Comparing notes on what to look for in an employer, and how great reasonable hours are.


I went with a friend for a bite,

As the afternoon turned into night

    Comparing job notes

    Benefits, values, and quotes,

And the value of leisure delight.

Twenty-four hours ago I put data into a web site called DocCafe, which helps doctors looking for work get in touch with employers and agencies.  An avalanche of email followed.

I emailed my CV right and left.  Over lunch I spent two hours and all of my cell phone’s voltage talking to recruiters.

I spoke directly.  The ratio of jobs that fell through to jobs that panned out runs 8:1.  Yes, I said, go ahead and present me but I’m working with more than one recruiter.

After my lectures I met a friend for a sandwich.  Rebecca knew our daughter Aliya in college; she lived in Sioux City for two years and in that time befriended Bethany and I.  She lives in Lower Downtown Denver now, and, like me, finds herself between jobs.

We compared notes.  She commented on the importance of employer appreciation, and that interpersonal respect, money and benefits much be considered as a whole package.  I talked about my job during my premed years at Cybertek, the software firm that did United American Life’s computer work in a building four blocks from where we sat (the building has since had an appropriately committed relationship with a wrecking ball).  They trained me, paid me $.80 above minimum wage, let me study while I worked, and let me eat the leftover breakfast pastries.

Later in the evening I ran into an ex-partner.  Rick left our Sioux City group in 1993 to move to Greeley.  Recently a hospital purchased his practice, he stopped doing OB and making hospital rounds.  Now that he doesn’t get awakened in the middle of the night, he gets good sleep on a regular basis, and has more time.  He feels rejuvenated.  Actually he says he almost feels like he retired. 

When we shared our views, I commented on how much happier I am now that I’m not the boss, and we both talked about how we work too much, but how much we love the work.

The topic eventually came to accessibility of medical care.  Yes, we agree, all these things that we’re doing result in more leisure for us, but if all the doctors had a sudden attack of sanity and stopped working those life-shortening overtime hours, there wouldn’t be enough doctors.  And especially there wouldn’t be enough family practitioners.

I presented my plan: eliminate the premed requirements; democratize the pre-clinical med school years and put the information on the net for free.  Anyone who can pass Part I of the Boards should be allowed to continue into a clinical program. Those last two years of med school would be extended from two to two and a half years to cover everything relevant in premed and those skills that cannot be taught by computer (interviewing and physical exam).  Current medical schools, for a price, would teach those students who don’t do well with distance learning.  The result would be a much larger number of doctors willing to work fewer hours for less money. 

We agreed about the feasibility and improbability of such a scheme.

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2 Responses to “Comparing notes on what to look for in an employer, and how great reasonable hours are.”

  1. Vaguely Crazy Says:

    Why do doctors work such random and crazy hours? I always wondered why hospitals keep the staff low at night and just rely on calling in health care workers when necessary. If most doctors work on salary, wouldn’t it make more sense to just have them all there at a set time every day?

    Of course, I understand being an OB doctor wouldn’t work that way since labor can’t always be timed correctly.

    I think your idea of democratizing the classroom portion of med school is amazing! Have you ever considered going into medicine policy or even seeking a position at a university to see if they can run a pilot program in that way? It seems if just one university were able to show even a margin of success, it might take off and become the model of medical education. Self-learning takes a lot of intelligence and discipline – characteristics which are vital for a career in medicine, I presume.

    • walkaboutdoc Says:

      Doctors work random and crazy hours because they invest a really expensive decade of their lives (their 20’s) to get to that position. Once the capital asset has been paid for, we like to maximize the return.

      If you put all the doctors on salary (and bear in mind I’m tending towards that model), you face the economic changes you get every time you go from production to hourly. If one brings home the same salary whether one works hard or not, one faces a personal disincentive to work hard. On a personal basis, when I went from straight salary to production I worked a lot harder and a lot more hours. In the long run it’s bad for the doctor but good for accessibility to medical care.

      Whatever model one uses, people will continue to get sick in the middle of the night, and will continue to need medical care when the doctor would rather be sleeping. Our ERs are staffed by docs who want those hours, and a lot of those docs work at night so that they don’t have to face a dysfunctional marriage.

      Strangely, most but not all deliveries can be timed with no medication.

      Sure I’ve thought of going into policy or academic medicine, generally for about four seconds at a time. I’m good at what I do and I don’t know that I’d be good in academia. With the growth of computer-based learning, I’m certain the online preclinical medical education will start soon, probably in the Caribbean.

      Change will come gradually and will face immense resistance because medical schools would face an existential crisis.

      I agree, it wouldn’t take much to start an avalanche and put a lot of professors out of business

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