The match is complete and now the 4th year

medical students are preparing to make their move to residency and chief residents

are preparing to start their new career as an attending. The next phase of their

lives are about to begin.

The match got me thinking about a comment I read recently

from a doctor who decided to not become a general surgeon, which she had always

wanted to be, and switched instead to a specialty that had a “better home

life.“

It is a misconception that general surgery doesn’t have a

good home life. There is no specialty that has or does not have a good home

life. The home life you have is determined by you and how you organize your

life, not by the specialty you choose. Yes, some specialties have more call,

but that alone will not ruin your home life.

I was a general surgeon in private practice for 20 years.

Then I became a locums surgeon for three years. Both afforded me a good home

life because I wanted to have a good home life and made it so.

When I first came to town, my partners made rounds and took

care of their own patients on the weekends if they were in town, and they expected

me to do the same. That was not what I wanted. I wanted to have the weekends

off if I was not on call. I knew this was a battle I could not win. So I took a

different tact. I bought a motor home.

With the motor home, I was able to check out to whoever was

on call and take my family away for the weekend. When I bought the rig my kids

were nearly three and one. We often went camping at a campground just outside

of town. We purchased an inexpensive, used motor home, with 47,000 miles. But

it gave me my weekends off with my family, which was my goal. Four years later,

after hiring another surgeon, we changed the weekend coverage. Whoever was on

call for the weekend would cover for all surgical patients.

When my kids needed a soccer coach on the U-8 soccer league,

I volunteered. Games were on weekends and I could set the weekday practice

days. Tuesday was my day out of the office and on Thursday, my operating day, I

was done by three. So practices were Tuesday and Thursday at 4pm. I asked to

not be on call on Thursdays during soccer season. I had a parent who could be

my backup if there was ever an emergency that kept me away. I really enjoyed

being a youth soccer coach.

We chose to buy a house that was close to my office and

close to the kids’ school. It was a choice we made for a better home life. When

my kids had a school event, I could duck out of the office, see their part of

the program, and get back to the office before anyone missed me. Many doctors

choose to buy their house out in the country, which meant their kids went to the

county schools which are a long way from their offices in town. Having my house

close to work also gave me a short commute, enabling me to spend more time with

my family. I was even able to make it home for lunch several times a week.

Weekend call was Friday at 7am to Monday at 7am. After my 72

hour call weekends I was usually very tired and had lots of clean up to do on

Monday. Other doctors with the same schedule had their Monday fully booked and

had to work their weekend add on cases into an already full day. I took that Monday

off, which cost me some income, but it gave me some breathing room. If the

weekend was light, I spent the day off with my family. If it was a tough

weekend, I could finish the work from the weekend and go home to sleep.

We chose to pay off all our debt and become debt free. Which

meant I could take a lot more time off, as I didn’t need money to make payments

on the house, cars, credit cards, etc. Others chose to run up debt by

purchasing toys they just had to have. Without the debt I was able to take 12

weeks of vacation a year. I chose a lower income for a better home life.

I had always wanted to be in a play. I auditioned and was

cast in On Golden Pond at our local theater. I made a deal with one of my

partners to trade call. He took all of my call for 12 weeks so I could be at

all rehearsals and every performance. After the show closed, I took all his

call for 12 weeks. I came up with a way to do both my job and something I

really wanted to do for fun.

As you can see, I could have missed out on many things and

claimed that general surgery was bad for my home life. But I found ways that

made my profession work well with my home life. You can too.

When you become an attending it is you who chooses where you

will live. You can live close to the hospital, or the office, and have more

time with your family, or you can live out in the country and not see them as

much. If you have a long commute, is that the specialty’s fault or yours? You

can’t believe how many times someone has told me they “had to” buy a house out

in the suburbs and have a one hour commute because of some special circumstance.

Then they complain about their work hours keeping them from their family.

You choose the size and expense of your house, how much you

spend and how often you buy a car, and which toys you acquire. Your debt burden

is completely within your control. Now is the time to decide what kind of life

you want. A big house, expensive cars, and lots of toys equal many hours

working to finance these luxuries. A modest home, reliable cars and toy

purchases, only after becoming debt free, will grant you more time with your

family and a less stressful life.

I have seen many doctors who have made poor choices blame their

lack of family time on their job. They spend their free time working extra

shifts to earn more money to spend on new toys, a bigger house, or a special

vacation. While their family is at home wishing they could spend more time with

them. It’s time we took control of our lives and do the right thing. Create a

working environment in which we and our families can thrive.

In the recent Medscape burnout report, general surgery had a

burnout rate of 46%. Pathology had a burnout rate of 33%. If it was the specialty driving the issue,

pathology should have a very low burnout rate. Pathologists have little to no

call, they never deal with dying patients, and they have extremely low stress.

Yet 1 in 3 pathologists are burning out.

It is not the specialty that is the biggest detriment to

becoming burnt out or to a poor home life. Make your family a priority. Make

your home life a priority. If you make them important, and not just say they

are important, then you will have a great life as a physician no matter what

specialty you choose.

So choose the specialty that you like the best, with no

regard to its perceived home life or income. Make your home life what you want

and take control. Even employed physicians can have a very nice home life with

a little negotiating.

Take control of your

job,

don’t let your job

control you.

If debt is causing you to work extra hours, then get a copy of The Doctors Guide to Eliminating Debt and take control today. You deserve it.

How about you? What have you done to take control of

something in your life or practice?