from referrals . You got to be there in clinic , which means that you're going to be ordering labs . You're going to be ordering tests . You're going to be ordering imaging that a lot of times may not come during office hours .
They're going to come after hours .
Mm-hmm or days later .
Fair enough . You need to check those to make sure that hey , make sure that nothing is crazy and that someone needs to go to the hospital in the middle of the night . You need to be there to make sure that those are going through . So it's a problem . You know there's a lot .
I mean we call it information overload , right , like there's just so much information that you have to handle while you're of the patients you saw were in a clinic setting and you enjoy taking care of patients and seeing them in a clinic , but the follow-up was a pain in the ass .
And I think even I was just like damn , like how much labs is somebody going to be checking after hours ?
Can we watch a movie without your computer ?
open . Can I have Duria Pua without you , like ? My Duria Pua is coming up all messed up , man . My susspua is coming all messed up because you looking at labs when you should be making my rice . That was real sexist on you , wasn't ?
it Well , do you make that dish ? Do you make ?
those dishes . No , I don't make that dish Exactly .
You're just talking about a reality of our household , but you know as much as , Like . I just want to be clear , though right , as much as it might seem very interesting and very attractive to do this acute , basically what we're doing talking about is acute care . Right , that people come into the acute set , you know , come in as an acute case .
Right , they come in because they have an actual issue that cannot be seen outpatient . As much as that might be attractive because of the schedule , you've got to understand that the work also has to be attractive , Right , oh
¶ The Reality of Acute Care Medicine
?
yeah , you got to be passionate about this .
Right . So the work has to be and not just like I'm not just talking about passionate being a doctor , I'm talking about passionate about a doctor . I'm talking about passionate about working in that setting right , because there are people who are like don't like being on call .
They just , they just don't like the , the on-call sporadic nature , the anything can happen the middle of the night that there are people who just don't like that and they're like listen , we see , we see that all the time .
Yeah , I see that , I see that when I'm at , when I'm at trauma programs that have residencies associated with it , I'll see residents who clearly have a talent for trauma , clearly are , are talented in that , and they'll tell me , doc , like I , I just don't want to deal with this like .
I don't like I don't like being able to not know what's coming through the door . I don't like the unknown , I don't like just kind of the jack of all trades , I just want to be really good at a couple of things and really really good at that . I don't want to have to know everything and that drives me nuts and I'm like dad , we lost one .
But it's the truth . I agree with you a hundred percent . It's not for everybody .
It's not for everybody . So , if you know , people listening are like oh yeah , you know I want to just be off and then this , that and the other . I'm like that's fine , but you got to remember , when you are on , the heat is on , Hit it , Alfred , the heat is on , Burn it , Right .
So you know , we just got to remember that when we are talking about the way that we work , part of the reason that we work the way that we work is because we enjoy that setting . Right , we actually do enjoy that setting . I enjoy being there for deliveries . I enjoy doing emergency surgeries Like I enjoy doing that .
I enjoy kind of the unknown , like okay , I don't know what the heck is coming through the door . It can be very scary for people , right , it can be a very like a really big source of stress for people who really , just , they're like I don't like running to the danger . I'm okay preventing the danger , but I don't want to run to it .