The Ideal Job #illumedati 2

Hey everyone, it’s Medicine Mondays again. Today we’re going to ponder “The Ideal Job“.

The Ideal Job

Stock Photo from: Pixabay

Why a Unicorn?

Well, “The Ideal Job” is kind of like the Unicorn in that people chase after it, but it probably doesn’t exist.

That’s ok though. It’s an ideal, not necessarily something that can actually happen. I mean, every job has its advantages and disadvantages. However, just because your job is a certain way doesn’t mean it needs to stay that way.

For example, let’s look at what I would consider a “typical” physician job. Of course, these hours will be different based on specialty, but just bare with me.

You have a normal work schedule 8am-5pm or 8am-6pm or something like that, Monday-Friday. You are maybe on call one night a week and one weekend a month. Or perhaps you take your call one whole week at a time. In other words, you are kind of on a q4 weekly call schedule.

Then you may have vacation, maybe 3-4 weeks, maybe more, depending on specialty. So your call schedule is sometimes jumbled around because of a vacation and you may end up doing 2 calls weeks in 3 weeks time or something like that. Either way, it all evens out in the end.

I think for many this is a “normal” schedule.

But does it have to be?

I guess the first question you need to ask yourself is if that schedule is ok with you. If it is, then there is no problem, just continue on.

However, maybe you don’t want to take so much call anymore. Maybe you only want to do one week of call every 8 weeks instead of every 4. So the the next question you need to ask yourself is: How much is that week of call worth to you?

It’s probably worthwhile to sit down and try to calculate how much a week of call is worth to you? Maybe it’s worth $5000 or maybe it’s worth $10000. This is all specialty specific of course. Would you be willing to take a pay cut of $5000 or $10000 or whatever to take one less week of call? This answer as a young gun straight out of fellowship would probably be a resounding no. However, later on in your career, this may change.

Let’s say the week of call is worth $5000 for round numbers.

So then, in this example, you want to drop down to q8 weeks of call from q4 weeks. So you want to “buy” 6 weeks of call.

6 x 5 = 30

So in this example, are you willing to drop your salary by $30000 in order to decrease your call burden? Let’s say you make $250000/yr. Would you be willing to drop down to $220000/yr in order to have 6 less weeks of call a year?

Now then, $30000 is a lot of money. However, as a physician you are likely in the highest tax bracket. Every dollar over $200000 for an unmarried person is taxed at 35% for 2018. So that $30000 is actually probably only $19,500 in actual in your pocket money. When you spread it out over 12 months, you’re looking at an extra $1625 a month in your pocket. Of course, $1625/month is still a lot of money. However, if you didn’t have car payments and your student loans were gone, then this option becomes more enticing. Time is money, friend.



Basically, what I’m trying to say is that we don’t have to accept our current job as they are. There is always room for negotiation. Every year we stay with a hospital or clinic or HMO or whatever, reconsider your options and think about where you are in life. Small changes to salary can increase job satisfaction – and your quality of life.

I would imagine that physicians with high job satisfaction retire later than those with low job satisfaction.

For your administrators who do the hiring and firing and want to retain good doctors… I hope you’re listening. Good doctors will leave if you don’t value them.

Hmm… what else you got?

Well the above example is very simplistic. You can be creative.

Perhaps this year your daughter made the varsity swim team and all the swim meets are on Wednesdays. It doesn’t hurt to ask if you can take a half day on Wednesday or leave early on Wednesdays as long as you make up the time working a little late on a Monday or something.

Or maybe this year all the student loans are paid off. The cars are all paid off too. You’ve looked at your finances and determined that you can take a small salary decrease and not change anything in terms of lifestyle (or retirement). So, then consider dropping down to 0.8 Full Time Equivalent (FTE). Maybe this allows your to leave a little earlier from work everyday in order to beat the traffic, or it allows you to take every Friday off or something. Things can get a little difficult when it comes to call schedules, but nothing changes if you don’t ask and don’t try.

Things can get really interesting if you have a shift schedule.

For example, let’s say you work 7 days on, 7 days off. You and another colleague share this schedule. However, you are both getting older and the schedule is getting harder for you. Maybe consider the possibility of adding a 3rd. So then you all work 7 days on, 14 days off. Of course, this will decrease your pay significantly, however, you will have a lot more time off. In this example, 2 x $250000 = $500000 / 3 = $167,000  That’s a pretty big cut, but then you may be ok with that. It really depends on where you are in life financially.

Or another interesting idea is if you drop down to part time (0.5 FTE) and then hire another part time (0.5 FTE) to split the work. So in the above example, you would each work 7 days straight a month. Of course, you part timers make “only” $125,000/yr, but you would both have a lot more spare time. I think this kind of split is ideal for two people who are both transitioning to retirement in 5 years or so.

Good doctors are hard to find and very difficult to replace.

Your job may be more flexible than you think. Especially if you’ve been there for a long time and have a lot of social capital in your bank.

Life is short. Be Happy.

Anything else?


I haven’t gotten into the logistics of health coverage or retirement benefits, but those are things you would have to evaluate on a case by case basis. Some places may give you partial benefits, some may not give you any. There may even be a “cut off” where you do or don’t receive benefits (>0.6FTE for partial or something). This may be different for health coverage versus retirement benefits as well and would require some research/discussion with human resources on your part.

As always. Look before you leap.


The Ideal Job is like a unicorn… everyone looks for it, but it may not exist.

However, consider making small changes to your job in order to increase job satisfaction and quality of life.

Good doctors are hard to find and very difficult to replace.

Your job may be more flexible than you think.

Life is short. Be Happy.

Medicine Mondays Sensei


Agree? Disagree? Questions, Comments and Suggestions are welcome.

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